The current case-control study provides complementary epidemiological information on oro-facial pain (OFP) and supports a multifactorial aetiology of PDS, with factors from many domains, including local mechanical factors, psychological and co-morbidities. People with PDS were characterized by frequent headaches, history of facial trauma, teeth grinding, sleep problems, pain elsewhere in the body and high levels of psychological distress. From the results of current study and available evidence it seems inappropriate to consider PDS in isolation and future research should adopt a multidisciplinary approach to OFP.
Temporomandibular joint pain dysfunction syndrome (TMJPDS) comprises of a constellation of signs and symptoms including joint tenderness and pain on function, restricted jaw movement, clicking, jaw locking and tenderness in the muscles of mastication. Headache may also be a feature. Physiotherapy is commonly employed in the treatment of this condition but there is little published material reporting the relative efficacy of the different types of treatment currently available. Further, no attempt seems to have been made to compare the costs of physiotherapy with other forms of treatment of this disorder such as occlusal splint therapy. This paper reports a comparative evaluation of four different physiotherapy treatments and placebo in the management of TMJPDS and comments on their cost benefit aspects compared with that of splint therapy. The four methods of physiotherapy tested were short-wave diathermy, megapulse, ultrasound and soft laser. There was no statistically significant difference in success rate between any of the four tested (range 70.4-77.7%) although each individually was significantly better than placebo treatment. The time of improvement appeared to vary between the four methods.
The aim of this review is to establish the effectiveness of stabilization splint (SS) therapy in reducing symptoms in patients with myofascial pain. Searching of electronic databases, handsearching of relevant key journals, and screening of reference lists of included studies were undertaken. There was no language restriction, and unpublished research was sought. The selection criteria were randomized controlled trials comparing splint therapy to either no treatment or another active treatment. Data extraction and validity assessment were carried out independently and in duplicate. Studies were grouped according to treatment type. Twenty potentially relevant Randomized Controlled Trials (RCTs) were identified. Only twelve met the inclusion criteria. There is insufficient evidence either for or against the use of stabilization splint therapy over other active interventions for the treatment of temporomandibular myofascial pain. However, it appears that stabilization splint therapy may be beneficial for reducing pain severity at rest and on palpation and depression when compared to no treatment. The authors suggested the need for well conducted RCTs that pay attention to method of allocation, blind outcome assessment, sample size, and duration of follow-up. Various measures were adopted to assess the outcomes of treatment. Standardization of the methods used to measure outcomes of the treatment of myofascial pain should be established in future RCTs. M yofascial pain is the most common temporomandibular disorder (TMD). There are many synonyms for this condition including facial arthromylagia, TMJ dysfunction syndrome, myofacial pain dysfunction syndrome, craniomandibular dysfunction, pain dysfunction syndrome (PDS), and myofacial pain dysfunction. 1 The etiology of myofascial pain is multifactorial. Consequently, many different therapies, some conservative and reversible, others irreversible, have been advocated for patients with myofascial pain. A number of successful treatment outcomes have been reported, including occlusal splints, physiotherapy, muscle-relaxing appliances, and pharmacological interventions.
Occlusal splints are one form of treatment in the management of patients with a temporomandibular disorder. Appliances are often used in conjunction with other forms of treatment such as physiotherapy or medication. A variety of splints is described in the literature and the dentist must ensure that the splint prescribed is of a design that has a proven success rate for the specific diagnosis. General principles that apply to the provision of all splints are outlined in this paper.
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