title: Treatment outcome of headache after occlusal appliance therapy in a randomised controlled trial among patients with temporomandibular disorders of mainly arthrogenous origin.
abstract: The aim of this study was to evaluate headaches before and after treatment with a stabilisation appliance and a control appliance in a randomised controlled trial in patients having temporomandibular disorders (TMD) of mainly arthrogenous origin. The effect of treatment was evaluated both in a short and in long-term perspective. 60 patients (mean age 30 years) with TMD of mainly arthrogenous origin were studied. The patients were selected from patients referred for treatment of TMD during a 3-year period to the Department of Stomathognathic Physiology, Faculty of Odontology, Malmö University. The 60 patients included in the study were randomly assigned to a treatment (T) or a control (C) group. The study was performed as a randomised controlled trial including evaluation of treatment effect on tension-type headache after 10 weeks, 6 and 12 months. At the 10 weeks follow-up, the patients who reported a negative treatment outcome and/or discomfort associated with the use of the appliances had their appliances readjusted. Patients who demanded further treatment received a stabilisation appliance (21 patients from the C-group), creating a new mixed (M) group. All the 60 patients reported frequency of headache from rarely up to daily at the start of the study. In the T-group 76% and in the C-group 83% of the patients reported headache at least once a week or more before treatment. At the 10 weeks follow-up, a statistically significant difference was found regarding headache several times a week or more between the T- and C-groups and within the T-group. At the 6 months follow-up, a statistically significant reduction was found in headache several times a week or more in the T- and M-groups. The number of patients with headache once a week or more decreased significantly in the T- and M-groups at the 12 months follow-up. We conclude that the stabilisation appliance seems to have an effect on the frequency of tension-type headache both in a short and in a long-term perspective in patients with TMD of mainly arthrogenous origin.
authors.affiliation: Department of Stomatognathic Physiology, Faculty of Odontology, Malmö University, Malmö, Sweden. ewacarin.ekberg@od.mah.se
authors.forename: EwaCarin
authors.initials: E
authors.lastname: Ekberg
authors.forename: Danila
authors.initials: D
authors.lastname: Vallon
authors.forename: Maria
authors.initials: M
authors.lastname: Nilner
mesh_terms: D000328:Adult; D018771:Arthralgia / Q000150:complications / Q000628:therapy; D016009:Chi-Square Distribution; D004311:Double-Blind Method; D005157:Facial Pain / Q000209:etiology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008410:Masticatory Muscles / Q000503:physiopathology; D017090:Occlusal Splints; D010147:Pain Measurement; D011446:Prospective Studies; D013705:Temporomandibular Joint Disorders / Q000150:complications* / Q000628:therapy*; D018781:Tension-Type Headache / Q000209:etiology / Q000628:therapy*; D016896:Treatment Outcome