title: Comparison of three different options for immediate treatment of painful temporomandibular disorders: a randomized, controlled pilot trial.
abstract: OBJECTIVE
  The purpose of this study was to compare the short-term effectiveness of three different types of immediate, non-pharmacological intervention for alleviation of the painful symptoms of temporomandibular disorders (TMD).
  
  
  METHODS
  Thirty-six patients (mean age 41.6 ± 16.7 years, 25 females) diagnosed with non-dysfunctional painful TMD received counselling and subsequently were randomly allocated to three treatment groups: patients in Group A received prefabricated oral splints with water-filled elastic pads (Aqualizer(®)), those in Group B were provided with vacuum-formed co-polyester oral splints and those in Group C were given appointments to receive Michigan-type hard splints. Clinical examination was conducted, at baseline and after 2 weeks, by use of the RDC/TMD. Current pain intensity was determined by evaluation of graded chronic pain status (GCPS) on a numerical rating scale (NRS). Active maximum mouth opening without pain (AMMOP) was also measured. Paired sample t-tests and one-way analysis of variance with a significance level of p ≤ 0.05 were conducted.
  
  
  RESULTS
  After 2 weeks, overall mean current pain was reduced by 41.95% (p < 0.001). Current pain reduction was significant for Group B (66.6%, p < 0.001) but not for Groups A (37.88%, p = 0.56) and C (22.29%, p = 0.26). After 2 weeks, current pain level for Group B was significantly lower than that for Group C (p = 0.041). Overall, there was a statistically significant increase of AMMOP (p = 0.01).
  
  
  CONCLUSIONS
  All therapeutic options were pain-reducing. The results from this study suggest that cost-effective and time-effective intervention of counselling combined with use of a vacuum-formed splint is a favourable option for initial, short-term treatment of painful TMD.
authors.affiliation: a Department of Prosthodontics , University of Heidelberg , Heidelberg , Germany ;
authors.forename: Nikolaos N
authors.initials: NN
authors.lastname: Giannakopoulos
authors.affiliation: b Department of Orthodontics , University of Heidelberg , Heidelberg , Germany.
authors.forename: Eleni N
authors.initials: EN
authors.lastname: Katsikogianni
authors.affiliation: a Department of Prosthodontics , University of Heidelberg , Heidelberg , Germany ;
authors.forename: Daniel
authors.initials: D
authors.lastname: Hellmann
authors.affiliation: a Department of Prosthodontics , University of Heidelberg , Heidelberg , Germany ;
authors.forename: Lydia
authors.initials: L
authors.lastname: Eberhard
authors.affiliation: a Department of Prosthodontics , University of Heidelberg , Heidelberg , Germany ;
authors.forename: Michael
authors.initials: M
authors.lastname: Leckel
authors.affiliation: a Department of Prosthodontics , University of Heidelberg , Heidelberg , Germany ;
authors.forename: Hans J
authors.initials: HJ
authors.lastname: Schindler
authors.affiliation: a Department of Prosthodontics , University of Heidelberg , Heidelberg , Germany ;
authors.forename: Marc
authors.initials: M
authors.lastname: Schmitter
mesh_terms: D000328:Adult; D000368:Aged; D005157:Facial Pain / Q000209:etiology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008334:Mandible / Q000503:physiopathology*; D008875:Middle Aged; D017090:Occlusal Splints; D010147:Pain Measurement; D013705:Temporomandibular Joint Disorders / Q000150:complications / Q000628:therapy*; D055815:Young Adult
keywords: Counselling; occlusal splints; orofacial pain