De la Torre Canales Giancarlo, Manfredini Daniele, Grillo Cássia M, Guarda-Nardini Luca, Machado Gonçalves Letícia, Rizzatti Barbosa Célia M
a Department of Prosthodontics and Periodontology, Piracicaba Dental School , University of Campinas , Piracicaba , Brazil.
b Department of Maxillofacial Surgery, Temporomandibular Disorders Clinic , University of Padova , Padova , Italy.
Cranio. 2017 May;35(3):180-186. doi: 10.1080/08869634.2016.1168071. Epub 2016 Apr 7.
This study aims to assess changes over time in pain intensity (VAS) and in pressure pain threshold (PPT) of the anterior temporalis and masseter muscles with a treatment protocol combining counseling and stabilization appliance as well as its effects on psychosocial factors.
Twenty individuals with myofascial pain of jaw muscles lasting from at least six months were selected for an uncontrolled before-after study. Counseling was performed by giving information on myofascial pain and advice on self-management. Stabilization appliances were delivered one week after the first counseling session. A number of outcome variables (i.e. visual analogue scale [VAS], pain pressure threshold [PPT] and Research Diagnostic Criteria for Temporomandibular Disorders axis II [RDC/TMD]) were assessed at different evaluation points during a six-month follow-up. ANOVA for repeated measures and Pearson's correlation test were used to evaluate changes in the outcome variables over time.
Compared to baseline data, a significant positive change was found at the 1st week, 1st, 3, and 6th month evaluations for VAS values (P < 0.0001) and at the 1st week, 3, and 6th month evaluations for PPT values (P < 0.05). RDC/TMD axis II values were significantly different (P < 0.05) from baseline to all evaluations points.
The association of counseling and stabilization appliance is effective in the management of chronic myofascial pain of jaw muscles. Future controlled studies are required to get deeper into the assessment of the relative effectiveness of counseling and stabilization appliances.
本研究旨在评估采用咨询与稳定矫治器相结合的治疗方案时，颞肌前束和咬肌的疼痛强度（视觉模拟评分法[VAS]）及压痛阈（PPT）随时间的变化，以及该方案对心理社会因素的影响。
选取20例下颌肌肉肌筋膜疼痛持续至少6个月的患者，进行一项非对照前后研究。通过提供有关肌筋膜疼痛的信息和自我管理建议来进行咨询。在首次咨询 session 一周后交付稳定矫治器。在6个月的随访期间，于不同评估点评估多个结局变量（即视觉模拟量表[VAS]、疼痛压力阈[PPT]和颞下颌关节紊乱病研究诊断标准轴II[RDC/TMD]）。采用重复测量方差分析和Pearson相关检验来评估结局变量随时间的变化。
与基线数据相比，VAS值在第1周、第1、3和6个月评估时出现显著正性变化（P<0.0001），PPT值在第1周、第3和6个月评估时出现显著正性变化（P<0.05）。从基线到所有评估点，RDC/TMD轴II值均有显著差异（P<0.05）。
咨询与稳定矫治器相结合在慢性下颌肌肉肌筋膜疼痛的管理中是有效的。未来需要进行对照研究，以更深入地评估咨询和稳定矫治器的相对有效性。
