Treating temporomandibular disorders in adolescents : a randomized, controlled, sequential comparison of relaxation training and occlusal appliance therapy

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Treating temporomandibular disorders in adolescents : a randomized, controlled, sequential comparison of relaxation training and occlusal appliance therapy

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Publication Article, peer reviewed scientific
Title Treating temporomandibular disorders in adolescents : a randomized, controlled, sequential comparison of relaxation training and occlusal appliance therapy
Author(s) Wahlund, Kerstin ; Nilsson, Ing-Marie ; Larsson, Bo
Date 2015
English abstract
AIMS: To compare the effects of occlusal appliance therapy (OA) and therapist-guided relaxation training (RT) on temporomandibular disorder (TMD) pain in adolescents, thereby replicating a previous randomized controlled trial, and to explore whether additional therapy administered in a crossover sequential design improves treatment outcomes. METHODS: The study involved 64 adolescents, aged 12 to 19 years, experiencing TMD pain at least once a week and diagnosed with myofascial pain in accordance with the Research Diagnostic Criteria for TMD. For phase 1 of the study, subjects were randomly assigned to OA or RT; nonresponders were offered the other treatment in phase 2. Self-reports of TMD pain and clinical assessments were performed before and after treatment in each phase and 6 months after the last treatment phase. Differences in outcomes between treatment groups across the different phases were analyzed by analysis of covariance (ANCOVA), and for differences in proportions, the chi-square test was used. RESULTS: After phase 1, a significantly higher proportion of adolescents treated with OA (62.1%) than those treated with RT (17.9%) responded to treatment, defined as a subjective report of "Completely well/Very much improved" or "Much improved." Similar differences in self- report of treatment effect occurred after phase 2. About two-thirds of all adolescents in both phases reported such an improvement level at the 6-month follow-up, including a somewhat higher proportion of phase 1 responders (79.2%) than phase 1 nonresponders (60%). CONCLUSION: The findings suggest that, for adolescents with TMD pain, use of standardized clinical treatment with OA is more effective than RT on self-evaluation of treatment improvement. For nonresponders, subsequent crossover treatment might be useful to improve subjective TMD pain.
DOI http://dx.doi.org/10.11607/ofph.1285 (link to publisher's fulltext)
Publisher Quintessence
Host/Issue Journal of Oral & Facial Pain and Headache;1
Volume 29
ISSN 2333-0384
Pages 41-50
Language eng (iso)
Subject(s) Medicine
Research Subject Categories::ODONTOLOGY
Handle http://hdl.handle.net/2043/19662 (link to this page)

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