Pain Assessment during Gnathological Treatment of Temporomandibular Myofascial Pain through Mandibular Repositioning Splints Designed after a Posture-Stabilometric Evaluation

Abstract

The aim of the study is to evaluate the effectiveness of two complementary mandibular repositioning splints (SVED and MORA) designed after a preliminary patients’ posture-stabilometric evaluation in treatment for temporomandibular myofascial pain (TMP) using the Pain-Intensity Numeric Rating Scale (PI-NRS) assessment. Eighty-six consecutive sportive non-agonistic subjects with TMP were randomly divided in two groups. Forty-two wear mandibular repositioning splints designed by a posture-stabilometric evaluation, thus constituting the test group. The other 44 subjects were not subjected to any treatment, thus represented the control group. To record pain intensity, subjects in both groups were asked to fill in a PI-NRS which ranged from 0 (no pain) to 10 (worst imaginable pain). In the test group, PI-NRS was assessed three times: before starting therapy (t0), after 4 months (t1) and after 8 months (t2) of treatment. Instead, in the control group PI-NRS was recorded during the first visit (t0) and after 8 months (t2). The Friedman test showed a statistically significant decrease in PI-NRS mean scores after 4 (t1) and 8 (t2) months from the start of the gnathological therapy with mandibular repositioning splints, (p < 0.001) in test group. There is enough evidence to assess that occlusal splint therapy for mandibular repositioning (MORA and SVED) designed through a posture-stabilometric evaluation could be considered in the treatment of temporomandibular myofascial pain.

The Application of Manual Techniques in Masticatory Muscles Relaxation as Adjunctive Therapy in the Treatment of Temporomandibular Joint Disorders

“…Effective treatment of such disorders depends on, among other things, an elimination of causes responsible for SS malfunction as well as a direct intervention within the muscular system in order to restore its physiological tension and reduce pain [ 1 ]. Clinicians and researchers also emphasize the importance of providing conservative treatment first, before introducing irreversible methods [ 1 , 3 , 8 , 9 , 10 ]. Therefore, currently recommended approaches in TMD therapy include primarily prosthetic and orthodontic treatment [ 1 , 8 , 10 ], pharmacotherapy [ 1 , 11 , 12 ], as well as rehabilitation and education as forms of supportive treatment [ 1 , 2 , 3 , 13 , 14 , 15 , 16 , 17 , 18 ].…”

“…Clinicians and researchers also emphasize the importance of providing conservative treatment first, before introducing irreversible methods [ 1 , 3 , 8 , 9 , 10 ]. Therefore, currently recommended approaches in TMD therapy include primarily prosthetic and orthodontic treatment [ 1 , 8 , 10 ], pharmacotherapy [ 1 , 11 , 12 ], as well as rehabilitation and education as forms of supportive treatment [ 1 , 2 , 3 , 13 , 14 , 15 , 16 , 17 , 18 ]. One of the most commonly used forms of conservative treatment is physiotherapy, including manual therapy [ 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 ].…”

“…Clinicians and researchers also emphasize the importance of providing conservative treatment first, before introducing irreversible methods [1,3,[8][9][10]. Therefore, currently recommended approaches in TMD therapy include primarily prosthetic and orthodontic treatment [1,8,10],…”

Evaluation of Body Posture during Class II Functional Treatment with Fränkel II: A Longitudinal Study

“…The subjects were carefully placed on the platform with the help of a footprint and some oblique lines drawn on the surface of the platform. In order to ensure greater reproducibility, a tool was made to customize the position of the malleolus [15]. This tool consisted of an elastic band surrounding the patient's ankle to which a wooden stick was fixed.…”

“…In 2011, Michelotti et al published an overview stating that the prevention or treatment of postural disorders cannot justify an occlusal and/or orthodontic treatment [14]. In 2021, D'Attilio et al introduced the use of posturostabilometric platforms as an aid for the mandibular repositioning treatment in gnathological patients [15].…”