scholarly journals Effects of occlusal splint therapy in patients with migraine or tension-type headache and comorbid temporomandibular disorder

Medicine ◽  
2019 ◽  
Vol 98 (33) ◽  
pp. e16805
Author(s):  
Felix Joyonto Saha ◽  
Almut Pulla ◽  
Thomas Ostermann ◽  
Theresa Miller ◽  
Gustav Dobos ◽  
...  
Keyword(s):  
Temporomandibular Disorder ◽  
Tension Type Headache ◽  
Occlusal Splint ◽  
Splint Therapy ◽  
Type Headache

scholarly journals Internet-Based Multimodal Pain Program With Telephone Support for Adults With Chronic Temporomandibular Disorder Pain: Randomized Controlled Pilot Trial

10.2196/22326 ◽  
2020 ◽  
Vol 22 (10) ◽  
pp. e22326
Author(s):  
Julia Lam ◽  
Peter Svensson ◽  
Per Alstergren
Keyword(s):  
Pain Intensity ◽  
Temporomandibular Disorder ◽  
Functional Limitation ◽  
Pilot Trial ◽  
The Internet ◽  
Occlusal Splint ◽  
Splint Therapy ◽  
Randomized Controlled ◽  
Temporomandibular Pain

Background Chronic pain from temporomandibular disorders remains an undertreated condition with debate regarding the most effective treatment modalities. Objective The aim of the study was to investigate the treatment effect of an internet-based multimodal pain program on chronic temporomandibular disorder pain and evaluate the feasibility of a larger randomized controlled trial. Methods An unblinded randomized controlled pilot trial was conducted with 43 participants (34 females, 9 males; median age 27, IQR 23-37 years) with chronic temporomandibular pain. Participants were recruited within the Public Dental Health Service and randomized to intervention (n=20) or active control (n=23). The intervention comprised a dentist-assisted internet-based multimodal pain program with 7 modules based on cognitive behavior therapy and self-management principles. The control group received conventional occlusal splint therapy. Primary outcomes included characteristic pain intensity, pain-related disability, and jaw functional limitation. Secondary outcomes were depression, anxiety, catastrophizing, and stress. Outcomes were self-assessed through questionnaires sent by mail at 3 and 6 months after treatment start. Feasibility evaluation included testing the study protocol and estimation of recruitment and attrition rates in the current research setting. Results Only 49% of participants (21/43) provided data at the 6-month follow-up (internet-based multimodal pain program: n=7; control: n=14). Of the 20 participants randomized to the internet-based multimodal pain program, 14 started treatment and 8 completed all 7 modules of the program. Between-group analysis showed no significant difference for any outcome measure at 3- or 6-month follow-up—characteristic pain intensity (3 months: P=.58; 6 months: P=.41), pain-related disability (3 months: P=.51; 6 months: P=.12), jaw functional limitation (3 months: P=.45; 6 months: P=.90), degree of depression (3 months: P=.64; 6 months: P=.65), anxiety (3 months: P=.93; 6 months: P=.31), stress (3 months: P=.66; 6 months: P=.74), or catastrophizing (3 months: P=.86; 6 months: P=.85). Within-group analysis in the internet-based multimodal pain program group showed a significant reduction in jaw functional limitation score at the 6-month follow-up compared to baseline (Friedman: χ2=10.2, P=.04; Wilcoxon: z=–2.3, P=.02). In the occlusal splint group, jaw function limitation was also reduced at the 6-month follow-up (Friedman: χ2=20.0, P=.045; Wilcoxon: z=–2.3, P=.02), and there was a reduction in characteristic pain intensity at the 3- and 6-month follow-up (Friedman: χ2=25.1, P=.01; Wilcoxon 3 months: z=–3.0, P=.003; Wilcoxon 6 months: z=-3.3, P=.001). Conclusions This study was not able to demonstrate a difference in treatment outcome between an internet-based multimodal pain program and occlusal splint therapy in patients with chronic temporomandibular pain. However, the findings suggested that the internet-based multimodal pain program improves jaw function. The results also confirmed the treatment effect of occlusal splint therapy for chronic temporomandibular pain. Furthermore, because of the high attrition rate, this pilot study showed that a randomized controlled trial with this design is not feasible. Trial Registration ClinicalTrials.gov NCT04363762; https://clinicaltrials.gov/show/NCT04363762

scholarly journals Modern view on the problem of splint therapy in treatment of chronic tension type headache

2021 ◽  
Vol 38 (3) ◽  
pp. 61-67
Author(s):  
N. B. Astashina ◽  
N. L. Starikova ◽  
K. R. Valiakhmetova
Keyword(s):  
Health Status ◽  
Tension Headache ◽  
Tension Type Headache ◽  
Therapeutic Approaches ◽  
Chronic Tension Type Headache ◽  
Splint Therapy ◽  
Key Points ◽  
Conducting Research ◽  
Type Headache

The review presents the epidemiology of tension type headache. The key points of etiology, pathogenesis and clinical picture are described, modern therapeutic approaches to the treatment of chronic tension headache are considered. The data on the possibility of using prosthetic and splint therapy for correction of health status in patients with chronic tension type headache are presented. The necessity of conducting research aimed at determining the role of using occlusive splints and the significance of correcting occlusive relationships in chronic tension type headache is grounded.

Application of ICHD-II Criteria for Headaches in a TMJ and Orofacial Pain Clinic

Cephalalgia ◽  
2009 ◽  
Vol 30 (1) ◽  
pp. 37-41 ◽  
Author(s):  
J-K Kang ◽  
J-W Ryu ◽  
J-H Choi ◽  
RL Merrill ◽  
ST Kim
Keyword(s):  
Muscle Pain ◽  
Orofacial Pain ◽  
Temporomandibular Disorder ◽  
Age Groups ◽  
Primary Headache ◽  
Headache Disorder ◽  
Tension Type Headache ◽  
Pain Clinic ◽  
Temporal Muscle ◽  
Type Headache

The aim of this study was to identify and diagnose headache in a temporomandibular joint and orofacial pain clinic population using the second edition of The International Classification of Headache Disorder criteria. In 502 temporomandibular disorder and orofacial pain patients, 246 patients (49%) were diagnosed with tension-type headache (TTH), followed by migraine without aura (14.5%), probable migraine (12.9%), migraine with aura (7%), probable TTH (4.8%) and cluster headache (0.2%). The prevalence of headaches was compared between male and female patients, and the prevalence of migraine was found to be higher in women than in men. In evaluating by age, the prevalence of migraine was highest in patients in their 20s and 30s and declined as age increased above 40. TTH showed the highest rate throughout all age groups, but it also decreased as age increased. In this study, the prevalence of migraine was lower than that reported in Dr Kim et al.'s study, and the prevalence of TTH much higher than that reported in the previous study. Of the headache patients, 81.1% presented with masseter muscle pain and 47.8% with temporal muscle pain. This finding suggests that pericranial muscle pain may be an inducing factor of primary headache.

scholarly journals Internet-Based Multimodal Pain Program With Telephone Support for Adults With Chronic Temporomandibular Disorder Pain: Randomized Controlled Pilot Trial (Preprint)

2020 ◽  
Author(s):  
Julia Lam ◽  
Peter Svensson ◽  
Per Alstergren
Keyword(s):  
Pain Intensity ◽  
Temporomandibular Disorder ◽  
Functional Limitation ◽  
Pilot Trial ◽  
The Internet ◽  
Occlusal Splint ◽  
Splint Therapy ◽  
Randomized Controlled ◽  
Temporomandibular Pain

BACKGROUND Chronic pain from temporomandibular disorders remains an undertreated condition with debate regarding the most effective treatment modalities. OBJECTIVE The aim of the study was to investigate the treatment effect of an internet-based multimodal pain program on chronic temporomandibular disorder pain and evaluate the feasibility of a larger randomized controlled trial. METHODS An unblinded randomized controlled pilot trial was conducted with 43 participants (34 females, 9 males; median age 27, IQR 23-37 years) with chronic temporomandibular pain. Participants were recruited within the Public Dental Health Service and randomized to intervention (n=20) or active control (n=23). The intervention comprised a dentist-assisted internet-based multimodal pain program with 7 modules based on cognitive behavior therapy and self-management principles. The control group received conventional occlusal splint therapy. Primary outcomes included characteristic pain intensity, pain-related disability, and jaw functional limitation. Secondary outcomes were depression, anxiety, catastrophizing, and stress. Outcomes were self-assessed through questionnaires sent by mail at 3 and 6 months after treatment start. Feasibility evaluation included testing the study protocol and estimation of recruitment and attrition rates in the current research setting. RESULTS Only 49% of participants (21/43) provided data at the 6-month follow-up (internet-based multimodal pain program: n=7; control: n=14). Of the 20 participants randomized to the internet-based multimodal pain program, 14 started treatment and 8 completed all 7 modules of the program. Between-group analysis showed no significant difference for any outcome measure at 3- or 6-month follow-up—characteristic pain intensity (3 months: <i>P</i>=.58; 6 months: <i>P</i>=.41), pain-related disability (3 months: <i>P</i>=.51; 6 months: <i>P</i>=.12), jaw functional limitation (3 months: <i>P</i>=.45; 6 months: <i>P</i>=.90), degree of depression (3 months: <i>P</i>=.64; 6 months: <i>P</i>=.65), anxiety (3 months: <i>P</i>=.93; 6 months: <i>P</i>=.31), stress (3 months: <i>P</i>=.66; 6 months: <i>P</i>=.74), or catastrophizing (3 months: <i>P</i>=.86; 6 months: <i>P</i>=.85). Within-group analysis in the internet-based multimodal pain program group showed a significant reduction in jaw functional limitation score at the 6-month follow-up compared to baseline (Friedman: χ2=10.2, <i>P</i>=.04; Wilcoxon: z=–2.3, <i>P</i>=.02). In the occlusal splint group, jaw function limitation was also reduced at the 6-month follow-up (Friedman: χ2=20.0, <i>P</i>=.045; Wilcoxon: z=–2.3, <i>P</i>=.02), and there was a reduction in characteristic pain intensity at the 3- and 6-month follow-up (Friedman: χ2=25.1, <i>P</i>=.01; Wilcoxon 3 months: z=–3.0, <i>P</i>=.003; Wilcoxon 6 months: z=-3.3, <i>P</i>=.001). CONCLUSIONS This study was not able to demonstrate a difference in treatment outcome between an internet-based multimodal pain program and occlusal splint therapy in patients with chronic temporomandibular pain. However, the findings suggested that the internet-based multimodal pain program improves jaw function. The results also confirmed the treatment effect of occlusal splint therapy for chronic temporomandibular pain. Furthermore, because of the high attrition rate, this pilot study showed that a randomized controlled trial with this design is not feasible. CLINICALTRIAL ClinicalTrials.gov NCT04363762; https://clinicaltrials.gov/show/NCT04363762

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