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Treatment of Temporomandibular Disorders of Arthrogeneous Origin. Controlled double-blind studies of a non-steroidal anti-inflammatory drug and a stabilisation appliance.

Ekberg, EwaCarin LU (1998)
Abstract
The aim of this thesis was to prospectively evaluate the short-term effect of a non-steroidal anti-inflammatory drug (diclofenac sodium, Voltaren) and stabilisation appliance in controlled trials of patients with temporomandibular disorders (TMD) of arthrogeneous origin. The active treatments were compared to placebo in the study of diclofenac and to a control appliance in the other study. Thirty-two patients in the first study and 60 patients in the second study were randomly assigned into two equally large groups. In the second study two different techniques regarding assessment of changes in condylar position on radiographs with and without an occlusal appliance was evaluated. Changes in condyle-fossa relationship was compared in the... (More)
The aim of this thesis was to prospectively evaluate the short-term effect of a non-steroidal anti-inflammatory drug (diclofenac sodium, Voltaren) and stabilisation appliance in controlled trials of patients with temporomandibular disorders (TMD) of arthrogeneous origin. The active treatments were compared to placebo in the study of diclofenac and to a control appliance in the other study. Thirty-two patients in the first study and 60 patients in the second study were randomly assigned into two equally large groups. In the second study two different techniques regarding assessment of changes in condylar position on radiographs with and without an occlusal appliance was evaluated. Changes in condyle-fossa relationship was compared in the two patient groups, and the changes in condyle-fossa relationship was compared with the treatment outcome between the two treatment groups. The influence of possible background variables on outcome of treatment with occlusal appliances were tested.



The group treated with diclofenac did not seem to have recovered better from TMD than placebo. However, in the other study the group treated with a stabilisation appliance showed a better treatment outcome, with respect to both symptoms and signs, than the group treated with a control appliance. The group treated with a stabilisation appliance more often showed a changed condylar position in the transcranial radiographs of the TMJ than the group treated with a control appliance. It was also shown that the patients treated with a stabilisation appliance more often experienced relief of TMD symptoms when the stabilisation appliance had achieved a changed condyle-fossa relationship. Treatment with a stabilisation appliance was still a strong explanatory factor when testing possible background variables for a positive treatment outcome, but also male sex (positive) and severe or very severe TMJ pain (negative) influenced the treatment outcome.



It was concluded that there was no evidence to suggest that diclofenac sodium (Voltaren) should be used as a primary treatment for TMJ pain in patients with TMD. However, the stabilisation appliance is recommended for the treatment of patients with TMD suffering from TMJ pain. (Less)
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author
opponent
  • Associate Professor Magnusson, Tomas, Institute for Postgraduate Dental Education, Jönköping, Sweden
organization
publishing date
type
Thesis
publication status
published
subject
keywords
Temporomandibular Joint Disorders, Randomized Controlled Trials, Non-steroidal Anti-inflammatory Agents, Occlusal Splints, Treatment Outcome, Mandibular Condyle Radiography, Subtraction Technique, Radiographic Image Enhancement, Causality, Odontology, stomatology, Odontologi
pages
99 pages
publisher
Department of Stomatognathic Physiology, Centre for Oral Health Sciences, Carl Gustafs v 34, S-214 21 Malmö, Sweden
defense location
Centre for Oral Health Sciences, Malmö, Sweden
defense date
1998-10-02 10:15
external identifiers
  • other:ISRN: SE-LUODD5/ODKB-98/1001+57P
  • scopus:0032239774
ISSN
0348-6672
ISBN
91-628-3129-1
language
English
LU publication?
yes
id
56bffad4-7c7e-4330-8bc0-c70e06ac77f7 (old id 38894)
date added to LUP
2007-06-21 10:00:28
date last changed
2017-01-01 07:02:16
@phdthesis{56bffad4-7c7e-4330-8bc0-c70e06ac77f7,
  abstract     = {The aim of this thesis was to prospectively evaluate the short-term effect of a non-steroidal anti-inflammatory drug (diclofenac sodium, Voltaren) and stabilisation appliance in controlled trials of patients with temporomandibular disorders (TMD) of arthrogeneous origin. The active treatments were compared to placebo in the study of diclofenac and to a control appliance in the other study. Thirty-two patients in the first study and 60 patients in the second study were randomly assigned into two equally large groups. In the second study two different techniques regarding assessment of changes in condylar position on radiographs with and without an occlusal appliance was evaluated. Changes in condyle-fossa relationship was compared in the two patient groups, and the changes in condyle-fossa relationship was compared with the treatment outcome between the two treatment groups. The influence of possible background variables on outcome of treatment with occlusal appliances were tested.<br/><br>
<br/><br>
The group treated with diclofenac did not seem to have recovered better from TMD than placebo. However, in the other study the group treated with a stabilisation appliance showed a better treatment outcome, with respect to both symptoms and signs, than the group treated with a control appliance. The group treated with a stabilisation appliance more often showed a changed condylar position in the transcranial radiographs of the TMJ than the group treated with a control appliance. It was also shown that the patients treated with a stabilisation appliance more often experienced relief of TMD symptoms when the stabilisation appliance had achieved a changed condyle-fossa relationship. Treatment with a stabilisation appliance was still a strong explanatory factor when testing possible background variables for a positive treatment outcome, but also male sex (positive) and severe or very severe TMJ pain (negative) influenced the treatment outcome.<br/><br>
<br/><br>
It was concluded that there was no evidence to suggest that diclofenac sodium (Voltaren) should be used as a primary treatment for TMJ pain in patients with TMD. However, the stabilisation appliance is recommended for the treatment of patients with TMD suffering from TMJ pain.},
  author       = {Ekberg, EwaCarin},
  isbn         = {91-628-3129-1},
  issn         = {0348-6672},
  keyword      = {Temporomandibular Joint Disorders,Randomized Controlled Trials,Non-steroidal Anti-inflammatory Agents,Occlusal Splints,Treatment Outcome,Mandibular Condyle Radiography,Subtraction Technique,Radiographic Image Enhancement,Causality,Odontology,stomatology,Odontologi},
  language     = {eng},
  pages        = {99},
  publisher    = {Department of Stomatognathic Physiology, Centre for Oral Health Sciences, Carl Gustafs v 34, S-214 21 Malmö, Sweden},
  school       = {Lund University},
  title        = {Treatment of Temporomandibular Disorders of Arthrogeneous Origin. Controlled double-blind studies of a non-steroidal anti-inflammatory drug and a stabilisation appliance.},
  year         = {1998},
}