A pilot study comparing the efficacy of hard and soft stabilizing appliances in treating patients with temporomandibular disorders

Author(s): Pettengill CA, Growney MR Jr, Schoff R, Kenworthy CR


Statement of problem:Soft and hard stabilizing appliances have been used to treat temporomandibular disorders. No data exist to suggest whether a hard or soft appliance is beneficial.

Purpose:This study compared soft and hard acrylic resin stabilizing appliances in the reduction of masticatory muscle pain in patients with temporomandibular disorders.

Materials and methods:Twenty-three patients with at least one clinical sign from the list of diagnostic subgroups of temporomandibular disorders were alternately assigned a hard or soft appliance for temporomandibular disorder treatment. No other temporomandibular disorder treatment (self-care, physical therapy, biofeedback, or muscle or joint injections) was rendered. Each patient was seen by two dentists at each visit. One dentist initially fabricated the appliance and adjusted the appliance on each visit and an examining dentist examined the patient each visit and recorded signs of temporomandibular disorders. The appliance material (soft or hard) was not disclosed to the examining dentist, only to the dentist who fabricated and adjusted the appliance. Patients were examined and appliances were adjusted every 2 to 3 weeks for a minimum of 10 weeks. Masticatory muscles were palpated and charted on each visit. Data were analyzed and subjected to nonparametric Mann-Whitney test.

Results:Eighteen of the initial 23 patients, 7 in the hard appliance group and 11 in the soft appliance group finished the study over 10- to 15-week period. Soft and hard appliances performed the same in reduction of masticatory muscle pain.

Conclusion:This study suggests, based on the limited number of participants, that soft and hard stabilizing appliances may be equally useful in reducing masticatory muscle pain in short-term appliance therapy.

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