Chronic orofacial pain Oral Health Temporomandibular joint dysfunction
Conditions
Interventions
For group I as well as group II, treatment outcome of the first type of therapy (physiotherapy or OA respectively) is evaluated in comparison to that of the second type of therapy (solely splint thera
Sponsors
University Medical Centre Utrecht
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Age between 18 and 65 years 2. Female or male 3. Pain and tenderness of the masticatory muscles (in the absence of Temporomandibular Joint pathology, solely myogenous TMD), of 3 months duration or longer 4. A good understanding of Dutch Added 07/12/2016: 5. Only for group II: Pronounced occlusal interferences, i.e. (i) a forward sliding of at least 2 mm and/or lateral sliding of at least 1 mm with respect to centric occlusion; and (ii) an interference on the non-active side that is not accompanied with contact on the active side 6. Only for group II: Feasibility of occlusal adjustment by grinding in a conservative way; assessment by mounting the patient’s dental casts in a semi-adjustable articulator
Exclusion criteria
Exclusion criteria: 1. Clinical and/or radiographic evidence of organic changes in the temporomandibular Joints 2. Previous treatment with an occlusal stabilization appliance, occlusal adjustment, or physiotherapy of the masticatory system 3. Other treatments for pain (also nonfacial pain) more recent than a year 4. Predominant craniovertebral dysfunction (pain of neck and/or shoulders that predominates that of facial areas) 5. Metabolic, neurologic, vascular disease, or disorders (eg, diabetes, neuralgia, migraine) 6. Recent dramatic life event (divorce, bereavement, physical abuse by partner, incest, and victim of criminal assault) and/or psychotherapy and/or use of psycho-medication 7. Odd sleep/wake cycles due to work shift 8. Gross anomalies of the natural dentition: full/partial denture, loss of dorsal support, collapsed bite, extensive migrations, or morphological malocclusion (eg, cross bite) 9. Only for group I: Pronounced occlusal interferences, i.e. (i) ) a forward sliding of at least 2 mm and/or lateral sliding of at least 1 mm with respect to centric occlusion; and (2) an interference on the non-active side that is not accompanied with contact on the active side
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| 1. Number of visits/duration of treatment used 2. Success rate based on post-treatment TDC 3. Effectiveness based on post-treatment TDC While number of visits/duration of treatment are known at the end of treatment, success rate and effectiveness are determined following treatment, i.e. after 4 weeks, 6 months and 12 months. | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. Predominant pain intensity of the masticatory system, , scored on a 100 mm Visual Analogue Scale (VAS) at the initial visit with diagnosis (4 weeks before the start of treatment), at the start of treatment, and following treatment, i.e. after 4 weeks, 6 months and 12 months Added 07/12/2016: 2. Mean actual pain intensity, scored on 100 mm VASs for 13 facial areas and 11 non-facial areas (neck and shoulder areas) which are depicted on illustrations of head, neck and shoulders from both sides of the body. These illustrations and VASs are included in the Pain Location Questionnaire 3. General Health-related Quality of Life, measured using utility values of Euroqol-5D (EQ-5D) Both measured at the start of treatment, and following treatment, i.e. after 4 weeks, 6 months and 12 months | — |
Countries
Netherlands
Outcome results
None listed