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稳定型咬合板治疗面部疼痛的疗效——1年随访

Efficacy of stabilisation splint treatment on facial pain - 1-year follow-up.

作者信息

Qvintus V, Suominen A L, Huttunen J, Raustia A, Ylöstalo P, Sipilä K

机构信息

Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.

出版信息

J Oral Rehabil. 2015 Jun;42(6):439-46. doi: 10.1111/joor.12275. Epub 2015 Jan 17.

Abstract

The aim of this randomised controlled trial was to assess the efficacy of stabilisation splint treatment on TMD-related facial pain during a 1-year follow-up. Eighty patients were randomly assigned to two groups: splint group (n = 39) and control group (n = 41). The patients in the splint group were treated with a stabilisation splint and received counselling and instructions for masticatory muscle exercises. The controls received only counselling and instructions for masticatory muscles exercises. The outcome variables were the change in the intensity of facial pain (as measured with visual analogue scale, VAS) as well as the patients' subjective estimate of treatment outcome. The differences in VAS changes between the groups were analysed using variance analysis and linear regression models. The VAS decreased in both groups, the difference between the groups being not statistically significant. The group status did not significantly associate with the decrease in VAS after adjustment for baseline VAS, gender, age, length of treatment and general health status. The only statistically significant predicting factor was the baseline VAS, which was also confirmed by the mixed-effect linear model. After 1-year follow-up, 27.6% of the patients in the splint group and 37.5% of the patients in the control group reported 'very good' treatment effects. The findings of this study did not show stabilisation splint treatment to be more effective in decreasing facial pain than masticatory muscle exercises and counselling alone in the treatment of TMD-related facial pain over a 1-year follow-up.

摘要

这项随机对照试验的目的是评估在为期1年的随访期间,稳定咬合板治疗颞下颌关节紊乱病(TMD)相关面部疼痛的疗效。80名患者被随机分为两组:咬合板组(n = 39)和对照组(n = 41)。咬合板组的患者接受稳定咬合板治疗,并接受咀嚼肌锻炼的咨询和指导。对照组仅接受咀嚼肌锻炼的咨询和指导。结果变量包括面部疼痛强度的变化(采用视觉模拟量表,VAS测量)以及患者对治疗结果的主观评估。使用方差分析和线性回归模型分析两组之间VAS变化的差异。两组的VAS均下降,组间差异无统计学意义。在对基线VAS、性别、年龄、治疗时长和总体健康状况进行调整后,组状态与VAS下降无显著关联。唯一具有统计学意义的预测因素是基线VAS,这也得到了混合效应线性模型的证实。经过1年的随访,咬合板组27.6%的患者和对照组37.5%的患者报告治疗效果“非常好”。本研究结果表明,在为期1年的随访中,对于治疗TMD相关面部疼痛,稳定咬合板治疗在减轻面部疼痛方面并不比单纯的咀嚼肌锻炼和咨询更有效。

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