Abstract
The relationship of bidirectional comorbidity between chronic migraine and pain in the cephalic segment led us to evaluate the improvement in reducing the pain in patients diagnosed with chronic migraine headache and awake bruxism, when undergoing treatment with a partial posterior interocclusal device designed for the management and control of awake bruxism through biofeedback. Seventy-four patients were evaluated during the following periods: pretreatment, seven, thirty, ninety, one hundred and eighty days, and one year. The evaluation was carried out by measuring the pain in the pretreatment period and pain reduction after awake bruxism treatment, using clinical evaluation and numerical scales for pain. Most of the patients who complained of headache migraine pain, masticatory myofascial pain, temporomandibular joint and neck pain experienced a significant reduction in overall pain, including headaches, between t0 and t30 (p<0.0001). After 30 days of using the device, it was observed that the improvement remained at the same level without any recurrence of pain up to t90. At t180 and t360, it was observed that even with the device withdrawal (at t90) the improvement remained at the same level. The utilization of a posterior interocclusal device designed for the management and control of awake bruxism through biofeedback seems to contribute to the reduction of pain (including migraine headache) in the majority of patients, and, even with the device withdrawal (at t90), the improvement remained at the same level, suggesting the patients succeeded in controlling their awake bruxism and consequently the pains.
Highlights
The non-functional habits of the awake and sleep periods have been described as important risk factors in the development and prolongation of functional disorders and orofacial pain, in that awake bruxism seems to be the most harmful to the patient
The objective of this study was to evaluate the improvement in reducing pain in patients diagnosed with migraine headache and masticatory myofascial pain when undergoing treatment with a partial posterior interocclusal device designed for the management and control of awake bruxism through “biofeedback”
At t180 and t360, it was observed that, even with the device withdrawal, the improvement remained at the same level, suggesting that the patients succeeded in controlling their awake bruxism (Figure 1)
Summary
The non-functional habits of the awake and sleep periods have been described as important risk factors in the development and prolongation of functional disorders and orofacial pain, in that awake bruxism seems to be the most harmful to the patient. Prolonged teeth contact, especially at low levels of contraction, has been associated with pain in the masticatory muscles and the skull[11,12], and a higher frequency of temporomandibular disorders (TMD)[13,14]. Conclusion: The utilization of a posterior interocclusal device designed for the management and control of awake bruxism through biofeedback seems to contribute to the reduction of pain (including migraine headache) in the majority of patients, and, even with the device withdrawal (at t90), the improvement remained at the same level, suggesting the patients succeeded in controlling their awake bruxism and the pains
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