Comparison of Early Effectiveness of Three Different Intervention Methods in Patients with Chronic Orofacial Pain: A Randomized, Controlled Clinical Trial

Abstract

Background. Occlusal appliances are still widely used instruments in the management of orofacial pain in dentistry, yet alone or as a part of multimodal therapy. However, some of those modalities have been lacking thorough randomized assessment, and there is a conflicting evidence available. It is hypothesized that pain symptoms might improve faster and in more tangible way due to combined therapy. Also, to our best knowledge, nimesulide was never examined in this aspect, too. Objective. The aim of this study was to compare early effectiveness of routine intervention methods in patients with myofascial pain (MP) after 3 weeks’ notice. Three modalities were evaluated: occlusal appliance (OA) with nonsteroidal anti-inflammatory drug (NSAID) therapy (nimesulide), occlusal appliance with dry needling (DN), and occlusal appliance (OA-control group) therapy. Design. Randomized controlled clinical trial (RCT) in which ninety patients with MP, who met the inclusion criteria, were randomly assigned to one of the three treatment groups. Sealed, opaque envelopes were used. Methods. For evaluation, each patient completed a Visual Analogue Scale (VAS) and Sleep and Pain Activity Questionnaire (SPAQ) twice, first at the beginning of the study and again after 3 weeks (0–3). Results. Posttreatment test comparison between the control group and both treated groups reveal significant differences between the control and the NSAID + occlusal appliance groups. There were also differences reported between the control and the DN + occlusal appliance groups, but these differences were, however, not statistically significant. Conclusions. Occlusal appliances in conjunction with NSAID showed better orofacial pain relief after 3 weeks of therapy, compared to the use of occlusal appliances alone or in conjunction with dry needling. Additionally, differences between pain perception and quality of life between OA and DN + OA groups were not found to be statistically significant.

The Effects of Prednisone/Ketoprofen Administration in Association with Amoxicillin Clavulanate Following Periodontal Surgical Therapy in Patients with Severe Chronic Periodontitis

“…Twenty-two subjects with severe chronic periodontitis and 19 clinically healthy subjects were recruited from a dental private office in Bucharest. Subjects under the age of 18, with systemic diseases [ 18 ], medication allergies, pregnancy, anti-inflammatory or antibiotic drugs administration in the last six months were excluded from the study.…”

Orally Administered NSAIDs—General Characteristics and Usage in the Treatment of Temporomandibular Joint Osteoarthritis—A Narrative Review

“…This summary agrees with the previously described conclusions by Kurita Varoli et al [ 74 ]. Dalewski et al [ 76 ] compared the effectiveness of occlusal splints alone, occlusal splints combined with dry needling and occlusal splints combined with NSAID (nimesulide 100 mg every 12 h for 14 days) in the treatment of unilateral pain in the area of TMJ. Although the observation time was longer (three weeks) compared to the research by Kurita Varoli et al [ 74 ] (10 days per each drug protocol), the authors noticed that combination of occlusal splint with nimesulide led to significantly better pain relief compared to the remaining two groups.…”

“…Table 2 presents the effectiveness of orally administered NSAIDs in the treatment of TMJ OA on the basis of the literature [ 73 , 74 , 75 , 76 , 77 , 78 ].…”

Distúrbios intracapsulares da articulação temporomandibular: da semiologia à terapêutica: uma revisão de literatura

“…Nesse contexto, o termo disfunção temporomandibular (DTM) é coletivo para representar um grupo de condições osteomusculares heterogêneas que acomete a região orofacial (Jordani et al, 2019;Galvão et al, 2020), afetando diretamente a anatomia e as características funcionais da ATM (Gil-Martínez et al, 2018). Por conseguinte, as DTM's podem ser subdivididas em distúrbios articulares e não-articulares, também denominados de condições intracapsulares e extracapsulares, respectivamente (Liu & Steinkeler, 2013;Dalewski et al, 2019). Os distúrbios que acometem elementos internos da articulação são categorizados como intracapsulares e as desordens que afetam as estruturas circundantes da ATM, por sua vez, são compreendidas como extracapsulares (Okeson, 2008) e a maior parte delas engloba condições crônicas, como fibromialgia, tensão muscular e miopatias (Scrivani et al, 2008).…”