Evaluation of craniocervical posture after myofascial pain treatment in adults with bruxism: A randomized clinical trial

Abstract

Background: Despite numerous clinical studies on bruxism management, critical evaluation parameters, including the impact of bruxism pain on quality of life and secondary issues like changes in craniocervical posture, are often disregarded.

Research question: Evaluate the effect of two treatments on the craniocervical posture of adult patients with myofascial pain.

Methods: This parallel randomized clinical trial included 60 patients with myofascial pain due to probable bruxism that fulfilled the study requirements. A computer-generated random sequence was used to allocate treatments: botulinum toxin-A or occlusal appliance. Follow-up time was 3 and 6 months. Kyphosis angle (α) and head posture measurement by cervical radiograph were assessed using two-way repeated measures ANOVA (alpha = 0.05).

Results: Sixty patients were randomized (mean age 30 ± 7.6) and 6 were excluded from the analysis (did not attend follow-up). No statistically significant difference was observed for the head posture measure (p = 0.98) and kyphosis angle (p = 0.74). Mild pain was reported by one patient after botulinum toxin-A application.

Significance: Results indicate that craniofacial posture does not seem to be influenced by the treatment of pain in bruxers. If a better posture is desired, this should probably be targeted with other therapies.

Trial registration: Clinical Trials NCT03456154.

Keywords: Botulinum toxins; Cervical vertebrae; Occlusal splints; Orofacial pain; Type A.