Ekberg Ewacarin, Nilner Maria
Department of Stomatognathic Physiology, Faculty of Odontology, Malmö University, Malmö, Sweden.
Acta Odontol Scand. 2004 Dec;62(6):343-9. doi: 10.1080/00016350410010063.
To compare the long-term effect of treatment with a stabilization appliance (group T) and treatment with a control appliance (group C) in temporomandibular disorder (TMD) patients with myofascial pain.
In this controlled trial, 60 patients (mean age 29 years) with myofascial pain were evaluated after 10 weeks of treatment with either a stabilization appliance or a control appliance. All 60 patients were then assigned to 1 of 3 groups according to demand for treatment. Seventeen patients from group C requested another appliance and were given a stabilization appliance, thus creating a mixed group (group M).
A significant difference in improvement of overall subjective symptoms in an intent-to-treat analysis between groups T and C was found at the follow-ups. In a survival analysis of treatment compliance, a significant difference was found between groups T and C. At the 6- and 12-month follow-ups, a significant reduction in myofascial pain, as measured on a visual analog scale, was found in all three groups. A significant decrease in frequency and intensity of myofascial pain was found in group T at the follow-ups. A significant decrease in number of tender sites on the masticatory muscles was found in group T at the follow-ups.
The results support the conclusion that the positive treatment outcome obtained by use of a stabilization appliance to alleviate the signs and symptoms in patients with myofascial pain persisted after 6 and 12 months. Most patients in groups T and M reported positive changes in overall subjective symptoms in this trial. We therefore recommend use of the stabilization appliance in the treatment of TMD patients with myofascial pain.
比较稳定矫治器治疗组（T组）和对照矫治器治疗组（C组）对颞下颌关节紊乱病（TMD）肌筋膜疼痛患者的长期疗效。
在这项对照试验中，60例（平均年龄29岁）肌筋膜疼痛患者在使用稳定矫治器或对照矫治器治疗10周后进行评估。然后根据治疗需求将所有60例患者分为3组中的1组。C组中有17例患者要求更换矫治器，于是给他们佩戴了稳定矫治器，从而形成了一个混合组（M组）。
在随访的意向性分析中，发现T组和C组在总体主观症状改善方面存在显著差异。在治疗依从性的生存分析中，T组和C组之间存在显著差异。在6个月和12个月的随访中，所有三组患者的肌筋膜疼痛在视觉模拟量表上的测量值均显著降低。随访时发现T组的肌筋膜疼痛频率和强度显著降低。随访时发现T组咀嚼肌压痛部位的数量显著减少。
结果支持以下结论：使用稳定矫治器缓解肌筋膜疼痛患者的体征和症状所获得的积极治疗效果在6个月和12个月后仍然存在。在本试验中，T组和M组的大多数患者报告总体主观症状有积极变化。因此，我们建议在治疗TMD肌筋膜疼痛患者时使用稳定矫治器。
