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Randomized Controlled Trial
. 2024 Aug;51(8):1566-1578.
doi: 10.1111/joor.13729. Epub 2024 May 17.

Physical therapy in addition to occlusal splint in myogenic temporomandibular disorders: A randomised controlled trial

Antonio Romeo  1 , Cristina Incorvati  1 , Carla Vanti  1 , Andrea Turolla  1   2 , Francesco Marinelli  3 , Luca Defila  1 , Chiara Gulotta  1 , Claudio Marchetti  1 , Paolo Pillastrini  1   2
Affiliations
Randomized Controlled Trial

Physical therapy in addition to occlusal splint in myogenic temporomandibular disorders: A randomised controlled trial

Antonio Romeo et al. J Oral Rehabil. 2024 Aug.

Abstract

Background: Myogenic temporomandibular disorders (M-TMD) commonly involve occlusal splint (OS) therapy and musculoskeletal physiotherapy (MPT).

Objectives: To compare the effects of combining OS with MPT and education (EG) against OS and education (CG), in chronic M-TMD patients.

Methods: In this double-blind randomised controlled trial, 62 participants were assigned to either EG or CG. The primary outcomes, pain levels at rest (VAS rest), maximum oral opening (VAS open) and during chewing (VAS chew), were measured by Visual Analogue Scale (VAS) in cm. The secondary outcome was the range of motion (ROM) for maximum oral opening. Both interventions lasted 3 months, with outcomes assessed at baseline (T0), post-treatment (T1) and 3 months post-treatment (T2).

Results: Intention-to-treat analysis revealed significant improvements favouring EG (VAS rest = -1.50 cm [CI95%: -2.67, -0.32], p = .04; VAS open = -2.00 cm [CI95%: -3.23, -0.75], p < .01; VAS chew = -1.71 cm [CI95%: -2.90, -0.52], p = .01; ROM = 4.61 [CI95%: 0.93, 8.30], p = .04). Additionally, VAS measures were influenced by follow-up times (VAS rest = -0.73 cm [CI95%: -1.30, -0.17], p = 0.03; VAS open = -0.97 cm [CI95%: -1.57, -0.37], p < .01; VAS chew = -1.15 cm [CI95%: -1.73, -0.58], p < .01). At T1, EG demonstrated higher number of responders compared to CG for VAS open (χ2(1) = 4.39, p = .04) and VAS chew (χ2(1) = 11.58, p < .01).

Conclusion: Adding MPT to education and OS yields better outcomes in terms of pain reduction and ROM improvement, in chronic M-TMD.

Trial registration number: NCT03726060.

Keywords: education; exercise therapy; manual therapy; musculoskeletal physiotherapy; occlusal splint; temporomandibular disorders.

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References

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