Effectiveness of Ultrasound Therapy, TheraBite Device, Masticatory Muscle Exercises, and Stabilization Splint for the Treatment of Masticatory Myofascial Pain: A Randomized Controlled Trial

IF 1.7 Q3 DENTISTRY, ORAL SURGERY & MEDICINE Clinical and Experimental Dental Research Pub Date : 2024-06-24 DOI:10.1002/cre2.921

Kenaz Salloum, Mawia Karkoutly, Ibrahim Haddad, Jihad Abou Nassar

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Abstract

Background

Myofascial pain syndrome (MPS) is a particular type of temporomandibular joint disorder. Research findings comparing various treatment approaches are scarce and controversial. Therefore, this study aimed to compare the effectiveness of ultrasound therapy, stabilization splint, TheraBite device, and masticatory muscle exercises in reducing pain intensity and improving mandibular mobility in patients with MPS.

Methods

It was a single-blind, randomized, parallel-group, active-controlled trial that took place between April 2023 and October 2023 at the Department of Fixed Prosthodontics, Damascus University. Patients older than 18 years old with myofascial pain accompanied by limited jaw opening and pain lasting for at least 6 months were included. Eighty patients were randomly assigned into four groups using online randomization software: ultrasound therapy, stabilization splint, TheraBite device, and masticatory muscle exercises. Only outcome assessors were masked to treatment allocation. The exercise regimen was the exercise program for patients with TMD. The following primary outcome measures were considered at the baseline (t₀), at the first (t₁), second (t₂), and fourth (t₃) week of treatment, and at the second (t₄) and fifth (t₅) month of follow-up: pain intensity using the visual analogue scale, maximum interincisal opening, right lateral movement, and left lateral movement measured in millimeters.

Results

The pain level changed from severe to mild at t₃ in ultrasound therapy, stabilization splint, and TheraBite device groups. In the masticatory muscle exercises group, it changed to moderate, with a significant difference between ultrasound therapy (p = 0.012) and stabilization splint (p = 0.013) groups. In addition, the mandibular mobility continued to improve at the subsequent follow-up periods (t₄ and t₅).

Conclusions

All therapies are equally effective after 5-month follow-up. However, ultrasound therapy and stabilization splints have the benefit of achieving rapid improvement.

Trial Registration

ISRCTN20833186.

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超声波疗法、TheraBite 设备、咀嚼肌锻炼和稳定夹板治疗咀嚼肌筋膜疼痛的效果：随机对照试验。

背景：肌筋膜疼痛综合征（MPS）是颞下颌关节紊乱的一种特殊类型。对各种治疗方法进行比较的研究结果很少，而且存在争议。因此，本研究旨在比较超声波疗法、稳定夹板、TheraBite装置和咀嚼肌锻炼在减轻MPS患者疼痛强度和改善下颌活动度方面的效果：这是一项单盲、随机、平行组、主动对照试验，于 2023 年 4 月至 2023 年 10 月在大马士革大学固定义齿修复科进行。患者年龄在 18 岁以上，患有肌筋膜疼痛并伴有下颌张开受限，疼痛持续至少 6 个月。使用在线随机软件将 80 名患者随机分配到四组：超声波疗法组、稳定夹板组、TheraBite 装置组和咀嚼肌锻炼组。只有结果评估者对治疗分配进行了屏蔽。锻炼方案是针对 TMD 患者的锻炼计划。在基线（t0）、治疗第一周（t1）、第二周（t2）和第四周（t3）以及随访的第二个月（t4）和第五个月（t5）时，对以下主要结果进行了评估：使用视觉模拟量表测量的疼痛强度、最大incisal开口、右侧移动和左侧移动（以毫米为单位）：结果：超声波治疗组、稳定夹板组和 TheraBite 装置组的疼痛程度在第 3 个月时由严重变为轻微。在咀嚼肌锻炼组，疼痛程度变为中度，超声波治疗组（p = 0.012）和稳定夹板组（p = 0.013）之间差异显著。此外，下颌骨活动度在随后的随访期间（t4 和 t5）继续得到改善：结论：5 个月随访后，所有疗法都同样有效。结论：所有疗法在5个月的随访后都同样有效，但超声波疗法和稳定夹板具有快速改善的优点：试验注册：ISRCTN20833186。

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来源期刊

Clinical and Experimental Dental Research DENTISTRY, ORAL SURGERY & MEDICINE-

CiteScore

3.30

自引率

5.60%

发文量

165

审稿时长

26 weeks

期刊介绍： Clinical and Experimental Dental Research aims to provide open access peer-reviewed publications of high scientific quality representing original clinical, diagnostic or experimental work within all disciplines and fields of oral medicine and dentistry. The scope of Clinical and Experimental Dental Research comprises original research material on the anatomy, physiology and pathology of oro-facial, oro-pharyngeal and maxillofacial tissues, and functions and dysfunctions within the stomatognathic system, and the epidemiology, aetiology, prevention, diagnosis, prognosis and therapy of diseases and conditions that have an effect on the homeostasis of the mouth, jaws, and closely associated structures, as well as the healing and regeneration and the clinical aspects of replacement of hard and soft tissues with biomaterials, and the rehabilitation of stomatognathic functions. Studies that bring new knowledge on how to advance health on the individual or public health levels, including interactions between oral and general health and ill-health are welcome.