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Temporary bite-raising onlays vs. stabilization splints for the management of pain-related temporomandibular
Francesca Agostini1, Roberto Ursini1, Antonino Fiorino2
1Postgraduate School of Orthodontics, the Catholic University of the Sacred Heart, Rome, Italy.
Background:
Management goals for patients with temporomandibular disorders (TMDs) include reducing pain, improving function and resuming normal daily activities.
Objectives:
The present retrospective study compared the effectiveness and efficiency of 2 different gnathological treatment options - temporary bite-raising onlays (TBR) and stabilization splints (SS) - for the management of pain-related TMDs.
Material And Methods:
Medical records of 86 patients treated in the Department of Orthodontics of the Agostino Gemelli University Hospital IRCCS, Rome, Italy, were retrieved: 43 patients were treated with TBR; and 43 with SS. We included adult patients (aged 18-65 years) of both sexes, with a diagnosis of pain-related TMDs according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), treated with TBR or SS, with no systemic diseases or comorbidities, who provided written informed consent for the use of their clinical data. The outcomes assessed were the presence of pain and reduced mouth opening (<40 mm) at the end of treatment, the number of clinical check-ups and appliance adjustments, the overall treatment duration, self-reported patient discomfort, and the time frame within which patients experienced improvement.
Results:
Temporary bite-raising onlays on molars achieved significantly higher pain recovery rates than SS in patients with pain-related TMDs (88.4% vs. 66.1%; p < 0.05). With regard to functional improvement in mouth opening, TBR and SS yielded comparable results, with no statistically significant difference between the groups (83.3% vs. 78.6%). Treatment with TBR was shorter than SS treatment, and required fewer clinical check-ups and repetitive occlusal adjustments. The initial self-reported discomfort was slightly more prevalent among TBR patients than among SS patients, while the initial improvement in pain symptomatology occurred earlier in the SS group. Overall, TBR was associated with a higher, although not statistically significant, prevalence of the initial self-reported discomfort, whereas SS was associated with statistically significantly earlier symptom relief.
Conclusions:
Despite the initial discomfort, TBR could be considered an effective and time-efficient treatment option for pain management in patients with pain-related TMDs.