Occlusal appliances: An alternative in pain treatment of temporomandibular disorders

Abstract

Introduction/Objective The pain that originates from musculoskeletal structures of the mastication system is one of the symptoms belonging to the category of temporomandibular disorders or temporomandibular dysfunction (TMD). The objective of the research was to evaluate the effect of therapy with stabilizing occlusal splint in the control of painful symptoms of TMD in comparison with the effect of drug therapy. Methods Using standard Research Diagnostic Criteria for Temporomandibular Disorders diagnostic protocol proposed by Dworkin and LeResche, a group of 44 patients with painful TMD was included. The patients were divided into three treatment groups by random selection. The first group was treated with stabilization occlusal splint for a period of one month. In the two control groups, therapy with non-steroidal anti-inflammatory drug ibuprofen (Brufen, Mylan, Canonsburg, PA, USA) or a combination therapy of ibuprofen and diazepam, a medication from the benzodiazepine family (Diazepam, Hemofarm, Vršac, Serbia) was carried out over a period of three weeks. In order to assess the effects of the therapy with stabilizing occlusal splint and the drug therapy, before and after the therapy, pain intensity measurements were performed with visual analogue scale and digital pressure algometer. Results A significant reduction in the intensity of painful symptoms was achieved in all three therapeutic groups. No significant differences in the effectiveness of pain reduction between the proposed therapeutic modalities were noted. Conclusion The obtained results confirm that the therapy with stabilization occlusal splint is a valid procedure in the reduction of pain in patients with TMD.

Uvod/Cilj Bol porekla mišićno-skeletnih struktura mastikatornog sistema predstavlja jedan od simptoma koji pripadaju kategoriji temporomandibularnih poremećaja ili temporomandibularnih disfunkcija (TMD). Cilj istraživanja je bio da se proceni efekat terapije stabilizacionim okluzalnim splintom u kontroli bolnih simptoma TMD u poređenju sa efektom terapije lekovima. Metode Korišćenjem standardnog dijagnostičkog protokola (RDC/TMD) predloženog od strane Dvorkina i Lerešea, izdvojena je grupa od 44 bolesnika sa bolnim temporomandibularnim disfunkcijama. Bolesnici su podeljeni u tri terapijske grupe slučajnim izborom. Prva grupa je podvrgnuta terapiji stabilizacionim okluzalnim splintom u periodu od mesec dana. U dve kontrolne grupe je sprovedena terapija nesteroidnim antiinflamatornim lekom ibuprofenom (brufen, Mylan) ili kombinacijom ibuprofena i leka iz grupe benzodiazepina - diazepama (diazepam, Hemofarm) u periodu od tri nedelje. U cilju procene efekata terapije stabilizacionim okluzalnim splintom i terapije lekovima, pre i posle sprovedene terapije izvedena su merenja intenziteta bola vizuelnom analognom skalom i digitalnim pritisnim algometrom. Rezultati U sve tri terapijske grupe postignuto je značajno smanjenje intenziteta bolnih simptoma. Nisu zabeležene značajne razlike u uspešnosti smanjenja bola između predloženih terapijskih modaliteta. Zaključak Dobijeni rezultati potvrđuju da je terapija stabilizacionim okluzalnim splintom validna procedura u smanjenju bola kod bolesnika sa TMD.