Journal of oral rehabilitation
-
Randomized Controlled Trial Comparative Study
Efficacy of stabilisation splint treatment on temporomandibular disorders.
The evidence supporting the use of stabilisation splints in the treatment of temporomandibular disorders (TMD) is scarce and a need for well-controlled studies exists. The aim of this randomised, controlled trial study was to assess the efficacy of stabilisation splint treatment on TMD. The sample consisted of 80 consecutive referred patients who were randomly assigned to the splint group (n = 39) and the control group (n = 41). ⋯ Facial pain decreased and most of the clinical TMD findings resolved in both of the groups. The differences in changes in VAS or clinical TMD findings between the groups were not statistically significant. The findings of this study did not show that stabilisation splint treatment in combination with counselling and masticatory muscle exercises has additional benefit in relieving facial pain and increasing the mobility of the mandible than counselling and masticatory muscle exercises alone in a short time-interval.
-
Randomized Controlled Trial
Behavioural changes and occlusal splints are effective in the management of masticatory myofascial pain: a short-term evaluation.
The aim of this research was to test the hypothesis that treatment with intra-oral appliances with different occlusal designs was beneficial in the management of pain of masticatory muscles compared with a control group. A total of 51 patients were analysed according to the research diagnostic criteria for temporomandibular disorders (RDC/TMD) to obtain the diagnosis of masticatory myofascial pain (MMP). The sample was then randomly divided into three groups: group I (n = 21) wore a full coverage acrylic stabilisation occlusal splint; group II (n = 16) wore an anterior device nociceptive trigeminal inhibitory (NTI) system; and group III (n = 14) only received counselling for behavioural changes and self-care (the control group). ⋯ The PPT values did not change significantly. It was concluded that behavioural changes are effective in the management of pain in MMP patients. However, the simultaneous use of occlusal devices appears to produce an earlier improvement.
-
Review
The dental occlusion as a suspected cause for TMDs: epidemiological and etiological considerations.
The relationship between the dental occlusion and temporomandibular disorders (TMDs) has been one of the most controversial topics in the dental community. In a large epidemiological cross-sectional survey - the Study of Health in Pomerania (Germany) - associations between 15 occlusion-related variables and TMD signs or symptoms were found. In other investigations, additional occlusal variables were identified. ⋯ Symptom improvement after insertion of an oral splint or after occlusal adjustment does not prove an occlusal aetiology either, because the amelioration may be due to the change of the appliance-induced intermaxillary relationship. In addition, symptoms often abate even in the absence of therapy. Although patients with a TMD history might have a specific risk for developing TMD signs, it appears more rewarding to focus on non-occlusal features that are known to have a potential for the predisposition, initiation or perpetuation of TMDs.
-
To explore the relationship between sleep bruxism (SB), painful temporomandibular disorders (TMD) and psychologic status in a cross-sectional study. The sample consisted of 272 individuals. The Research Diagnostic Criteria for TMD (RDC/TMD) was used to diagnose TMD; SB was diagnosed by clinical criteria proposed by The American Academy of Sleep Medicine. ⋯ Patients with SB had an increased risk for the occurrence of myofascial pain (OR = 5·93, 95% CI: 3·19-11·02) and arthralgia (2·34, 1·58-3·46). Group 3 had an increased risk for moderate/severe depression and non-specific physical symptoms (10·1, 3·67-27·79; 14·7, 5·39-39·92, respectively), and this risk increased in the presence of SB (25·0, 9·65-64·77; 35·8, 13·94-91·90, respectively). SB seems to be a risk factor for painful TMD, and this in turn is a risk factor for the occurrence of higher depression and non-specific physical symptoms levels, but a cause-effect relationship could not be established.
-
Multicenter Study
Self-reported bruxism and temporomandibular disorders: findings from two specialised centres.
The aims of this investigation were to report the frequency of temporomandibular disorders (TMD) diagnoses and the prevalence of self-reported awake and sleep bruxism as well as to describe the possible differences between findings of two specialised centres as a basis to suggest recommendations for future improvements in diagnostic homogeneity and accuracy. A standardised Research Diagnostic Criteria for TMD (RDC/TMD) assessment was performed on patients attending both TMD Clinics, viz., at the University of Padova, Italy (n=219; 74% women) and at the University of Tel Aviv, Israel (n=397; 79% women), to assign axis I physical diagnoses and to record data on self-reported awake and sleep bruxism. ⋯ The more widespread use of TMJ imaging techniques in one clinic sample led to a higher prevalence of multiple diagnoses, and the higher prevalence of self-reported bruxism in patients with myofascial pain alone described in the other clinic sample was not replicated, suggesting that the different adoption of clinical and imaging criteria to diagnose TMD may influence also reports on their association with bruxism. From this investigation, it emerged that the features of the study samples as well as the different interpretation of the same diagnostic guidelines may have strong influence on epidemiological reports on bruxism and TMD prevalence and on the association between the two disorders.