Giannakopoulos Nikolaos N, Katsikogianni Eleni N, Hellmann Daniel, Eberhard Lydia, Leckel Michael, Schindler Hans J, Schmitter Marc
a Department of Prosthodontics , University of Heidelberg , Heidelberg , Germany ;
b Department of Orthodontics , University of Heidelberg , Heidelberg , Germany.
Acta Odontol Scand. 2016 Aug;74(6):480-6. doi: 10.1080/00016357.2016.1204558. Epub 2016 Jul 13.
The purpose of this study was to compare the short-term effectiveness of three different types of immediate, non-pharmacological intervention for alleviation of the painful symptoms of temporomandibular disorders (TMD).
Thirty-six patients (mean age 41.6 ± 16.7 years, 25 females) diagnosed with non-dysfunctional painful TMD received counselling and subsequently were randomly allocated to three treatment groups: patients in Group A received prefabricated oral splints with water-filled elastic pads (Aqualizer(®)), those in Group B were provided with vacuum-formed co-polyester oral splints and those in Group C were given appointments to receive Michigan-type hard splints. Clinical examination was conducted, at baseline and after 2 weeks, by use of the RDC/TMD. Current pain intensity was determined by evaluation of graded chronic pain status (GCPS) on a numerical rating scale (NRS). Active maximum mouth opening without pain (AMMOP) was also measured. Paired sample t-tests and one-way analysis of variance with a significance level of p ≤ 0.05 were conducted.
After 2 weeks, overall mean current pain was reduced by 41.95% (p < 0.001). Current pain reduction was significant for Group B (66.6%, p < 0.001) but not for Groups A (37.88%, p = 0.56) and C (22.29%, p = 0.26). After 2 weeks, current pain level for Group B was significantly lower than that for Group C (p = 0.041). Overall, there was a statistically significant increase of AMMOP (p = 0.01).
All therapeutic options were pain-reducing. The results from this study suggest that cost-effective and time-effective intervention of counselling combined with use of a vacuum-formed splint is a favourable option for initial, short-term treatment of painful TMD.
本研究旨在比较三种不同类型的即时非药物干预对缓解颞下颌关节紊乱病（TMD）疼痛症状的短期效果。
36例被诊断为无功能障碍性疼痛性TMD的患者（平均年龄41.6±16.7岁，25名女性）接受了咨询，随后被随机分为三个治疗组：A组患者接受带有充水弹性垫的预制口腔矫治器（Aqualizer®），B组患者使用真空成型的共聚酯口腔矫治器，C组患者预约接受密歇根型硬矫治器。在基线和2周后，使用RDC/TMD进行临床检查。通过数字评分量表（NRS）评估分级慢性疼痛状态（GCPS）来确定当前疼痛强度。还测量了无痛主动最大开口度（AMMOP）。进行了配对样本t检验和显著性水平为p≤0.05的单因素方差分析。
2周后，总体平均当前疼痛减轻了41.95%（p<0.001）。B组当前疼痛减轻显著（66.6%，p<0.001），而A组（37.88%，p=0.56）和C组（22.29%，p=0.26）则不显著。2周后，B组的当前疼痛水平显著低于C组（p=0.041）。总体而言，AMMOP有统计学显著增加（p=0.01）。
所有治疗方案均能减轻疼痛。本研究结果表明，咨询与使用真空成型矫治器相结合的具有成本效益和时间效益的干预措施是疼痛性TMD初始短期治疗的有利选择。
