Department of Oral & Maxillofacial Pathology, Radiology & Medicine, New York University College of Dentistry, 380 2nd Avenue, Suite 301, New York, NY, 10010, USA.
Clin Oral Investig. 2019 Jul;23(7):2929-2939. doi: 10.1007/s00784-018-02797-6. Epub 2019 Jan 8.
This study examined whether patients with myofascial temporomandibular disorder (mTMD) comorbid with fibromyalgia (FM) receive different treatments or respond differently to these treatments than mTMD-only patients.
A total of 125 mTMD+ women were enrolled (26 FM+ and 98 FM-). mTMD and FM were assessed via clinical research examinations. Treatment histories and self-reported treatment-related improvement were obtained via interview.
The top 3 most common treatments reported were oral appliances (59%), physical therapy (54%), and jaw exercises at home (34%). Use of alternative medicine was reported more frequently among FM+ women, but self-reported improvement did not differ by comorbid FM. Physical therapy was as likely reported by FM status but self-reported improvement scores trended higher for FM+ women.
Oral appliances were as likely to be reported by FM comorbid as FM- women. Oral appliances did not outperform self-management treatments on self-reported improvement of facial pain.
Results support the use of self-management as first-line treatment for mTMD and potential utility of inquiring about widespread pain for treatment planning.
本研究旨在探讨肌筋膜颞下颌紊乱（mTMD）合并纤维肌痛（FM）的患者是否接受了不同的治疗或对这些治疗的反应与单纯 mTMD 患者不同。
共纳入 125 名 mTMD+女性（26 名 FM+和 98 名 FM-）。mTMD 和 FM 通过临床研究检查进行评估。通过访谈获得治疗史和自我报告的与治疗相关的改善情况。
报告的前 3 种最常见的治疗方法是口腔矫治器（59%）、物理疗法（54%）和在家进行下颌运动（34%）。FM+女性更常使用替代医学，但合并 FM 并不会导致自我报告的改善程度不同。物理疗法的报告频率与 FM 状态相同，但 FM+女性的自我报告改善评分趋势更高。
口腔矫治器在 FM 合并和 FM-女性中同样常见。口腔矫治器在自我报告的面部疼痛改善方面并未优于自我管理治疗。
结果支持将自我管理作为 mTMD 的一线治疗方法，并可能需要询问广泛疼痛以进行治疗计划。
