An In-vivo Study to Evaluate the Onset of Relief from Ibuprofen, Placebo and Occlusal Splint in Patients with Acute Myalgia in Muscles Related to Temporomandibular Joint: A Comparative Pilot Study

Jump To References Section

Authors

  • Deeksha Gupta
     Reader, Department of Prosthodontics and Crown and Bridge, MP Dental College and Oral Research Institute, MK Bhavnager University, Vadodara – 390011, Gujarat ,IN
  • Narendra J. Nirmal
     Professor and HOD, Department of Prosthodontics and Crown and Bridge, MP Dental College and Oral Research Institute, MK Bhavnager University, Vadodara – 390011, Gujarat ,IN
  • Himanshu Arora
     Reader, Department of Prosthodontics and Crown and Bridge, MP Dental College and Oral Research Institute, MK Bhavnager University, Vadodara – 390011, Gujarat ,IN
  • Sonal Mehta
     Professor, Department of Prosthodontics and Crown and Bridge, MP Dental College and Oral Research Institute, MK Bhavnagar University, Vadodara – 390011, Gujarat ,IN
  • Jishnu S.
     Assistant Professor, Department of Prosthodontics and Crown and Bridge, MP Dental College and Oral Research Institute, MK Bhavnagar University, Vadodara – 390011, Gujarat ,IN
  • Ruchi Raj
     Assistant Professor, Department of Prosthodontics and Crown and Bridge, MP Dental College and Oral Research Institute, MK Bhavnagar University, Vadodara – 390011, Gujarat ,IN

DOI:

https://doi.org/10.18311/jpfa/2021/27136

Keywords:

Myalgia, NSAIDs, Occlusal Splint, Placebo, Temporomandibular Disorder

Abstract

Purpose: The treatment priority in management of Temporomandibular Joint (TMJ) pain is directed towards the causative factor along with symptomatic treatment. In this process many times psychological aspect is overlooked. Hence with this pilot study, importance of psychological aspect of Temporomandibular Joint Disorder (TMD) is emphasised. Methods and Material: 15 patients suffering from pain in TMD region who qualify under myalgia pain in DC/TMD Axis I category were selected. Patients were divided into 3 groups; Ibuprofen, placebo and occlusal splint with 5 patients in each group. Pain assessment was done at the first visit, 7th day visit and 14th day visit using a VAS scale. Statistical Analysis Used: Friedman Test was applied to determine overall relief from pain in the three groups. Wilcoxon sign rank test evaluated pain relief between each time interval. Kruskal Wallis Test compared different groups for relief from pain at each time interval. Key Finding: Wilcoxon sign rank test showed a significant pain relief in all three groups from I day to I follow up day and I day to II follow up day. However Pain relief from I follow up to II follow up day was significant only in placebo group. Conclusions: Management of TMD myalgia requires a comprehensive understanding of physical and psychological aspect. This will aid us in formulating a treatment plan comprising pharmacotherapy, placebo or physical therapy or combination of any of these.

Downloads

Published

2022-07-19

How to Cite

Gupta, D., Nirmal, N. J., Arora, H., Mehta, S., S., J., & Raj, R. (2022). An In-vivo Study to Evaluate the Onset of Relief from Ibuprofen, Placebo and Occlusal Splint in Patients with Acute Myalgia in Muscles Related to Temporomandibular Joint: A Comparative Pilot Study. Journal of Pierre Fauchard Academy (India Section), 35(4), 111–118. https://doi.org/10.18311/jpfa/2021/27136

Issue

Volume 35, Issue 4, December 2021

Section

Original Research Article

License

All the articles published in JPFA are distributed under a creative commons license. The journal allows the author(s) to hold the copyright of their work (all usages allowed except for commercial purpose).

 

References

Romero-Reyes M and Uyanik JM. Orofacial pain management: Current perspectives. J Pain Res. 2014; 7:99–115. PMid: 24591846 PMCid: PMC3937250. https://doi.org/10.2147/JPR.S37593

Sidebottom AJ, Farook S, Cascarini L. Current management of Temporomandibular Joint (TMJ) Disease. J Arthiritis 2014 3:3. https://doi.org/10.4172/2167-7921.1000138

Schiffman E and Ohrbach R. Diagnostic criteria for Temporomandibular Disorders (DC/TMD) for clinical and research application. Journal of Oral Facial Headache. 2014; 28:6–27.

Okeson JP. Management of Temporomandibular Disorders and occlusion. 6th ed. St. Louis, MO: CV Mosby, 2008.

Dionne RA. Pharmacologic treatments for Temporomandibular Disorders. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997; 83(1):134–42. https://doi.org/10.1016/ S1079-2104(97)90104-9

Ouanounou A, Goldberg M and Haas DA. Pharmacotherapy in Temporomandibular Disorders: A Review. J Can Dent Assoc. 2017; 83:h7.

Singer EJ, Sharav Y, Dubner R and Dionne RA. The efficacy of diazepam and ibuprofen in the treatment of chronic myofascial orofacial pain. Pain. 1987; 4:S83. https://doi.org/10.1016/0304-3959(87)91245-0

Pramod GV, Shambulingappa P, Shashikanth MC and Lele S. Analgesic efficacy of diazepam and placebo in patients with Temporomandibular Disorders: A double blind randomized clinical trial. IJDR. 2011; 22(3):404–9. PMid: 22048580. https://doi.org/10.4103/0970-9290.87062

Klasser GD and Greene CS. Oral appliances in the management of Temporomandibular Disorders. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009; 107(2):212–23. PMid: 19138639. https://doi.org/10.1016/j.tripleo.2008.10.007

Ouanounou A, Goldberg M and Haas DA. Pharmacologic considerations in the management of Temporomandibular Disorders. J Can Dent Assoc. 1995; 61(2):105–9.

Ta LE and Dionne RA. Treatment of painful Temporomandibular Joints with a cyclooxygenase-2 inhibitor: A randomized placebo-controlled comparison of celecoxib to naproxen. Pain. 2004; 111(1-2):13–21. PMid: 15327804. https://doi.org/10.1016/j.pain.2004.04.029

Haas DA. Adverse drug interactions in dental practice: Interactions associated with analgesics, Part III in a series. J Am Dent Assoc. 1999; 130(3):397–407. PMid: 10085663. https://doi.org/10.14219/jada.archive.1999.0210

Varoli FK, Pita MS, Sato S and Issa JPM. Analgesia evaluation of 2 NSAID drugs as adjuvant in management of chronic Temporomandibular Disorders. Scientific World Journal. 2015; 359152. PMid: 25874243 PMCid: PMC4385689. https://doi.org/10.1155/2015/359152

Friction J. Myogenous TMDs: Diagnostic and management considerations. DCNA 2007; 51(1):61–83. PMid: 17185060. https://doi.org/10.1016/j.cden.2006.10.002

Clark GT, Beemsterboer PL and Rugh JD. Nocturnal electromyographic evaluation of MPDS in patients undergoing occlusal splint therapy. J Am Dsent Assoc. 199; 99(4):607. PMid: 292717. https://doi.org/10.14219/jada.archive.1979.0348

Dube C, Rompre PH, Manzini C, Guitard F, de Grandmont P and Lavigne GJ. Quantitative polygraphic controlled study on efficacy and safety of oral splint devices in tooth-grinding subjects. J Dent Res. 2004; 83(5):398–403. PMid: 15111632. https://doi.org/10.1177/154405910408300509

Jyoti RSB and Devi P. Oral splint for Temporomandibular Joint disorders with revolutionary fluid system. Dent Res J (Isfahan). 2013 May-Jun; 10(3):307–13.

Manfredini D, Landi N, Bandettini Di Poggio A, Dellosso L and Bosco M. A critical review on the importance of psychological factors in Temporomandibular Disorders. Minerva Stomatol. 2003; 52(6):321–30.

Murray GM and Peck CC. Orofacial pain and jaw muscle activity: A new model. J Orofac Pain. 2007; 21:263–78.

Cairns BE. Pathophysiology of TMD pain - basic mechanisms and their implications for pharmacotherapy. Journal of Oral Rehabilitation. 2010; 37:391–410. PMid: 20337865. https://doi.org/10.1111/j.1365-2842.2010.02074.x

Gale EM and Dixon DC. A simplified psychologic questionnaire as a treatment planning aid for patients with Temporomandibular Joint Disorders. J Prosthet Dent. 1989; 61(2):235–8. https://doi.org/10.1016/00223913(89)90381-8

Pereira LJ, Pereira-Cenci T, Pereira SM, Del Bel Cury AA, Ambrosano GMB and Pereira AC. Psychological factors and the incidence of Temporomandibular Disorders in early adolescence. Braz Oral Res. 2009; 23(2):155–60. PMid: 19684950. https://doi.org/10.1590/S1806-83242009000200011

Ekberg E. Treatment of Temporomandibular Disorders of arthrogeneous origin. Controlled double-blind studies of a non-steroidal anti-inflammatory drug and a stabilization appliance. Swed Dent J Suppl. 1998; 131:1–57.

Beck FM. Placebos in dentistry: Their profound potential affects. JADA. 1977; 95:1122–6. PMid: 271675. https://doi.org/10.14219/jada.archive.1977.0222

Beecher HK. The powerful placebo. JAMA. 1955; 159(17):1602–6. PMid: 13271123. https://doi.org/10.1001/jama.1955.02960340022006