Effectiveness of applied relaxation method vs splint in treatment of temporomandibular disorders in Finnish students.

Abstract

Temporomandibular disorders (TMDs) include pain and dysfunction in masticatory muscles and temporomandibular joints (TMJs). Applied relaxation (AR) is a coping skill that may be applicable for treatment of TMD. The aim of this randomised, controlled study was to evaluate the effectiveness of AR as compared to stabilisation splint (SS), for treatment of TMD during 12-month follow-up. The data were derived from 96 university students seeking treatment due to TMD symptoms at Finnish Student Health Service in Finland. The subjects were randomly divided into two treatment groups: SS (n=41) and AR (n=51) groups. Clinical TMD examinations (a modified version of DC/TMD, Axis I) were performed for both the groups at baseline and 3-, 6- and 12-month follow-ups. Depressive and non-specific physical symptoms (NSPS) were estimated with Axis II questionnaire (RDC/TMD), and a number of other pain sites were screened at baseline and 12-month follow-up. Data were analysed by means of chi-square test for both groups on five variables, t test for VAS pain intensity and repeated measures ANOVA for palpation pain at follow-up points. Statistical significance was set on P<.05. Decrease in the number of painful masticatory muscles and TMJs and VAS on pain intensity did not differ between groups. During follow-up, NSPS and number of body pain sites decreased significantly more in the AR than the SS group. The dropout was 56 patients. Neither of the treatments showed more benefit in decreasing local TMD pain. AR gave more benefit on psychological well-being and general pain symptoms.