Comparison of device‐supported sensorimotor training and splint intervention for myofascial temporomandibular disorder pain patients

医学 夹板(药) 研究诊断标准 物理疗法 肌电图 咬人 物理医学与康复 咬肌 慢性疼痛 牙科 生态学 生物
作者
Nikolaos Nikitas Giannakopoulos,Ann-Kristin Rauer,Daniel Hellmann,Sybille Hugger,Marc Schmitter,Alfons Hugger
出处
期刊:Journal of Oral Rehabilitation [Wiley]
卷期号:45 (9): 669-676 被引量:25
标识
DOI:10.1111/joor.12662
摘要

Summary This study was to compare the short‐term therapeutic efficacy of device‐supported sensorimotor training with that of standard splint therapy for patients with myofascial temporomandibular disorder (TMD) pain over a treatment period of 3 months. We tested the hypothesis that both types of intervention are equally effective for pain reduction. In addition, the electromyographic (EMG) activity of the temporal and masseter muscles was recorded under conditions of force‐controlled submaximum and maximum biting in intercuspation. Of consecutive patients seeking treatment for non‐odontogenic oro‐facial pain, 45 patients with myofascial TMD pain (graded chronic pain status, GCPS, I and II) were randomly assigned to 2 treatment groups (sensorimotor training and conventional splint treatment). Patients were evaluated 4 times (initial examination, 2, 6 and 12 weeks later) by use of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Electromyographic activity was recorded at the initial session and after 3 months. Ease‐of‐use of the treatment options was also evaluated. Significant ( P < .0001) pain reduction (sensorimotor training 53%, splint therapy 40%) was achieved for both groups, with no significant differences ( P > .05) between the groups. Force‐controlled sub‐maximum normalized electromyographic activity was significantly different between T0 and T3 for group A (sensorimotor training, P < .05) but was not significantly different for group B (splint, P > .05). For normalized maximum‐biting EMG activity in intercuspation, however, a significant increase in EMG activity was observed for group A for the masseter and temporal muscles ( P < .001) and for group B for the masseter muscle only ( P < .001). Moreover, sensorimotor training was significantly ( P < .05) less easy to use than the splint. The results of this study confirm the pain‐reducing effect of sensorimotor training for patients with myofascial TMD pain (GCPS I and II). This innovative active treatment might be a promising option for TMD pain patients.
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