Article

Self-perceived effects of occlusal appliance therapy on TMD patients: an eight-year follow-up.

Department of Stomatognathic Physiology, Faculty of Odontology, Malmö University, Sweden.
Swedish dental journal (Impact Factor: 1.08). 01/2013; 37(1):13-22.
Source: PubMed

ABSTRACT There are few long-term follow-up studies of treatment of temporomandibular disorders (TMD).The aim of this questionnaire study was to evaluate eight-year outcomes of appliance therapy in patients suffering from arthralgia/osteoarthritis and/or myofascial pain. The subjects comprised 120 patients, originally randomly assigned to treatment with an occlusal or a control (palatal) appliance. Eight years later, a questionnaire was sent to 118 eligible patients: 90 (76%) responded. The outcome measures were intensity and frequency of pain, physical and emotional functioning, and overall improvement of pain and headache. Maximum pain intensity had decreased by > 30% in 54 patients (60%); frequency of pain had also decreased significantly. A majority, 57/90, reported improved physical function. Fifty-nine patients reported moderate to severe depression and 61 reported non-specific physical symptoms. Sixty-eight patients reported an overall improvement in TMD pain and 61 perceived overall improvement in severity of headaches. In the intervening years, 57 patients had undergone further treatment, most frequently in the form of another occlusal appliance. The majority of respondents reported improvement in TMD pain and headache. However, it is difficult to evaluate the long-term outcome of appliance therapy as more than 60% of the patients had additional treatments during the eight years.

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    ABSTRACT: Objective: There are contradicting results on the efficacy of stabilization splint treatment on temporomandibular disorders (TMD). The aim of this randomized control trial was to assess the efficacy of stabilization splint treatment on TMD-related facial pain during a one-year follow-up. Method: The sample consisted of 80 TMD patients who were randomly assigned to two groups; splint group (n=39) and control group (n=41). The patients in the splint group were treated with a stabilization splint and received counseling and instructions for masticatory muscle exercises. The controls received only counseling and instructions for masticatory muscles exercises. The outcome variables were the change in the intensity of facial pain (as measured with VAS, visual analogue scale) between baseline and one-year follow-up as well as the patients’ subjective estimate of treatment outcome. The differences in VAS changes between the groups were analyzed using variance analysis and linear regression models. Result: Facial pain decreased in both groups but the difference in VAS change between the groups was not statistically significant. In the linear regression analysis the group status did not associate with the change in VAS after adjustment for baseline VAS, gender, age, length of treatment and general health status. After one-year follow-up, 27.6% of the patients in the splint group and 37.5% of the patients in the control group reported “very good” treatment effects. Conclusion: The findings of this study did not show stabilization splint treatment to be more effective in decreasing facial pain than masticatory muscle exercises and counseling alone in treatment of TMD over a one-year follow-up.
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