Kashiwagi Kosuke, Noguchi Tomoyasu, Fukuda Kenichi
Division of Special Needs Dentistry and Orofacial Pain, Department of Oral Health and Clinical Science, Tokyo Dental College, Tokyo, Japan.
J Dent Anesth Pain Med. 2021 Feb;21(1):71-80. doi: 10.17245/jdapm.2021.21.1.71. Epub 2021 Jan 29.
The options for stabilization appliance therapy for masticatory muscle pain include soft occlusal and hard stabilization appliances. A previous study suggested that hard stabilization appliance therapy was effective for patients with local myalgia who developed long facets on their occlusal appliances. The objective of this study was to identify patients in whom a soft occlusal appliance should be used to treat masticatory muscle pain by analyzing the type of muscle pain present and patient factors that influenced the effectiveness of this treatment.
The study included 42 patients diagnosed with local myalgia or myofascial pain according to the Diagnostic Criteria for Temporomandibular Disorders Diagnostic Decision Tree. The analysis of patient factors included variables believed to be associated with temporomandibular disorders. First, a temporary screening appliance was used for 2 weeks to assess each patient for bruxism during sleep. Soft appliance therapy was then started. For each patient, the effectiveness of the appliance was evaluated according to the intensity of tenderness during muscle palpation and the treatment satisfaction score at one month after starting treatment.
Data from 37 of the 42 patients were available for analysis. Twenty-five patients reported satisfaction with the appliance. In logistic regression analysis, the odds ratio for reduction of facet length was 1.998. Nineteen patients showed at least a 30% improvement in the visual analog scale score. The odds ratio for local myalgia was 18.148.
Soft appliance therapy may be used in patients with local myalgia. Moreover, patients who develop short facets on the appliance surface are likely to be satisfied with soft appliance therapy. Soft appliance therapy may be appropriate for patients with local myalgia who develop short facets on their occlusal appliance.
咀嚼肌疼痛的稳定矫治器治疗方法包括软咬合矫治器和硬稳定矫治器。先前的一项研究表明，硬稳定矫治器治疗对在咬合矫治器上出现长小面的局部肌痛患者有效。本研究的目的是通过分析存在的肌痛类型和影响该治疗效果的患者因素，确定应使用软咬合矫治器治疗咀嚼肌疼痛的患者。
该研究纳入了42例根据颞下颌关节紊乱病诊断标准诊断决策树被诊断为局部肌痛或肌筋膜疼痛的患者。对患者因素的分析包括被认为与颞下颌关节紊乱病相关的变量。首先，使用临时筛查矫治器2周，以评估每位患者睡眠时的磨牙症情况。然后开始软矫治器治疗。对于每位患者，根据肌肉触诊时的压痛强度和开始治疗后1个月的治疗满意度评分评估矫治器的效果。
42例患者中有37例的数据可供分析。25例患者报告对矫治器满意。在逻辑回归分析中，小面长度减少的比值比为1.998。19例患者的视觉模拟量表评分至少提高了30%。局部肌痛的比值比为18.148。
软矫治器治疗可用于局部肌痛患者。此外，矫治器表面出现短小面的患者可能对软矫治器治疗满意。软矫治器治疗可能适用于在咬合矫治器上出现短小面的局部肌痛患者。
