Institute of Dentistry, University of Eastern Finland, Kuopio, Finland.
Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland.
J Oral Rehabil. 2020 Feb;47(2):123-131. doi: 10.1111/joor.12884. Epub 2019 Nov 9.
Temporomandibular disorders (TMDs) include pain and dysfunction in masticatory muscles and temporomandibular joints (TMJs). Applied relaxation (AR) is a coping skill that may be applicable for treatment of TMD.
The aim of this randomised, controlled study was to evaluate the effectiveness of AR as compared to stabilisation splint (SS), for treatment of TMD during 12-month follow-up.
The data were derived from 96 university students seeking treatment due to TMD symptoms at Finnish Student Health Service in Finland. The subjects were randomly divided into two treatment groups: SS (n = 41) and AR (n = 51) groups. Clinical TMD examinations (a modified version of DC/TMD, Axis I) were performed for both the groups at baseline and 3-, 6- and 12-month follow-ups. Depressive and non-specific physical symptoms (NSPS) were estimated with Axis II questionnaire (RDC/TMD), and a number of other pain sites were screened at baseline and 12-month follow-up. Data were analysed by means of chi-square test for both groups on five variables, t test for VAS pain intensity and repeated measures ANOVA for palpation pain at follow-up points. Statistical significance was set on P < .05.
Decrease in the number of painful masticatory muscles and TMJs and VAS on pain intensity did not differ between groups. During follow-up, NSPS and number of body pain sites decreased significantly more in the AR than the SS group. The dropout was 56 patients.
Neither of the treatments showed more benefit in decreasing local TMD pain. AR gave more benefit on psychological well-being and general pain symptoms.
颞下颌关节紊乱症(TMD)包括咀嚼肌和颞下颌关节(TMJ)的疼痛和功能障碍。应用放松(AR)是一种应对技能,可能适用于 TMD 的治疗。
本随机对照研究的目的是评估 AR 与稳定夹板(SS)相比在 12 个月随访期间治疗 TMD 的效果。
数据来自芬兰大学生健康服务中心因 TMD 症状寻求治疗的 96 名大学生。将受试者随机分为两组:SS 组(n=41)和 AR 组(n=51)。对两组患者在基线和 3、6 和 12 个月随访时进行临床 TMD 检查(DC/TMD 的改良版,轴 I)。使用 RDC/TMD 轴 II 问卷评估抑郁和非特异性躯体症状(NSPS),并在基线和 12 个月随访时筛查其他多个疼痛部位。对两组的五个变量进行卡方检验,对 VAS 疼痛强度进行 t 检验,对随访点的触诊疼痛进行重复测量方差分析。P<.05 为统计学意义。
咀嚼肌和 TMJ 的疼痛部位减少和 VAS 疼痛强度在两组之间没有差异。在随访期间,AR 组的 NSPS 和身体疼痛部位数量明显少于 SS 组。脱落率为 56 例。
两种治疗方法在减轻局部 TMD 疼痛方面均未显示出更多益处。AR 在心理幸福感和一般疼痛症状方面的益处更大。