Effects of massage therapy and occlusal splint therapy on electromyographic activity and the intensity of signs and symptoms in individuals with temporomandibular disorder and sleep bruxism: a randomized clinical trial

Abstract

IntroductionTemporomandibular disorder (TDM) is the most common source of orofacial pain of a non-dental origin. Sleep bruxism is characterized by clenching and/or grinding the teeth during sleep and is involved in the perpetuation of TMD. The aim of the present study was to investigate the effects of massage therapy, conventional occlusal splint therapy and silicone occlusal splint therapy on electromyographic activity in the masseter and anterior temporal muscles and the intensity of signs and symptoms in individuals with severe TMD and sleep bruxism.MethodsSixty individuals with severe TMD and sleep bruxism were randomly distributed into four treatment groups: 1) massage group, 2) conventional occlusal splint group, 3) massage + conventional occlusal splint group and 4) silicone occlusal splint group. Block randomization was employed and sealed opaque envelopes were used to conceal the allocation. Groups 2, 3 and 4 wore an occlusal splint for four weeks. Groups 1 and 3 received three weekly massage sessions for four weeks. All groups were evaluated before and after treatment through electromyographic analysis of the masseter and anterior temporal muscles and the Fonseca Patient History Index. The Wilcoxon test was used to compare the effects of the different treatments and repeated-measures ANOVA was used to determine the intensity of TMD.ResultsThe inter-group analysis of variance revealed no statistically significant differences in median frequency among the groups prior to treatment. In the intra-group analysis, no statistically significant differences were found between pre-treatment and post-treatment evaluations in any of the groups. Group 3 demonstrated a greater improvement in the intensity of TMD in comparison to the other groups.ConclusionMassage therapy and the use of an occlusal splint had no significant influence on electromyographic activity of the masseter or anterior temporal muscles. However, the combination of therapies led to a reduction in the intensity of signs and symptoms among individuals with severe TMD and sleep bruxism.Trial registrationThis study is registered in August, 2014 in the ClinicalTrials.gov (NCT01874041).Electronic supplementary materialThe online version of this article (doi:10.1186/s12998-014-0043-6) contains supplementary material, which is available to authorized users.

Changes in salivary oxidative status, salivary cortisol, and clinical symptoms in female patients with temporomandibular disorders during occlusal splint therapy: a 3-month follow up

“…Physical therapy, behavioral therapy, and the use of occlusal splints are often mentioned as successful treatment methods, with few or no differences in treatment outcomes [5]. In some studies, the combination of non-invasive modalities showed better results than the use of just one treatment option [6, 7]. The role of occlusal splints is still not fully understood, but some evidence suggests that this treatment is better than no treatment at all [8].…”

Physiotherapy in Bruxism: A Scoping Review

“…37 Another study mentions a reduction in the muscular activity as well. 38 A study concludes Exercise therapy with jaw mobility exercise and Psychological intervention reduces temporomandibular pain and jaw movement in parafunctional activity patients. 39…”

Tratamento para disfunções temporomandibulares: uma revisão sistemática

“…Regarding the tested treatments, most studies investigated the effects of manual therapy and/or massage (21,22,24,26,29) , often associated with other techniques such as the use of occlusal splints, to improve the symptoms of TMDs. As in the other fields, most of the studies verified the effects of the respective technique by comparing the pre-treatment data with the post-treatment data.…”