Abstract
The aim of the study is to evaluate the effectiveness of two complementary mandibular repositioning splints (SVED and MORA) designed after a preliminary patients’ posture-stabilometric evaluation in treatment for temporomandibular myofascial pain (TMP) using the Pain-Intensity Numeric Rating Scale (PI-NRS) assessment. Eighty-six consecutive sportive non-agonistic subjects with TMP were randomly divided in two groups. Forty-two wear mandibular repositioning splints designed by a posture-stabilometric evaluation, thus constituting the test group. The other 44 subjects were not subjected to any treatment, thus represented the control group. To record pain intensity, subjects in both groups were asked to fill in a PI-NRS which ranged from 0 (no pain) to 10 (worst imaginable pain). In the test group, PI-NRS was assessed three times: before starting therapy (t0), after 4 months (t1) and after 8 months (t2) of treatment. Instead, in the control group PI-NRS was recorded during the first visit (t0) and after 8 months (t2). The Friedman test showed a statistically significant decrease in PI-NRS mean scores after 4 (t1) and 8 (t2) months from the start of the gnathological therapy with mandibular repositioning splints, (p < 0.001) in test group. There is enough evidence to assess that occlusal splint therapy for mandibular repositioning (MORA and SVED) designed through a posture-stabilometric evaluation could be considered in the treatment of temporomandibular myofascial pain.
Highlights
The aim of this study was to evaluate the effectiveness of two complementary mandibular repositioning splints designed after a posture-stabilometric evaluation, obtaining a personalized jaw-repositioning splint that could promote temporomandibular myofascial pain reduction in head and neck districts according to Pain-Intensity Numeric Rating Scale (PI-NRS) during an 8-month follow-up
The following inclusion criteria were used for the enrolment: (i) patients with clinical features fulfilling the DC/Temporomandibular disorders (TMDs) [10] of local myalgia, myofascial pain with spreading and myofascial pain with referral; (ii) absence of long-term illnesses that may affect temporomandibular joints (TMJs) or the masticatory muscles; (iii) absence of previous treatment for TMD; (iv) no vestibular apparatus alteration or history of vertigo caused by central nervous disease; (v) absence of neuropathic pain, generalized pain, neurovascular headache, or any psychiatric disorder
The splints design was based on a posture-stabilometric evaluation to find out if a mandibular repositioning could both improve the postural arrangement of the body and reduce myofascial pain in the orofacial region
Summary
One of the most common TMDs’ clinical manifestations is temporomandibular myofascial pain (TMP) [5], which causes pain in orofacial region, and disability and deterioration of quality of life. This is a highly significant health problem and about 85% of the general population experience at least one episode during their lifetime, while the estimated overall prevalence is ∼46% [6]. Myofascial pain is a collection of sensory, motor, and autonomic symptoms that include local and referred pain, decreased range of motion, and weakness; and its main cause is believed to be attributable to myofascial trigger points (MTrPs) [7,8]. Investigations about myogenous and internal disorders of TMJ could be developed using the Research Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) to allow standardization and replication of the research on TMDs [10]
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