基于口腔内传感器对肌筋膜疼痛患者稳定矫治器治疗的监测

Krohn Sebastian, Hampe Tristan, Brack Frederike, Wassmann Torsten, Bürgers Ralf

Int J Comput Dent. 2020;23(1):11-16.

AIM

The present study aimed to evaluate intraoral microsensors for the objective measurement of patient compliance during splint therapy and to comparatively analyze the duration of mandibular and maxillary splint application in patients with myofascial pain.

MATERIALS AND METHODS

Thirty-two patients with sole myofascial pain without limited opening (Research Diagnostic Criteria for Temporomandibular Disorders [RDC/TMD] Ia) were divided into two groups. To ensure patient comparability, all pressure-sensitive sites from the initial palpation were summarized as pain scores. The subjects in group 1 were treated with maxillary stabilization splints, and those in group 2 with mandibular stabilization splints. All splints were equipped with a microsensor without interfering static or dynamic occlusion. Wear pattern was recorded at three intervals of 30 days each. Following the observation period, the data were retrieved and statistically evaluated using multi-factor analysis of variance (ANOVA) and the Bland-Altman analysis.

RESULTS

During the observation period, maxillary splints were applied in 44.4% and mandibular splints in 44.2% of the days. Regarding patient compliance, there was no significant difference between the maxillary and mandibular splints (P = 0.359). Patients with an increased pain score (P < 0.0001) and female patients (P = 0.013) wore their splints significantly more often. The wear time decreased over the observation period, whereas only the initial and terminal interval differed significantly across both the mandibular and maxillary splint groups (P < 0.0001).

CONCLUSION

The microsensor used in the present study was an effective and reliable tool for monitoring patient compliance in patients with temporomandibular disorders (TMD). This method also allows for the reliable recording of intraoral splint application prior to the required bite elevations. The two types of splints analyzed in the present study had no significant influence on compliance.

目的

本研究旨在评估口腔内微传感器在夹板治疗期间客观测量患者依从性的情况，并比较分析肌筋膜疼痛患者使用上颌和下颌夹板的时长。

材料与方法

32例仅有肌筋膜疼痛且无开口受限的患者（颞下颌关节紊乱病研究诊断标准[RDC/TMD] Ia）被分为两组。为确保患者具有可比性，将初次触诊时所有压痛点的情况汇总为疼痛评分。第1组患者使用上颌稳定夹板治疗，第2组患者使用下颌稳定夹板治疗。所有夹板均配备微传感器，且不影响静态或动态咬合。分别在3个30天的时间段记录佩戴模式。观察期结束后，检索数据并使用多因素方差分析（ANOVA）和布兰德-奥特曼分析进行统计学评估。

结果

在观察期内，上颌夹板的使用天数占44.4%，下颌夹板的使用天数占44.2%。关于患者依从性，上颌夹板和下颌夹板之间无显著差异（P = 0.359）。疼痛评分增加的患者（P < 0.0001）和女性患者（P = 0.013）佩戴夹板的频率明显更高。佩戴时间在观察期内有所减少，而下颌夹板组和上颌夹板组仅在初始和末期时间段存在显著差异（P < 0.0001）。