Abstract
BackgroundThe efficacy of stabilization appliance therapy for masticatory muscle pain is debated. Therefore, there are currently no clear usage standards. We analyzed patient factors influencing its efficacy and characterized masticatory muscle pain subtypes to determine appropriate therapy candidates.MethodsThis case series study recruited patients diagnosed with local myalgia or myofascial pain and used variables related to temporomandibular disorders in the analysis. We used temporary appliance to screen patients for sleep bruxism for 2 weeks. Afterwards, we initiated therapy with stabilization appliances. Efficacy was evaluated via tenderness intensity during muscle palpation and the treatment satisfaction score after 2 months of treatment.ResultsWe analyzed 62 (91%) patients. Tenderness upon muscle palpation was mitigated in 27 patients. Mitigated tenderness odds ratios were 0.035 for myofascial pain, 0.804 for 15‐item Patient Health Questionnaire scores, and 1.915 for facet length. Thirty‐nine patients expressed satisfaction; satisfaction odds ratios were 0.855 for 9‐item Patient Health Questionnaire scores, 1.606 for facet length, and 4.023 for awake bruxism awareness.ConclusionsStabilization appliance therapy is most effective for patients with awake bruxism awareness, local myalgia, long facets, and no psychosocial risk factors.
Highlights
IntroductionThe efficacy of stabilization appliance therapy for masticatory muscle pain is debated
Psychosocial factors influence the risk of developing chronic lower back pain and other musculoskeletal disorders,(Hasenbring, Hallner, & Klasen, 2001) including chronic temporomandibular disorder (TMD).(Harper, Schrepf, & Clauw, 2016; Slade et al, 2016) We found that high 9-item Patient Health Questionnaire (PHQ-9) scores were significantly associated with dissatisfaction with treatment and that high 15-item Patient Health (PHQ-15) scores were associated with visual analog scale (VAS) scores indicating a lack of improvement
Our results showed that higher PHQ-9 scores were associated with lower likelihoods of satisfaction with Stabilization appliance therapy (SAT), whereas higher PHQ15 scores were associated with lower likelihoods of experiencing improvements, as reflected in VAS scores
Summary
The efficacy of stabilization appliance therapy for masticatory muscle pain is debated. We analyzed patient factors influencing its efficacy and characterized masticatory muscle pain subtypes to determine appropriate therapy candidates. Methods: This case series study recruited patients diagnosed with local myalgia or myofascial pain and used variables related to temporomandibular disorders in the analysis. Efficacy was evaluated via tenderness intensity during muscle palpation and the treatment satisfaction score after 2 months of treatment. Mitigated tenderness odds ratios were 0.035 for myofascial pain, 0.804 for 15-item Patient Health Questionnaire scores, and 1.915 for facet length. Thirty-nine patients expressed satisfaction; satisfaction odds ratios were 0.855 for 9-item Patient Health Questionnaire scores, 1.606 for facet length, and 4.023 for awake bruxism awareness. Conclusions: Stabilization appliance therapy is most effective for patients with awake bruxism awareness, local myalgia, long facets, and no psychosocial risk factors
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