Turkish Journal of Physical Medicine and Rehabilitation 2009 , Vol 55 , Num 1

Comparative the Effectiveness of Occlusal Splint and TENS Treatments on Clinical Findings and Pain Threshold of Temporomandibular Disorders Secondary to Bruxism

Beril Doğu 1 ,Ayşe Karan 2 ,Ernur Ergöz 3 ,Banu KURAN 4
1 İstanbul Şişli Etfal Eğitim ve Araştırma Hastanesi, Fizik Tedavi Kliniği, İstanbul, Türkiye
2 İstanbul Üniversitesi İstanbul Tıp Fakültesi, Fiziksel Tıp ve Rehabilitasyon Anabilim Dalı, İstanbul, Türkiye
3 Isparta Gülkent Devlet Hastanesi, Isparta
4 Clinic of Physical Medicine and Rehabilitation, Şişli Etfal Training and Research Hospital, İstanbul, Turkey

Objective: In the present study we compared the effectiveness of occlusal splint and TENS treatments  with respect to clinical findings and pain threshold  in patients with myofascial pain syndrome and temporomandibular disorders.

Material and Methods: Thirty patients included in the study were randomized into occlusal splint and TENS groups. The severity of pain of the patients (pressure-pain threshold determined with algometric measurements of the trigger point, the degree of pain during rest and functional activities measured with visual analogue, range of motion of joints (measured with a ruler), quality of lives questionnaire specific to masticatory functions and general quality of life scale Short Form-36) were evaluated. These evaluations were repeated three times namely once before, during and after the therapies. 

Results: Our post-treatment algometric measurements of trigger points pain scores showed that both splint and TENS treatments had been effective (p<0,05). However effectiveness in the TENS group decreased in the first month controls (p>0,05). In both groups pain scores were improved (p<0,05). Improvement in mandibular movements in the patients who applied splint treatment was more significant (p<0,05). We obtained an increase in quality of life measurement scores which is specific to temporomandibular disorders both in TENS group and splint group in post treatment and one month after controls. (p<0,05). However in Short Form-36 evaluations, the pain category was positively influenced and improvement in the TENS group was more apparent (p<0,05).

Conclusion: In myofascial pain syndrome secondary to bruxism both splint and TENS treatments are effective in the short term. However the effectiveness of TENS is observedly  short lived  when compared with TENS treatments. Therefore we suggested that, due to the analgesic properties, usage of TENS in combination with other treatment modalities would be more appropriate. 

Keywords : Temporomandibular disorders, bruxism, occlusal splint, TENS