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

Giannakopoulos, Nikolaos Nikitas; Katsikogianni, Eleni; Hellmann, Daniel; Eberhard, Lydia; Leckel, Michael; Schindler, H. J.; Schmitter, Marc

doi:10.1080/00016357.2016.1204558

Cited by 20 publications

(18 citation statements)

References 30 publications

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“…However, the predominantly used criteria were the RDC, 6 used in 17 studies. 11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27 The DC criteria 7 were used in two studies, 28,29 and an additional three studies used criteria that approximated to the RDC (either by citing the instrument and/or their description matched a similar process). 30,31,32 No studies used the AAOP criteria.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…Ten of these studies used a no treatment control group. 14,23,30,32,33,34,35,37,41,43 Twenty had a co-intervention in each arm, with 13 having a 'minimal' co-intervention of usual treatment, counselling, information or exercise, 11,12,13,15,16,17,18,19,21,22,25,26,36 while 7 had a 'non-minimal' co-intervention of 'acuhealth' , manipulative and physical therapy, massage, Prozac, microcurrent electrical nerve stimulation, physical therapy with vapocoolant spray, arthrocentesis and sodium hyaluronate. 27,28,29,39,40,44,47 The remaining six studies had minimal treatment controls: three were self-exercises, 24,28,42 and three were information-based.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

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Oral splints for temporomandibular disorder or bruxism: a systematic review

et al. 2020

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This systematic review comprehensively summarised the best available evidence from randomised controlled trials on the effects of oral splints for temporomandibular disorders (TMD) and bruxism.There is no evidence to support the use of oral splints for either condition based on the results found.For TMD patients, sensitivity analyses were conducted to explore the effects of differences in: 1) diagnostic criteria; 2) splint types; and 3) outcome measures used and reported. There were no differences in the results based on these factors. AbstractObjectives To evaluate the clinical-effectiveness of oral splints for patients with TMD or bruxism for the primary outcomes: pain (TMD) and tooth wear (bruxism).Data sources Four databases including MEDLINE and EMBASE were searched from inception until 1 October 2018. Data selection and extractionRandomised controlled trials comparing all types of splints versus no/minimal treatment for patients with TMD or bruxism were eligible. Standard Cochrane review methods were used. Standardised mean differences (SMD) were pooled for the primary outcome of pain, using random effects models in TMD patients. Data synthesisThirty-seven trials were included and the evidence identified was of very low certainty using GRADE assessments. When all subtypes of TMD were pooled into one global TMD group, there was no evidence that splints reduced pain: SMD (up to 3 months) -0.18 (95% CI -0.42 to 0.06); 13 trials, 1,076 participants. There was no evidence that any other outcomes improved when using splints. There was no evidence of adverse events associated with splints, but reporting was poor regarding this outcome. No trials measured tooth wear in patients with bruxism. There was a large variation in diagnostic criteria, splint types and outcome measures used and reported. Sensitivity analyses based on these factors did not indicate a reduction in pain. ConclusionsThe very low-certainty evidence identified did not demonstrate that splints reduced pain in TMD as a group of conditions. There is insufficient evidence to determine whether splints reduce tooth wear in patients with bruxism.

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Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Oral splints for temporomandibular disorder or bruxism: a systematic review

et al. 2020

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“…The primary outcome measure was a score of pain intensity and severity of jaw dysfunction as assessed by two 0 to 10 NRSs ("Rate the maximal pain (or dysfunction) over the last 4 weeks."). The NRS is commonly used to evaluate the effect of therapeutic interventions for TMD, 14,15 with a 15% change (reduction) in the evaluation of chronic musculoskeletal pain reported as the minimal clinically important difference. 16 We also calculated the percentage of joints with 50% or more improvement in pain or function, as this criterion has previously been associated with clinically important improvement in several musculoskeletal conditions.…”

Section: Outcome Measuresmentioning

confidence: 99%

Treatment of Temporomandibular Dysfunction With Hypertonic Dextrose Injection (Prolotherapy): A Randomized Controlled Trial With Long-term Partial Crossover

Louw

Reeves²,

Lam

et al. 2019

Mayo Clinic Proceedings

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Objective: To assess the efficacy and longer-term effectiveness of dextrose prolotherapy injections in participants with temporomandibular dysfunction. Patients and Methods: A randomized controlled trial with masked allocation was conducted from January 14, 2013, through December 19, 2015. Forty-two participants (with 54 joints) meeting temporomandibular dysfunction criteria were randomized (1:1) to 3 monthly intra-articular injections (20% dextrose/0.2% lidocaine or 0.2% lidocaine) followed by as-needed dextrose/0.2% lidocaine injections through 1 year. Primary and secondary outcome measures included a 0 to 10 Numerical Rating Scale score for facial pain and jaw dysfunction; maximal interincisal opening (MIO) measured in millimeters, percentage of joints with 50% or more change (improvement) in pain and function, and satisfaction.

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“…Other treatment options (besides NSAID), for instance, cognitive behavioural therapy, physiotherapy or trigger‐point injections, are not real options, because of their high cost, the lack of standardisation of the intervention or their lack of availability in many primary care treatment settings. The different types of splint that have been shown to be effective for immediate non‐pharmacological pain relief have, moreover, only been tested for very short periods (2 weeks), or cannot be used for longer without the risk of orthodontic changes. The innovative sensorimotor training device is, because of its availability and the possibility of self‐administered use, a relatively good cost‐ and time‐effective option.…”

Section: Discussionmentioning

confidence: 99%

Comparison of device‐supported sensorimotor training and splint intervention for myofascial temporomandibular disorder pain patients

Giannakopoulos

Rauer

Hellmann

et al. 2018

J of Oral Rehabilitation

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This study was to compare the short-term therapeutic efficacy of device-supported sensorimotor training with that of standard splint therapy for patients with myofascial temporomandibular disorder (TMD) pain over a treatment period of 3 months. We tested the hypothesis that both types of intervention are equally effective for pain reduction. In addition, the electromyographic (EMG) activity of the temporal and masseter muscles was recorded under conditions of force-controlled submaximum and maximum biting in intercuspation. Of consecutive patients seeking treatment for non-odontogenic oro-facial pain, 45 patients with myofascial TMD pain (graded chronic pain status, GCPS, I and II) were randomly assigned to 2 treatment groups (sensorimotor training and conventional splint treatment). Patients were evaluated 4 times (initial examination, 2, 6 and 12 weeks later) by use of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Electromyographic activity was recorded at the initial session and after 3 months. Ease-of-use of the treatment options was also evaluated. Significant (P < .0001) pain reduction (sensorimotor training 53%, splint therapy 40%) was achieved for both groups, with no significant differences (P > .05) between the groups. Force-controlled sub-maximum normalized electromyographic activity was significantly different between T0 and T3 for group A (sensorimotor training, P < .05) but was not significantly different for group B (splint, P > .05). For normalized maximum-biting EMG activity in intercuspation, however, a significant increase in EMG activity was observed for group A for the masseter and temporal muscles (P < .001) and for group B for the masseter muscle only (P < .001). Moreover, sensorimotor training was significantly (P < .05) less easy to use than the splint. The results of this study confirm the pain-reducing effect of sensorimotor training for patients with myofascial TMD pain (GCPS I and II). This innovative active treatment might be a promising option for TMD pain patients.

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

Abstract: 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.

Cited by 20 publications

References 30 publications

Oral splints for temporomandibular disorder or bruxism: a systematic review

Oral splints for temporomandibular disorder or bruxism: a systematic review

Treatment of Temporomandibular Dysfunction With Hypertonic Dextrose Injection (Prolotherapy): A Randomized Controlled Trial With Long-term Partial Crossover

Comparison of device‐supported sensorimotor training and splint intervention for myofascial temporomandibular disorder pain patients

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