engleski

Effectiveness of Stabilization Splint Compared to Placebo in Temporomandibular Disorders

Objectives Stabilization splint is frequently recommended treatment for temporomandibular disorders (TMD). Although its role in TMD management is unclear, it might be attributed to various factors, including increase of vertical dimension, change of condylar position but also a placebo effect. In this randomized clinical trial aim was to compare long-term effectiveness of stabilization splint (SS) with that of placebo in TMD treatment. Differences in treatment outcomes based on diagnostic subgroups [disc displacement(DD)/myofascial pain(MP)] were also investigated. Methods Thirty-two female patients, diagnosed with chronic TMD, were classified in treatment groups: one provided with SS (made in centric relation, 2mm thick at first- molar level) and other with placebo (0.5mm thermoforming-foil). Six-month followup was carried out. Treatment outcomes included spontaneous pain [visual analogue scale(VAS)], maximal comfortable mouth opening (MCO), self-perceived quality of life (OHIP-14) and level of perceived stress (PSS). Repeated-measurements ANOVA was used, with time (within factor), and treatment group and diagnostic subgroup (between factors). Results At baseline there wasn't significant difference between groups for all measured parameters. Significant reduction of VAS and OHIP-14 scores over time was observed (p=0.0001, p=0.001 respectively) ; effect of treatment differed significantly between treatment groups, with greater reduction of VAS and OHIP-14 scores in SS comparing to placebo group (p=0.004, p=0.01 respectively). At all time points, MCO values were higher in SS comparing to placebo group (p= 0.03) and in MP comparing to DD (p= 0.03). Conclusions Study showed reduction of spontaneous pain followed by improvement of self-perceived quality of life in SS and placebo group, however in SS group the improvement of VAS and OHIP-14 scores was present at all time points, while in placebo only short-term effectiveness was observed. Significantly higher values of MCO were present in SS and MP groups. Although placebo might be contributing factor in management of TMD it likely cannot maintain constant long- term positive therapeutic effect.

temporomandibular disorders ; orofacial pain

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