title: Additional effect of occlusal splints on the improvement of psychological aspects in temporomandibular disorder subjects: A randomized controlled trial.
abstract: OBJECTIVE
  To measure the effect of occlusal splints as an additional treatment on psychological aspects in temporomandibular disorder patients.
  
  
  METHODS
  A randomized controlled trial was performed comprising 60 adults diagnosed with masticatory myofascial pain according the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). The participants were divided equally into 2 treatment groups, which received only counselling (Group 1) or occlusal splints in addition to counselling (Group 2). The assessments occurred at baseline and at 2 and 5 months after treatment. The outcomes were symptoms of anxiety and depression, as well as pain catastrophizing. Two-way ANOVA, Friedman and Mann-Whitney tests were used to perform the statistical analysis, considering a significance level of 5%.
  
  
  RESULTS
  In relation to the baseline assessment, 60% of the subjects had at least mild anxiety and 25% had at least mild depression, and the mean and standard deviation (SD) of pain catastrophizing was 2.41 (1.33) for Group 1 and 2.06 (1.04) for Group 2. Comparisons between baseline and the fifth-month evaluation showed an improvement in anxiety and depression symptoms only in Group 2 (p<0.05). Otherwise, there was a significant reduction in pain catastrophizing in both groups (p<0.05), with a mean (SD) of 1.14 (1.28) for Group 1 and 0.76 (0.82) for Group 2.
  
  
  CONCLUSIONS
  Minimally invasive strategies could provide an improvement in the psychological aspects of temporomandibular disorder patients, and the use of an occlusal splint seems to hasten the manifestation of these effects.
authors.affiliation: Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil. Electronic address: yurimartinscosta@yahoo.com.br.
authors.forename: Yuri Martins
authors.initials: YM
authors.lastname: Costa
authors.affiliation: Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil.
authors.forename: André Luís
authors.initials: AL
authors.lastname: Porporatti
authors.affiliation: Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil.
authors.forename: Juliana
authors.initials: J
authors.lastname: Stuginski-Barbosa
authors.affiliation: Department of Biological Sciences, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil.
authors.forename: Leonardo Rigoldi
authors.initials: LR
authors.lastname: Bonjardim
authors.affiliation: Department of Prosthodontics, Bauru School of Dentistry, University of São Paulo, Bauru, Brazil.
authors.forename: Paulo César Rodrigues
authors.initials: PC
authors.lastname: Conti
mesh_terms: D000328:Adult; D001007:Anxiety / Q000453:epidemiology; D001938:Brazil; D003376:Counseling; D003863:Depression / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D017090:Occlusal Splints; D010147:Pain Measurement; D012307:Risk Factors; D013705:Temporomandibular Joint Disorders / Q000523:psychology* / Q000534:rehabilitation*; D016896:Treatment Outcome
keywords: Anxiety; Depression; Pain catastrophizing; Temporomandibular disorders