Oral Health Prev Dent. 2024 Jul 12;22:249-256. doi: 10.3290/j.ohpd.b5569645.
This cross-sectional longitudinal observational study aimed to clarify the question of whether painful temporomandibular disorders (TMD) in psychiatrically confirmed patients hospitalised for post-traumatic stress disorder (PTSD) therapy after using splint therapy (ST) show long-term therapeutic effects in the case of functional disorders.
One hundred fifty-three (153) inpatients (123 male and 20 female soldiers, age 35.8 ± 9.2 years, 26.6 ± 2.2 teeth) with confirmed PTSD (Impact of Event Scale - Revised ≥33), grade 3 to 4 chronic pain according to von Korff's Chronic Pain Scale and the research diagnostic criteria of painful TMD (RDC-TMD) were recorded. All participants received a maxillary occlusal splint that was worn at night. Control check-ups of the therapeutic effect of the splint were conducted for up to 9 years during psychiatric follow-ups.
TMD pain worsened in 22 (14.4%) patients within the first 6 weeks and led to the removal of the splint. The pain intensity (PI) at BL was reported to be a mean of VAS 7.7 ± 1.1. Six weeks after ST (n = 131), the average PI was recorded as VAS 2.6 ± 1.3. Based on the last examination date of all subjects, the average PI was recorded as 0.7 ± 0.9. Seventy-two (72) patients used a second stabilisation splint in the maxilla after 14.4 ± 15.7 months, and 38 patients used between 3 and 8 splints during their psychiatric and dental treatment time (33.7 ± 29.8 months).
The presented data shows that therapeutic pain reduction remained valid in the long term despite continued PTSD. The lifespan of a splint seems to be dependent on individual factors. Long-term splint therapy appears to be accepted by the majority of patients with PTSD and painful TMD.
本横断面纵向观察性研究旨在阐明以下问题：接受夹板治疗（ST）后，因创伤后应激障碍（PTSD）而住院的精神病学确诊患者中出现的疼痛性颞下颌关节紊乱（TMD）是否在功能障碍的情况下显示出长期的治疗效果。
共记录了 153 名住院患者（123 名男性和 20 名女性士兵，年龄 35.8 ± 9.2 岁，26.6 ± 2.2 颗牙齿），这些患者均被确诊患有 PTSD（修订后的事件影响量表 - 修订版≥33），根据 vonKorff 慢性疼痛量表和疼痛性 TMD 的研究诊断标准（RDC-TMD），疼痛程度为 3 至 4 级慢性疼痛。所有参与者均接受了夜间佩戴的上颌咬合夹板。在精神病学随访期间，进行了长达 9 年的夹板治疗效果的对照检查。
在最初的 6 周内，有 22 名（14.4%）患者的 TMD 疼痛恶化，导致夹板拆除。基线时的疼痛强度（PI）报告为 VAS 7.7 ± 1.1。ST 治疗后 6 周（n = 131），平均 PI 记录为 VAS 2.6 ± 1.3。根据所有受试者的最后检查日期，平均 PI 记录为 0.7 ± 0.9。72 名（72）患者在 14.4 ± 15.7 个月后在上颌使用了第二副稳定夹板，38 名患者在精神病学和牙科治疗期间（33.7 ± 29.8 个月）使用了 3 至 8 副夹板。
尽管持续存在 PTSD，但呈现的数据表明治疗性疼痛减轻在长期内仍然有效。夹板的寿命似乎取决于个体因素。长期夹板治疗似乎被大多数患有 PTSD 和疼痛性 TMD 的患者所接受。
