Quayle A A, Gray R J, Metcalfe R J, Guthrie E, Wastell D
Department of Oral and Maxillofacial Surgery, University of Manchester, UK.
J Dent. 1990 Jun;18(3):123-9. doi: 10.1016/0300-5712(90)90048-j.
Fifty-seven patients suffering from migraine, tension headache or tension vascular headache were prescribed a soft occlusal splint for night-time wear. Dental, psychosocial/psychiatric and neurological data were recorded prior to commencement of therapy and at the conclusion of a 3 month treatment period. A statistically significant number of patients presenting with migraine or tension vascular headache experienced marked improvement or complete relief of headache symptoms, but most patients suffering from tension headache failed to benefit from splint therapy. A majority of patients displaying intercurrent features of craniomandibular dysfunction experienced reduction in these symptoms also. There was a statistically significant association between TMJ improvement and headache type. Prior to treatment, patients who subsequently benefited from splint therapy in terms of headache improvement had experienced significantly fewer headaches than patients who failed to respond, although headache intensity and duration were similar in both groups. It is suggested that headache type and frequency may be prognostic indicators of the likely success of dental splint therapy in treatment of headache. Nevertheless, the use of occlusal splints in the treatment of patients complaining of headache in the absence of evidence of craniomandibular dysfunction should not be embarked upon until medical examination has excluded the possibility of organic neurological disorder.
57名患有偏头痛、紧张性头痛或紧张性血管性头痛的患者被开了一种夜间佩戴的软咬合夹板。在治疗开始前以及3个月治疗期结束时记录牙科、心理社会/精神科和神经科数据。相当数量的偏头痛或紧张性血管性头痛患者头痛症状有显著改善或完全缓解,但大多数紧张性头痛患者未从夹板治疗中获益。大多数表现出颅下颌功能紊乱并发特征的患者这些症状也有所减轻。颞下颌关节改善与头痛类型之间存在统计学上的显著关联。治疗前,随后在头痛改善方面从夹板治疗中获益的患者比无反应的患者头痛次数明显更少,尽管两组的头痛强度和持续时间相似。提示头痛类型和频率可能是牙科夹板治疗头痛可能成功的预后指标。然而,在没有颅下颌功能紊乱证据的情况下,在医学检查排除器质性神经疾病的可能性之前,不应开始使用咬合夹板治疗主诉头痛的患者。