Comparison of three different options for immediate treatment of painful temporomandibular disorders: a randomized, controlled pilot trial

Acta Odontol Scand. 2016 Aug;74(6):480-6. doi: 10.1080/00016357.2016.1204558. Epub 2016 Jul 13.

Abstract

Objective: The purpose of this study was to compare the short-term effectiveness of three different types of immediate, non-pharmacological intervention for alleviation of the painful symptoms of temporomandibular disorders (TMD).

Material and methods: Thirty-six patients (mean age 41.6 ± 16.7 years, 25 females) diagnosed with non-dysfunctional painful TMD received counselling and subsequently were randomly allocated to three treatment groups: patients in Group A received prefabricated oral splints with water-filled elastic pads (Aqualizer(®)), those in Group B were provided with vacuum-formed co-polyester oral splints and those in Group C were given appointments to receive Michigan-type hard splints. Clinical examination was conducted, at baseline and after 2 weeks, by use of the RDC/TMD. Current pain intensity was determined by evaluation of graded chronic pain status (GCPS) on a numerical rating scale (NRS). Active maximum mouth opening without pain (AMMOP) was also measured. Paired sample t-tests and one-way analysis of variance with a significance level of p ≤ 0.05 were conducted.

Results: After 2 weeks, overall mean current pain was reduced by 41.95% (p < 0.001). Current pain reduction was significant for Group B (66.6%, p < 0.001) but not for Groups A (37.88%, p = 0.56) and C (22.29%, p = 0.26). After 2 weeks, current pain level for Group B was significantly lower than that for Group C (p = 0.041). Overall, there was a statistically significant increase of AMMOP (p = 0.01).

Conclusion: All therapeutic options were pain-reducing. The results from this study suggest that cost-effective and time-effective intervention of counselling combined with use of a vacuum-formed splint is a favourable option for initial, short-term treatment of painful TMD.

Keywords: Counselling; occlusal splints; orofacial pain.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Facial Pain / etiology
  • Facial Pain / therapy*
  • Female
  • Humans
  • Male
  • Mandible / physiopathology*
  • Middle Aged
  • Occlusal Splints*
  • Pain Measurement
  • Temporomandibular Joint Disorders / complications
  • Temporomandibular Joint Disorders / therapy*
  • Young Adult