Aim:  In a randomized controlled trial investigate the short‐term effect of treatment with stabilization appliance compared with a control appliance in patients with temporomandibular disorders (TMD) of mainly myogenous pain. Material and methods:  Out of 926 referrals to the Department of Stomatognathic Physiology in Malmö for treatment of TMD during 2 years, 338 patients were clinically screened for possible participation in the study. Patients with mainly myogenous pain were selected from the original group of 926 patients. Sixty TMD patients with mainly myogenous pain were allocated at random into two equally sized groups: (T) treatment group given a stabilization appliance; (C) control group given a control appliance. The study was performed as a randomized controlled trial and comprised four visits. At the last visit, after 10 weeks of treatment with occlusal appliance, the treatment outcome was evaluated. Results:  There was a significant reduction of changes in overall severity of pain, reported pain during mandibular movements and reduction of changes in severity of headache in the treatment group compared with the control group. There was also a significant decreased number of tender masticatory muscles in the treatment group compared with the control group. Conclusion:  The results of this short‐term evaluation suggest that the stabilization appliance is effective in the alleviation of symptoms and signs in TMD patients of mainly myogenous pain. The stabilization appliance can therefore be recommended for TMD patients of mainly myogenous pain.

Stabilization appliances are commonly used in the treatment of temporomandibular disorders (TMD), although the treatment effects are not fully understood. This study evaluated the short-term efficacy of a stabilization appliance in patients with TMD of arthrogeneous origin, using a randomized, controlled, and double-blind design. Sixty patients were assigned to two equally sized groups: a treatment group given a stabilization appliance and a control group given a control appliance. Improvement of overall subjective symptoms was reported in both groups but significantly more often in the treatment group than in the control group (P = 0.006). Frequency of daily or constant pain showed a significant reduction in the treatment group (P = 0.02) compared with the control group. The results of this short-term evaluation showed that both the stabilization appliance and the control appliance had an effect on temporomandibular joint (TMJ) pain. It is improbable that the difference observed between the groups is due to chance alone.

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The results support the conclusion that the positive treatment outcome obtained by use of a stabilization appliance to alleviate the signs and symptoms in patients with myofascial pain persisted after 6 and 12 months. Most patients in groups T and M reported positive changes in overall subjective symptoms in this trial. We therefore recommend use of the stabilization appliance in the treatment of TMD patients with myofascial pain.

The aim was to compare the short- and long-term effect of a stabilization appliance with a control appliance in myofascial pain patients suffering from episodic or chronic tension-type headache. Sixty patients (mean age 29 +/- 12 years) with temporomandibular disorders (TMD) of myogenous origin and headache were studied in this prospective controlled study. Seventy-seven per cent of the patients reported episodic and 23% chronic tension-type headache at the start of the study. The 60 patients were randomly assigned to a treatment group (stabilization appliance) or to a control group (control appliance). The patients were interviewed regarding symptoms of headache and myofascial pain and clinically examined for masticatory muscle tenderness. At the 10-week and the 6- and 12-month evaluations of appliance therapy, the treatment outcome of tension-type headache was studied. At the 10-week evaluation, 17 patients dropped-out from the control group by requesting another appliance and receiving a stabilization appliance. Another patient in the control group dropped out later during the trial. In an intent-to-treat analysis, significant differences in improvement of headache between treatment and control groups were found at the follow-ups. A 30% reduction of muscles tender to palpation correlated significantly to improvement of headache at all follow-ups. The stabilization appliance seems to have a positive effect on tension-type headache, both in a short- and in a long-term perspective in patients with TMD with pain of myogenous origin.

The aim of this study was to compare the findings on magnetic resonance imaging (MRI) in temporomandibular disorders (TMD) pain patients with clinical diagnoses of myofascial pain or arthralgia/osteoarthritis in combination with myofascial pain according to the Research Diagnostic Criteria for TMD. The temporomandibular joints of 60 consecutive patients, 19 with myofascial pain and 41 patients with arthralgia/osteoarthritis in combination with myofascial pain were examined clinically and with MRI. Overall the most common MRI findings were different kinds of disc displacements and structural bone changes, which were found in both pain groups. However, disc displacements were found significantly (P=0.002) more often in the group arthralgia/osteoarthritis in combination with myofascial pain. One hundred and four joints were found to have no clinical diagnosis of disc displacements, but 64 of these joints had findings of disc displacements on MRI. Joint fluid was found in both pain groups. Patients having a combination of disc displacement and joint fluid were significantly (P=0.047) more common in the pain group arthralgia/osteoarthritis in combination with myofascial pain. In conclusion, the MRI findings of different kinds of disc displacement and structural bone changes were common in TMD patients. The clinical diagnoses for subdivision into myogenous only or combined arthrogenous and myogenous pain groups were not confirmed by MRI.

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