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The role of occlusal splints (soft and hard) in the management of Myofascial Pain Dysfunction Syndrome | ||
| Journal of baghdad college of dentistry | ||
| Article 1, Volume 23, Issue 2, 2011, Pages 61-69 | ||
| Authors | ||
| Ali Abd Al-Hur Al-Ibrahemy; Sabah Moshi Saka; Hajer Ibrahem Abdulla | ||
| Abstract | ||
| ABSTRACTBackground: The term temporomandibular disorders (TMDs) are a collective term embracing a number of clinicalproblems that involve the masticatory muscles, the temporomandibular joints (TMJ) and associated structures, orboth. The TMDs can be broadly divided into masticatory muscle disorders (TMJ dysfunction syndrome) and TMJdisorders. Dysfunction of the masticatory muscles or myofascial pain dysfunction syndrome (MPDS) is relativelycommon. The occlusal interferences theory and psychophysiological theory are the major causes of MPDS. The softand hard occlusal splints (OSs) used in the management of MPDS had been controversial.The aim of study was to test the role of OSs as a treatment modality for myofascial pain dysfunction syndrome of TMJcaused by spasm of masseter and temporalis muscles by the use of surface electromyography (EMG) and Helkimoindex criteria, and to compare between the efficacy of soft and hard occlusal splints in the management ofmyofascial pain dysfunction syndrome.Patients and methods: This study was carried out through clinical examinations for a sample of sixty patients withMPDS, by use of Helkimo index criteria. The ages ranged from 20 to 53 years, the gender distributed as 20 males and40 females. The patients divided into group A and group B, subjected to soft OS and hard OS respectively. Eachpatient subjected to three visits of measurements by EMG for superficial masseter and temporalis muscles andHelkimo index criteria records. The primary visit was for diagnosis and impression taking, then the first visit calledpretreatment visit, then two weeks, and four weeks after insertion of OS.Results and discussion of this study showed that the clinical dysfunction index (type 2 Helkimo index) which was morereliable index in the assessment of TMJ dysfunction syndrome that related to masticatory muscles, since 1974 tonowadays. This study gave this index its reliability and accuracy by approximately coincidence between the EMGand Helkimo index results, this fact encourage by the reliability of the use of EMG in the researches of TMDs andMPDS. This study also showed that the records of Helkimo index criteria for patients managed with soft OS had moresignificant differences from patients managed with hard OS in the second visit after treatment, while the differenceswere not significant in the third visit after treatment. The results of EMG measurements of masseter muscle are ofhighly significant differences in soft OS group compared with the hard OS group in third visit after treatment, but nosignificant differences in the second visit after treatment. The results of EMG records for temporalis muscle were highlysignificant differences in the soft OS group comparing with hard OS group in the third visit after treatment, but it wassignificant in the second visit after treatment.Conclusion: The OS play a major role in the management of MPDS by reducing the symptoms associated with thissyndrome which are pain, muscle spasm, TMJ sounds, and limitation of mandibular movements in different degrees.The use of soft OS was more effective than hard OS in the management of MPDS.Key words: MPDS - Soft and Hard OSs - Surface EMG - Helkimo index - Masseter muscle - Temporalis muscle –Parafunctions – Malocclusion. (J Bagh Coll Dentistry 2011;23(61-69). | ||
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