The efficacy of traditional, low-cost and nonsplint therapies for temporomandibular disorder: a randomized controlled trial.
BACKGROUND
Treatment recommendations for patients with painful temporomandibular disorders (TMDs) range from conservative treatments such as physiotherapy to aggressive and irreversible treatments such as restorative reconstruction and joint surgery.


METHODS
The authors randomized 200 subjects diagnosed with TMD into three groups: usual conservative, dentist-prescribed self-care treatment without any intraoral splint appliance (UT); UT plus a conventional flat-plane hard acrylic splint (HS); and UT plus a soft vinyl (a low-cost athletic mouth guard) splint (SS). Subjects completed questionnaires and clinical examinations at three, six and 12 months.


RESULTS
The authors observed no significant differences among the groups in TMD-related pain levels or other common signs and symptoms of TMD at baseline (BL) or at any follow-up. The changes from BL were comparable for all three groups. The authors did not note any significant differences at any follow-up for compliance with study protocols or for occurrences of adverse effects from either splint type. For HS versus SS, there were significant differences in rates of splint use, but these differences were not accompanied by differences in either self-reported symptoms or in clinical findings.


CONCLUSIONS
All patients improved over time, and traditional splint therapy offered no benefit over the SS splint therapy. Neither splint therapy provided a greater benefit than did self-care treatment without splint therapy.


CONCLUSIONS
These findings suggest that clinicians who treat patients with TMD should consider prescribing low-cost nonsplint self-care therapy for most patients.
Truelove
Edmond
E
Department of Oral Medicine, School of Dentistry, University of Washington, Seattle, 98195, USA. edmondt@u.washington.edu
Huggins
Kimberly Hanson
KH
Mancl
Lloyd
L
Dworkin
Samuel F
SF
D000180:Acrylic Resins; D000293:Adolescent; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D005081:Exercise Therapy; D005260:Female; D005500:Follow-Up Studies; D006358:Hot Temperature / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008410:Masticatory Muscles / Q000503:physiopathology; D008875:Middle Aged; D009064:Mouth Protectors; D017090:Occlusal Splints; D010147:Pain Measurement; D010349:Patient Compliance; D017060:Patient Satisfaction; D016059:Range of Motion, Articular / Q000502:physiology; D012648:Self Care / Q000191:economics; D013705:Temporomandibular Joint Disorders / Q000191:economics / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome; D014753:Vinyl Compounds
D000180:Acrylic Resins; D000894:Anti-Inflammatory Agents, Non-Steroidal; D014753:Vinyl Compounds