DOI QR코드

DOI QR Code

Effects of soft occlusal appliance therapy for patients with masticatory muscle pain

  • Kashiwagi, Kosuke (Division of Special Needs Dentistry and Orofacial Pain, Department of Oral Health and Clinical Science, Tokyo Dental College) ;
  • Noguchi, Tomoyasu (Division of Special Needs Dentistry and Orofacial Pain, Department of Oral Health and Clinical Science, Tokyo Dental College) ;
  • Fukuda, Kenichi (Division of Special Needs Dentistry and Orofacial Pain, Department of Oral Health and Clinical Science, Tokyo Dental College)
  • Received : 2020.10.07
  • Accepted : 2021.01.08
  • Published : 2021.02.28

Abstract

Background: 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. Methods: 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. Results: 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. Conclusion: 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.

Keywords

References

  1. Wiens JP. A progressive approach for the use of occlusal devices in the management of temporomandibular disorders. Gen Dent 2016; 64: 29-36.
  2. Conti PC, de Alencar EN, da Mota Correa AS, Lauris JR, Porporatti AL, Costa YM. Behavioural changes and occlusal splints are effective in the management of masticatory myofascial pain: a short-term evaluation. J Oral Rehabil 2012; 39: 754-60. https://doi.org/10.1111/j.1365-2842.2012.02327.x
  3. Ekberg E, Nilner M. Treatment outcome of appliance therapy in temporomandibular disorder patients with myofascial pain after 6 and 12 months. Acta Odontol Scand 2004; 62: 343-9. https://doi.org/10.1080/00016350410010063
  4. Qvintus, Suominen AL, Huttunen J, Raustia A, Ylostalo P, Sipila K. Efficacy of stabilisation splint treatment on facial pain - 1-year follow-up. J Oral Rehabil 2015; 42: 439-46. https://doi.org/10.1111/joor.12275
  5. Niemela K, Korpela M, Raustia A, Ylostalo P, Sipila K. Efficacy of stabilisation splint treatment on temporomandibular disorders. J Oral Rehabil 2012; 39: 799-804. https://doi.org/10.1111/j.1365-2842.2012.02335.x
  6. Okeson JP. The effects of hard and soft occlusal splints on nocturnal bruxism. J Am Dent Assoc 1987; 114: 788-91. https://doi.org/10.14219/jada.archive.1987.0165
  7. Gnauck M, Helkimo M, Magnusson T. Routines for interocclusal appliance therapy among general dental practitioners in a Swedish county. Swed Dent J 2012; 36: 125-32.
  8. Candirli C, Korkmaz YT, Celikoglu M, Altintas SH, Coskun U, Memis S. Dentists' knowledge of occlusal splint therapy for bruxism and temporomandibular joint disorders. Niger J Clin Pract 2016; 19: 496-501. https://doi.org/10.4103/1119-3077.183310
  9. Karakis D, Dogan A, Bek B. Evaluation of the effect of two different occlusal splints on maximum occlusal force in patients with sleep bruxism: a pilot study. J Adv Prosthodont 2014; 6: 103-8. https://doi.org/10.4047/jap.2014.6.2.103
  10. Wright E, Anderson G, Schulte J. A randomized clinical trial of intraoral soft splints and palliative treatment for masticatory muscle pain. J Orofac Pain 1995; 9: 192-9.
  11. Pettengill CA, Growney MR Jr, Schoff R, Kenworthy CR. A pilot study comparing the efficacy of hard and soft stabilizing appliances in treating patients with temporomandibular disorders. J Prosthet Dent 1998; 79: 165-8. https://doi.org/10.1016/S0022-3913(98)70211-2
  12. Seifeldin SA, Elhayes KA. Soft versus hard occlusal splint therapy in the management of temporomandibular disorders (TMDs). Saudi Dent J 2015; 27: 208-14. https://doi.org/10.1016/j.sdentj.2014.12.004
  13. Harkins S, Marteney JL, Cueva O, Cueva L. Application of soft occlusal splints in patients suffering from clicking temporomandibular joints. Cranio 1988; 6: 71-6. https://doi.org/10.1080/08869634.1988.11678222
  14. Srinivasan K, Sucharita S, Vaz M. Effect of standing on short term heart rate variability across age. Clin Physiol Funct Imaging 2002; 22: 404-8. https://doi.org/10.1046/j.1475-097X.2002.00450.x
  15. Pomeranz B, Macaulay RJ, Caudill MA, Kutz I, Adam D, Gordon D, et al. Assessment of autonomic function in humans by heart rate spectral analysis. Am J Physiol 1985; 248: 151-3. https://doi.org/10.1152/ajpheart.1985.248.1.H151
  16. Takahashi M, Miyai N, Nagano S, Utsumi M, Oka M, Yamamoto M, et al. Orthostatic blood pressure changes and subclinical markers of atherosclerosis. Am J Hypertens 2015; 28: 1134-40. https://doi.org/10.1093/ajh/hpu301
  17. Sakamoto T, Fukuda K, Saita N, Koukita Y, Yamashita S, Koizumi J, et al. Autonomic nervous activity of patients with gagging problems during dental mirror insertion. Spec Care Dentist 2016; 36: 80-4. https://doi.org/10.1111/scd.12148
  18. Farrar JT, Young JP Jr, LaMoreaux L, Werth JL, Poole RM. Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale. Pain 2001; 94: 149-58. https://doi.org/10.1016/S0304-3959(01)00349-9
  19. Noguchi T, Kashiwagi K, Fukuda K. The effectivness of stabilization appliance therapy among patients with myalgia. Clin Exp Dent Res 2020; 6: 244-53. https://doi.org/10.1002/cre2.266
  20. Maekawa K, Clark GT, Kuboki T. Intramuscular hypoperfusion, adrenergic receptors, and chronic muscle pain. J Pain 2002; 3: 251-60. https://doi.org/10.1054/jpai.2002.125923
  21. Masi AT, Hannon JC. Human resting muscle tone (HRMT): narrative introduction and modern concepts. J Bodyw Mov Ther 2008; 12: 320-32. https://doi.org/10.1016/j.jbmt.2008.05.007
  22. Velly AM, Gornitsky M, Philippe P. Contributing factors to chronic myofascial pain: a case-control study. Pain 2003; 104: 491-9. https://doi.org/10.1016/S0304-3959(03)00074-5
  23. Raphael KG, Sirois DA, Janal MN, Wigren PE, Dubrovsky B, Nemelivsky LV, et al. Sleep bruxism and myofascial temporomandibular disorders: a laboratory-based polysomnographic investigation. J Am Dent Assoc 2012; 143: 1223-31. https://doi.org/10.14219/jada.archive.2012.0068
  24. de Leeuw R, Klasser GD. Orofacial pain: guidelines for assessment, diagnosis, and management. 5th ed. Chicago, Quintessence. 2013.
  25. Narita N, Funato M, Ishii T, Kamiya K, Matsumoto T. Effects of jaw clenching while wearing an occlusal splint on awareness of tiredness, bite force, and EEG power spectrum. J Prosthodont Res 2009; 53: 120-5. https://doi.org/10.1016/j.jpor.2009.02.006
  26. Harper DE, Schrepf A, Clauw DJ. Pain mechanisms and centralized pain in temporomandibular disorders. J Dent Res 2016; 95: 1102-8. https://doi.org/10.1177/0022034516657070
  27. Slade GD, Ohrbach R, Greenspan JD, Fillingim RB, Bair E, Sanders AE, et al. Painful temporomandibular disorder: decade of discovery from OPPERA Studies. J Dent Res 2016; 95: 1084-92. https://doi.org/10.1177/0022034516653743
  28. Yeung E, Abou-Foul A, Matcham F, Poate T, Fan K. Integration of mental health screening in the management of patients with temporomandibular disorders. Br J Oral Maxillofac Surg 2017; 55: 594-9. https://doi.org/10.1016/j.bjoms.2017.03.014
  29. American Psychiatric Association. Assessment measures. In: Diagnostic and Statistical Manual of Manual of Mental Disorders, Fifth Edition. Arlington: American Psychiatric Association 2003: 733-48.
  30. Fillingim RB, Ohrbach R, Greenspan JD, Knott C, Dubner R, Bair E, et al. Potential psychosocial risk factors for chronic TMD: descriptive data and empirically identified domains from the OPPERA case-control study. J Pain 2011; 12: 46-60.
  31. Bertoli E, de Leeuw R. Prevalence of suicidal ideation, depression, and anxiety in chronic temporomandibular disorder patients. J Oral Facial Pain Headache 2016; 30: 296-301. https://doi.org/10.11607/ofph.1675
  32. Eze-Nliam CM, Quartana PJ, Quain AM, Smith MT. Nocturnal heart rate variability is lower in temporomandibular disorder patients than in healthy, pain-free individuals. J Orofac Pain 2011; 2: 232-9.
  33. Maixner W, Greenspan JD, Dubner R, Bair E, Mulkey F, Miller V, et al. Potential autonomic risk factors for chronic TMD: descriptive data and empirically identified domains from the OPPERA case-control study. J Pain 2011; 12: 75-91.
  34. Greenspan JD, Slade GD, Bair E, Dubner R, Fillingim RB, Ohrbach R, et al. Pain sensitivity and autonomic factors associated with development of TMD: the OPPERA prospective cohort study. J Pain 2013; 14: 63-74.