Abstract
IntroductionTemporomandibular disorder (TDM) is the most common source of orofacial pain of a non-dental origin. Sleep bruxism is characterized by clenching and/or grinding the teeth during sleep and is involved in the perpetuation of TMD. The aim of the present study was to investigate the effects of massage therapy, conventional occlusal splint therapy and silicone occlusal splint therapy on electromyographic activity in the masseter and anterior temporal muscles and the intensity of signs and symptoms in individuals with severe TMD and sleep bruxism.MethodsSixty individuals with severe TMD and sleep bruxism were randomly distributed into four treatment groups: 1) massage group, 2) conventional occlusal splint group, 3) massage + conventional occlusal splint group and 4) silicone occlusal splint group. Block randomization was employed and sealed opaque envelopes were used to conceal the allocation. Groups 2, 3 and 4 wore an occlusal splint for four weeks. Groups 1 and 3 received three weekly massage sessions for four weeks. All groups were evaluated before and after treatment through electromyographic analysis of the masseter and anterior temporal muscles and the Fonseca Patient History Index. The Wilcoxon test was used to compare the effects of the different treatments and repeated-measures ANOVA was used to determine the intensity of TMD.ResultsThe inter-group analysis of variance revealed no statistically significant differences in median frequency among the groups prior to treatment. In the intra-group analysis, no statistically significant differences were found between pre-treatment and post-treatment evaluations in any of the groups. Group 3 demonstrated a greater improvement in the intensity of TMD in comparison to the other groups.ConclusionMassage therapy and the use of an occlusal splint had no significant influence on electromyographic activity of the masseter or anterior temporal muscles. However, the combination of therapies led to a reduction in the intensity of signs and symptoms among individuals with severe TMD and sleep bruxism.Trial registrationThis study is registered in August, 2014 in the ClinicalTrials.gov (NCT01874041).Electronic supplementary materialThe online version of this article (doi:10.1186/s12998-014-0043-6) contains supplementary material, which is available to authorized users.
Highlights
Temporomandibular disorder (TDM) is the most common source of orofacial pain of a non-dental origin
The aim of the present study was to investigate the effects of massage therapy, traditional occlusal splint therapy and silicone occlusal splint therapy on electromyographic activity in the masseter and anterior temporal muscles and the intensity of signs of symptoms in individuals with severe Temporomandibular disorder (TMD) and sleep bruxism
Significant differences were found between the pre-treatment and post-treatment evaluations in the massage group (MG), conventional occlusal splint group (COSG) and massage + conventional occlusal splint group (MCOSG), the latter of which exhibited greater improvement in comparison to the other groups
Summary
Temporomandibular disorder (TDM) is the most common source of orofacial pain of a non-dental origin. Sleep bruxism is characterized by clenching and/or grinding the teeth during sleep and is involved in the perpetuation of TMD. Temporomandibular disorder (TMD) is considered the most common source of orofacial pain of a non-dental origin and constitutes a heterogeneous group of conditions that affect the temporomandibular joint and/or masticatory muscles [1]. Sleep bruxism is characterized by clenching and/or grinding one’s teeth during sleep and may be involved in triggering and/or perpetuating TMD [2]. Treatment strategies for both conditions are founded on minimally invasive, reversible interventions involving a multidisciplinary team [3]. The multifactor etiology of both TMD and sleep bruxism suggests that it may be advantageous to investigate the effects of different resources used either alone or in combination
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