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Abstract

The purpose of this study was to evaluate the relative efficacy of different biopsychosocial treatment conditions on patients with chronic temporomandibular disorder. Ninety-four patients with chronic temporomandibular disorder were assigned to either a biofeedback treatment group, a cognitive-behavioral skills training (CBST) treatment group, a combined (combination of biofeedback/CBST) treatment group, or a no-treatment control group. Pain scores were analyzed pretreatment and posttreatment to determine group and within-subjects treatment effects. Results demonstrated that, in terms of a self-reported pain score, all three treatment groups had significantly decreased pain scores from pretreatment to posttreatment, while the no-treatment group did not. Moreover, patients in the biofeedback group were the most significantly improved compared to the no-treatment group. Finally, participants in the three treatment groups displayed significant improvement in mood states.

The Relaxation Response Resiliency Enhancement Program in the Management of Chronic Refractory Temporomandibular Joint Disorder: Results from a Pilot Study

“…The findings of this study are consistent with previous reports (10,11) and underscore the benefits of incorporating the biopsychosocial perspective of pain in order to comprehensively deal with both physical and psychosocial concomitants of chronic pain conditions such as TMD. Given the high cost of treatment for TMD, its relative unresponsiveness to purely medical management approaches, and the established evidence that as the duration of pain increases, patients become more and more refractory and distressed, it is of utmost importance to identify patients at risk within the acute stage in order to prevent the development of chronicity and treatment difficulties.…”

“…Another study (12) compared the effects of combined education and medication, combined education and physical therapy and combined education and masseter muscle biofeedback training on symptom reduction in TMD patients and found that although all three groups showed reduction in symptoms, the combined education-medication group showed the most rapid improvements in pain intensity and jaw function (12). These studies were concordant with prior research suggesting that a combination of medical, relaxation, education and CBT components may be the most efficacious for short- and long-term treatment improvement in patients with TMD (3,5,13). …”

“…A recent series of studies evaluating the relative efficacy of four methods for treating chronic TMD [nonsurgical medical treatment alone, relaxation-biofeedback treatment, cognitive behavioral skills treatment [CBST], and combined relaxation-bio-feedback and CBST] showed a significant decrease in pain intensity and improvement in mood in the three biobehavioral groups as compared to the standard medical treatment (10,11). In these studies, relaxation-biofeedback was found to be most efficacious short term, while the combined treatment was found to be most efficacious at a one-year follow-up.…”

Temporomandibular Disorder Diagnostic Groups Affect Outcomes Independently of Treatment in Patients at Risk for Developing Chronicity: A 2-Year Follow-Up Study

“…28, 41, 53, 62, 66 This was supported by the finding in the current study that the patients with m-TMD alone reported poorer masticatory performance than participants with either multiple diagnoses including m-TMD or participants with no diagnoses. This deficiency in functionality was hypothesized to extend beyond mastication, and that a biobehavioral intervention could provide relief.…”

“…This outcome is similar to the earlier laboratory findings in the scientific literature. For instance, Mishra, Gatchel, and Gardea 28 found that there were no differences in treated versus non-treated TMD patients with regard to pain-related disability. It was speculated that the emphasis on psychosocial techniques in the biobehavioral intervention may have conflicted with the patients' physiological view of their disorder, thereby hindering the intervention's efficacy.…”