Additional effect of occlusal splints on the improvement of psychological aspects in temporomandibular disorder subjects: A randomized controlled trial.

OBJECTIVE: To measure the effect of occlusal splints as an additional treatment on psychological aspects in temporomandibular disorder patients. DESIGN: A randomized controlled trial was performed comprising 60 adults diagnosed with masticatory myofascial pain according the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). The participants were divided equally into 2 treatment groups, which received only counselling (Group 1) or occlusal splints in addition to counselling (Group 2). The assessments occurred at baseline and at 2 and 5 months after treatment. The outcomes were symptoms of anxiety and depression, as well as pain catastrophizing. Two-way ANOVA, Friedman and Mann-Whitney tests were used to perform the statistical analysis, considering a significance level of 5%. RESULTS: In relation to the baseline assessment, 60% of the subjects had at least mild anxiety and 25% had at least mild depression, and the mean and standard deviation (SD) of pain catastrophizing was 2.41 (1.33) for Group 1 and 2.06 (1.04) for Group 2. Comparisons between baseline and the fifth-month evaluation showed an improvement in anxiety and depression symptoms only in Group 2 (p<0.05). Otherwise, there was a significant reduction in pain catastrophizing in both groups (p<0.05), with a mean (SD) of 1.14 (1.28) for Group 1 and 0.76 (0.82) for Group 2. CONCLUSION: Minimally invasive strategies could provide an improvement in the psychological aspects of temporomandibular disorder patients, and the use of an occlusal splint seems to hasten the manifestation of these effects.