Comparison of treatment options for myogenous temporomandibular dysfunction

A randomized clinical trial which included a follow-up of one year was applied to 118 myogenous TMD-patients. The therapies investigated were: physiotherapy of the masticatory system or splint therapy for patients without occlusal interferences, and occlusal adjustment therapy or the combination of splint and occlusal adjustment therapy for patients with pronounced occlusal interferences. Counseling, which yielded a reduction of 27% of the scored pain intensity, will most likely eliminate any further need for treatment of patients with a low level of myogenous TMD signs and symptoms. Otherwise, physiotherapy might be preferred as a starting option with respect to splint therapy because of 1. A similar efficacy; 2. A shorter treatment duration so that either chronic facial pain is earlier relieved or a patient can undergo a second type of therapy earlier; and 3. Lower costs. One third of the patients selected had pronounced occlusal interferences. Using stringent criteria it might be possible to apply occlusal adjustment therapy without involvement of splint therapy yielding a similar therapy efficacy and with advantages of a shorter treatment duration and lower costs. All types of therapy diminished not only facial pain but also pain of neck and shoulder areas.