Do psychological factors and general health influence the short-term efficacy of resilient appliance therapy in patients with temporomandibular disorder pain?
OBJECTIVE
To study how sense of coherence (SOC), grade of depression and non-specific physical symptoms and general health influence the efficacy of intraoral appliance therapy in patients with temporomandibular disorder (TMD) pain. A second objective was to study the association between SOC, grade of depression, grade of non-specific physical symptoms and general health.


METHODS
A total of 73 TMD pain patients participated; 36 were treated with a resilient appliance and 37 with a non-occluding control appliance in a randomized controlled trial for a period of 10 weeks. All patients had at least one pain diagnosis according to the research diagnostic criteria for TMD, including both the Symptom Checklist-90-Revised (Axis II) measuring grade of depression and non-specific physical symptoms, and general health (physical characteristics). Patients also filled in the 29-item SOC questionnaire.


RESULTS
A low grade of SOC was found in eight of the patients in the treatment group and in 17 of the control group at baseline, with a statistically significant difference between the groups. Logistic regression analyses revealed that, after correcting for the background variables, the resilient appliance did not differ from the non-occluding control appliance in terms of treatment outcome. No statistically significant differences were found when correlating mean SOC with grade of depression, grade of non-specific physical symptoms and general health.


CONCLUSIONS
These findings indicate that none of the studied background variables (age, gender, SOC, depression, non-specific physical symptoms or general health) seemed to influence the short-term efficacy of intraoral appliances. No association was found between SOC and depression, non-specific physical symptoms or general health in TMD pain patients.
Nilsson
Håkan
H
Department of Stomatognathic Physiology, Malmö University, Malmö, Sweden. Hakan.Nilsson@mah.se
Ekberg
Ewacarin
E
D000328:Adult; D000367:Age Factors; D000704:Analysis of Variance; D018771:Arthralgia / Q000209:etiology / Q000523:psychology; D003863:Depression / Q000150:complications*; D005157:Facial Pain / Q000209:etiology / Q000523:psychology*; D005260:Female; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008297:Male; D017090:Occlusal Splints; D060685:Sense of Coherence; D012737:Sex Factors; D016037:Single-Blind Method; D011795:Surveys and Questionnaires; D013705:Temporomandibular Joint Disorders / Q000150:complications / Q000523:psychology* / Q000628:therapy*; D055815:Young Adult