Effects of Soft Occlusal Appliance Therapy for Masticatory Muscle Pain

Objectives: Stabilization appliance therapy for masticatory muscle pain includes soft occlusal appliance and hard stabilization appliance. A previous study suggested that a hard stabilization appliance therapy was effective for patients with local myalgia who develop longer facets on their occlusal appliance. The objective of this study was to identify patients in whom a soft occlusal appliance should be used to treat masticatory muscle pain by analyzing the type of muscle pain present and patient factors that influence the effectiveness of this treatment.
Methods: The study included 42 patients with a diagnosis of local myalgia or myofascial pain according to the Diagnostic Criteria for Temporomandibular Disorders Diagnostic Decision Tree. Variables believed to be associated with temporomandibular disorders were included in the analysis of patient factors. First, a temporary screening appliance was used for two weeks to assess each patient for bruxism during sleep. Soft appliance therapy was then started. The effectiveness of the appliance was evaluated according to the intensity of tenderness during muscle palpation and the treatment satisfaction score one month after starting treatment.
Results: Data from 37 of the 42 patients were available for analysis. Twenty-five patients reported satisfaction with the appliance. In logistic regression analysis, the odds ratio for reduction of facet length was 1.998. Nineteen patients showed at least a 30% improvement in their visual analogue scale score. The odds ratio for local myalgia was 18.148.
Conclusions: Soft appliance therapy may be used in patients with local myalgia. Moreover, patients who develop short facets on the appliance surface are likely to be satisfied with soft appliance therapy. Soft appliance therapy may be appropriate for patients with local myalgia who develop short facets on their occlusal appliance.