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Pain is an unpleasant sensory and emotional experience that is one of the main symptoms of temporomandibular disorder (TMD). One way to assess pain is through algometry. The aim of this study was to evaluate, by the pressure pain threshold measurements, the efficacy of a short-term conservative treatment for the management of temporomandibular disorders. This study is a randomized controlled clinical trial where 84 participants were diagnosed with myofascial pain according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD), with a mean age of 44 years old ranging from 18 to 76 years old. These individuals were asked about parafunctional habits and the treatment was applied by providing an explanation concerning the role of pain, possible aetiological factors of the patient's TMD, the relationship between chronic pain and psychosocial distress, and its benign character. They also had to perform once daily application of hot packs on both sides of the face for 20 minutes and after that they must perform active free therapeutic exercise of mouth opening for 10 times. The pressure pain threshold of the masseter and temporalis muscles and the lateral pole of the condyle were obtained at baseline (T0), between 15 and 30 days after (T1) and at 75 to 90 days after (T2) representing the end of the treatment. Two groups of subjects were obtained. The first was considered the study group (SG) and included those who underwent the treatment proposed. The control group (CG) consisted of participants who did not undergo treatment because they did not believe in it.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| counseling and exercises | Active Comparator | These individuals were asked about parafunctional habits and the treatment was applied by providing an explanation concerning the role of pain, possible aetiological factors of the patient's TMD, the relationship between chronic pain and psychosocial distress, and its benign character. They also had to perform once daily application of hot packs on both sides of the face for 20 minutes and after that they must perform active free therapeutic exercise of mouth opening for 10 times |
|
| lifestyle counseling | Placebo Comparator | These individuals were asked about parafunctional habits and the treatment was applied by providing an explanation concerning the role of pain, possible aetiological factors of the patient's TMD, the relationship between chronic pain and psychosocial distress, and its benign character. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| counseling and exercises | Behavioral | These individuals were asked about parafunctional habits and the treatment was applied by providing an explanation concerning the role of pain, possible aetiological factors of the patient's TMD, the relationship between chronic pain and psychosocial distress, and its benign character. They also had to perform once daily application of hot packs on both sides of the face for 20 minutes and after that they must perform active free therapeutic exercise of mouth opening for 10 times |
| Measure | Description | Time Frame |
|---|---|---|
| pressure pain threshold (PPT) in Kilogram-force (Kgf) | -pressure pain threshold (PPT) from masseter and temporalis muscles, and lateral pole of the condyle in both sides of the face. It was measured with a digital algometer. | at baseline (first appointment) |
| pressure pain threshold (PPT) in Kilogram-force (Kgf) | -pressure pain threshold (PPT) from masseter and temporalis muscles, and lateral pole of the condyle in both sides of the face. It was measured with a digital algometer. | 3 to 4 weeks (second appointment) |
| pressure pain threshold (PPT) in Kilogram-force (Kgf) | pressure pain threshold (PPT) from masseter and temporalis muscles, and lateral pole of the condyle in both sides of the face. It was measured with a digital algometer. | 10 to 12 weeks (last appointment) |
| Measure | Description | Time Frame |
|---|---|---|
| Visual analogue scale (VAS). A line with 100mm where in one extremity its wrote "no pain" and in the end of the line its wrote "the worst pain" | - Visual analogue scale (VAS) for measuring pain. | at baseline (first appointment) |
| Verbal numerical scale (VNS) is a 11- point scale (0 to 10) |
| Measure | Description | Time Frame |
|---|---|---|
| oral health impact profile - (OHIP-14) modified | It's a questionnaire to avaliate the impact profile of his temporomandibular joint condition and pain on his lifestyle. | at baseline (first appointment) |
| Catastrophizing scale of the coping strategies questionnaire (CSQ) |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Luis G Alonso, PhD | Federal University of São Paulo | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ambulatorio de Disfunção Temporomandibular e Dor Orofacial | São Paulo | São Paulo | 04023-061 | Brazil |
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| ID | Term |
|---|---|
| D010146 | Pain |
| D005157 | Facial Pain |
| ID | Term |
|---|---|
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D003376 | Counseling |
| D015444 | Exercise |
| ID | Term |
|---|---|
| D008605 | Mental Health Services |
| D004191 | Behavioral Disciplines and Activities |
| D003153 | Community Health Services |
| D006296 | Health Services |
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|
| lifestyle counseling | Behavioral |
|
- Verbal numerical scale (VNS) for measuring pain. Ask the patient to quantify his pain in a 11-point pain scale, where 0 is no pain and 10 the worst pain he ever had. |
| at baseline (first appointment) |
| Visual analogue scale (VAS). A line with 100mm where in one extremity its wrote "no pain" and in the end of the line its wrote "the worst pain" | Visual analogue scale (VAS) for measuring pain. | 3 to 4 weeks (second appointment) |
| Visual analogue scale (VAS). A line with 100mm where in one extremity its wrote "no pain" and in the end of the line its wrote "the worst pain" | Visual analogue scale (VAS) for measuring pain. | 10 to 12 weeks (last appointment) |
| Verbal numerical scale (VNS) is a 11- point scale (0 to 10) | Verbal numerical scale (VNS) for measuring pain. Ask the patient to quantify his pain in a 11-point pain scale, where 0 is no pain and 10 the worst pain he ever had. | 3 to 4 weeks (second appointment) |
| Verbal numerical scale (VNS) is a 11- point scale (0 to 10) | Verbal numerical scale (VNS) for measuring pain. Ask the patient to quantify his pain in a 11-point pain scale, where 0 is no pain and 10 the worst pain he ever had. | 10 to 12 weeks (last appointment) |
CSQ - coping strategies questionnaire To avaliate how catastrophizing toughts are present before and after treatment protocol was applied. |
| at baseline (first appointment) |
| oral health impact profile - (OHIP-14) modified | It's a questionnaire to avaliate the impact profile of his temporomandibular joint condition and pain on his lifestyle. | 10 to 12 weeks (last appointment) |
| Catastrophizing scale of the coping strategies questionnaire (CSQ) | CSQ - coping strategies questionnaire To avaliate how catastrophizing toughts are present before and after treatment protocol was applied. | 10 to 12 weeks (last appointment) |
| D005159 | Health Care Facilities Workforce and Services |
| D009043 | Motor Activity |
| D009068 | Movement |
| D009142 | Musculoskeletal Physiological Phenomena |
| D055687 | Musculoskeletal and Neural Physiological Phenomena |