Musculoskeletal Diseases Clinical Trial
Official title:
The Efficacy of Occlusal Stabilization Appliance Associated to Counseling in the Management of Myofascial Pain Chronic and in the Improvement of the Quality of Life of Patients With Temporomandibular Disorders
The aim of this study was to evaluate the effectiveness of the splint occlusal associated with counseling in reducing pain in patients with temporomandibular disorders, under the assumption that the occlusal appliance offers the highest rates of improvement than their placebo.
- The aim of this double-blind randomized control trial was to evaluate the efficacy of
occlusal stabilization appliance associated to counseling in the management of
myofascial pain chronic and in the improvement of the quality of life of patients with
temporomandibular disorders (TMD).
- In order to reduce the likelihood of systematic errors and allow the use of statistical
tests is used randomization processes or randomization of the volunteers in the
different groups from a sequence generated by a specific program (Randomization.com),
and the principal investigator masked for this division. For this, a second researcher,
appointed to undertake the division of patients into groups that maintain confidential
information from groups and their participants, revealing only the researcher therapist
at the time of first therapy session. The number of individuals randomized to the
experimental group will be equal to the control group.
1. Study Group Intervention The reversible occlusal therapy by stabilizing appliance
used by patients in Study Group shall be made by the same dental technician and
will be adjusted by the same dentist, therapist represented by the researcher.
Will be played simultaneous occlusal contacts in centric relation position and
malocclusion by canine and protrusive guides. The patients will be assessed at
weekly intervals (between the query and the following board installation) and then
biweekly during the period of 90 days. There shall be a gradual reduction in the
daily use of the plate, and the first two weeks the device is indicated for 24
hours a day, being removed only for eating and cleaning. At each visit clinical
follow-up, shall be established a gradual reduction in the time of use so that the
last three weeks of treatment are achieved 8h/day use.
2. Control Group Intervention The non-occlusive splint (placebo) will also be made by
the same dental technician. They differ by the plates did not interfere with the
occlusal tooth gear, i.e., do not alter the position of closing jaws. As not lead
acrylic on the occlusal surfaces of teeth, adequate retention is given by an arch
wire in orthodontic buccal surface of teeth. They are adjusted based on the
verification of the occlusion, so that the card does not interfere with movements
or maximum intercuspation excursive lateral and protrusion, so that only the
patient's teeth come into contact, without interference from the resin and the
acrylic staple . The assessment of these patients occur at the same intervals
recommended for patients in the experimental group being established on the same
treatment protocol with respect to the daily use of the plate.
- In this study, all patients (study and control group) will undergo a counseling
approach/self-care. Patients receive oral and written instructions about self-care,
including, in addition to instructions on their condition of TMD and an explanation of
the possible factors that contribute to the etiology of the same. The program also
includes self-care guidelines on the use of moist heat or ice, use of soft diet,
reduction of parafunctional habits (such as clenching and grinding your teeth or
chewing gum), holding the rest of the postural position of the jaw (teeth apart , lips
and tongue touching slightly pushing the front teeth), performing simultaneous
bilateral chewing and modify posture to sleep. This approach will be reinforced
verbally at each subsequent session.
;
Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Double Blind (Subject, Caregiver, Investigator), Primary Purpose: Treatment
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