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咬合板与治疗性运动对颞下颌关节紊乱症患者的协同作用——一项初步研究。

The synergism of occlusal splints along with therapeutic exercise on individuals with temporomandibular joint disorders - A pilot study.

作者信息

Bachani Tanuj, Raza Fathima Banu, Vaidyanathan Anand Kumar

机构信息

Department of Prosthodontics, Sri Ramachandra Dental College and Hospital, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.

出版信息

J Indian Prosthodont Soc. 2025 Jan 1;25(1):52-58. doi: 10.4103/jips.jips_373_24. Epub 2025 Jan 3.

Abstract

AIM

Aberrative occlusal contacts were associated with Temporomandibular disorder (TMD), but whether stabilization splints with therapeutic exercises alleviate the symptoms is unclear. Hence, this study aims to compare the short-term efficacy of occlusal splint therapy and the synergistic effect of therapeutic exercise with occlusal splint therapy for 3 weeks in individuals with TMD.

SETTINGS AND DESIGN

in-vivo observational pilot study.

MATERIALS AND METHODS

Fourteen participants were grouped based on the type of treatment: Group A, assigned with combination therapy, stabilization splint with therapeutic exercises, and Group B, with only stabilization splint therapy. Surface electromyography (EMG) was taken to evaluate the masseter and temporalis muscle activity at baseline and 2nd week. The patient's perception of TMD was evaluated using the Fonseca questionnaire at baseline, 48 h, 14th, and 21st days.

STATISTICAL ANALYSIS

Chi-square statistical analysis was applied to the quantitative data obtained from the Fonseca questionnaire and EMG analysis, with P < 0.05 as significant.

RESULTS

Fonseca questionnaire revealed a significant difference between the two groups at 48 h (P < 0.05). EMG outcome showed no significant difference between the groups at baseline and 14th day (P > 0.05). However, the mean muscle activity recorded at the masseter in Group B was increased on 14th day (56.5 ± 3 μV) and an isotonic muscle pattern was observed in Group A.

CONCLUSION

Combination therapy, which included stabilization splint and home care exercises for moderate to severe TMD patients, led to earlier curative changes in the temporomandibular joint and improved functional jaw movements, along with a reduction in pain. An isotonic muscle activity pattern was also observed, confirming the effect of combination therapy.

摘要

目的

异常咬合接触与颞下颌关节紊乱病(TMD)相关,但稳定咬合板联合治疗性锻炼是否能缓解症状尚不清楚。因此,本研究旨在比较咬合板治疗的短期疗效以及咬合板治疗联合治疗性锻炼3周对TMD患者的协同效应。

设置与设计

体内观察性试点研究。

材料与方法

14名参与者根据治疗类型分组:A组接受联合治疗,即稳定咬合板加治疗性锻炼;B组仅接受稳定咬合板治疗。在基线和第2周时进行表面肌电图(EMG)检查,以评估咬肌和颞肌的肌肉活动。使用丰塞卡问卷在基线、48小时、第14天和第21天评估患者对TMD的感知。

统计分析

对从丰塞卡问卷和EMG分析中获得的定量数据应用卡方统计分析,P < 0.05为有显著性差异。

结果

丰塞卡问卷显示两组在48小时时有显著差异(P < 0.05)。EMG结果显示两组在基线和第14天无显著差异(P > 0.05)。然而,B组咬肌在第14天记录的平均肌肉活动增加(56.5 ± 3 μV),而A组观察到等张肌肉模式。

结论

对于中重度TMD患者,联合治疗(包括稳定咬合板和家庭护理锻炼)可使颞下颌关节更早出现治愈性变化,改善下颌功能运动,并减轻疼痛。还观察到等张肌肉活动模式,证实了联合治疗的效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1435/11853946/d6097a7f303d/JIPS-25-52-g001.jpg

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