Additional effect of occlusal splints on the improvement of psychological aspects in temporomandibular disorder subjects: A randomized controlled trial

Abstract

Objective: To measure the effect of occlusal splints as an additional treatment on psychological aspects in temporomandibular disorder patients.

Design: A randomized controlled trial was performed comprising 60 adults diagnosed with masticatory myofascial pain according the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). The participants were divided equally into 2 treatment groups, which received only counselling (Group 1) or occlusal splints in addition to counselling (Group 2). The assessments occurred at baseline and at 2 and 5 months after treatment. The outcomes were symptoms of anxiety and depression, as well as pain catastrophizing. Two-way ANOVA, Friedman and Mann-Whitney tests were used to perform the statistical analysis, considering a significance level of 5%.

Results: In relation to the baseline assessment, 60% of the subjects had at least mild anxiety and 25% had at least mild depression, and the mean and standard deviation (SD) of pain catastrophizing was 2.41 (1.33) for Group 1 and 2.06 (1.04) for Group 2. Comparisons between baseline and the fifth-month evaluation showed an improvement in anxiety and depression symptoms only in Group 2 (p<0.05). Otherwise, there was a significant reduction in pain catastrophizing in both groups (p<0.05), with a mean (SD) of 1.14 (1.28) for Group 1 and 0.76 (0.82) for Group 2.

Conclusion: Minimally invasive strategies could provide an improvement in the psychological aspects of temporomandibular disorder patients, and the use of an occlusal splint seems to hasten the manifestation of these effects.

Keywords: Anxiety; Depression; Pain catastrophizing; Temporomandibular disorders.