Division of Special Needs Dentistry and Orofacial Pain, Department of Oral Health and Clinical Science, Tokyo Dental College, Tokyo, Japan.
Clin Exp Dent Res. 2020 Apr;6(2):244-253. doi: 10.1002/cre2.266. Epub 2019 Dec 2.
The efficacy of stabilization appliance therapy for masticatory muscle pain is debated. Therefore, there are currently no clear usage standards. We analyzed patient factors influencing its efficacy and characterized masticatory muscle pain subtypes to determine appropriate therapy candidates.
This case series study recruited patients diagnosed with local myalgia or myofascial pain and used variables related to temporomandibular disorders in the analysis. We used temporary appliance to screen patients for sleep bruxism for 2 weeks. Afterwards, we initiated therapy with stabilization appliances. Efficacy was evaluated via tenderness intensity during muscle palpation and the treatment satisfaction score after 2 months of treatment.
We analyzed 62 (91%) patients. Tenderness upon muscle palpation was mitigated in 27 patients. Mitigated tenderness odds ratios were 0.035 for myofascial pain, 0.804 for 15-item Patient Health Questionnaire scores, and 1.915 for facet length. Thirty-nine patients expressed satisfaction; satisfaction odds ratios were 0.855 for 9-item Patient Health Questionnaire scores, 1.606 for facet length, and 4.023 for awake bruxism awareness.
Stabilization appliance therapy is most effective for patients with awake bruxism awareness, local myalgia, long facets, and no psychosocial risk factors.
关于稳定器治疗咀嚼肌疼痛的疗效存在争议。因此，目前尚无明确的使用标准。我们分析了影响其疗效的患者因素，并对咀嚼肌疼痛亚型进行了特征分析，以确定合适的治疗候选者。
本病例系列研究招募了被诊断为局部肌痛或肌筋膜疼痛的患者，并在分析中使用了与颞下颌关节紊乱相关的变量。我们使用临时矫治器对患者进行 2 周的睡眠磨牙筛查。之后，我们开始使用稳定器进行治疗。通过肌肉触诊时的压痛强度和治疗 2 个月后的治疗满意度评分来评估疗效。
我们分析了 62 例（91%）患者。27 例患者的压痛减轻。压痛缓解的优势比分别为肌筋膜疼痛 0.035、15 项患者健康问卷评分 0.804、小关节长度 1.915。39 例患者表示满意；满意的优势比分别为 9 项患者健康问卷评分 0.855、小关节长度 1.606、清醒磨牙意识 4.023。
对于有清醒磨牙意识、局部肌痛、小关节长度较长且无心理社会危险因素的患者，稳定器治疗效果最佳。
