Effect of jaw-opening exercise on prevention of temporomandibular disorders pain associated with oral appliance therapy in obstructive sleep apnea patients: A randomized, double-blind, placebo-controlled trial
Effect of jaw-opening exercise on prevention of temporomandibular disorders pain associated with oral appliance therapy in obstructive sleep apnea patients: A randomized, double-blind, placebo-controlled trial
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DOI：
10.1016/j.jpor.2016.12.001
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发表时间：
2017-07-01
影响因子：
3.6
通讯作者：
Wakabayashi, Noriyuki
中科院分区：
文献类型：
--
作者：
Ishiyama, Hiroyuki;Inukai, Shusuke;Wakabayashi, Noriyuki
目的：目前还没有关于预防阻塞性睡眠呼吸暂停（OSA）患者使用口腔矫治器（OA）治疗相关的颞下颌关节和/或咀嚼肌疼痛（TMD疼痛）的研究。本研究的目的是确定的效果，下颌开放运动对TMD疼痛与OA治疗OSA patients.Methods：25 OSA患者无疼痛相关的TMD连续入组一个双臂，随机，双盲，安慰剂对照试验。一组进行了为期1个月的开颌运动（JE，n= 13），另一组进行了为期1个月的安慰剂运动（PE，n=12），并在插入可调节OA前2周开始。在基线时，使用颞下颌关节紊乱病研究诊断标准评估TMD体征，并使用视觉模拟量表（VAS）评估早晨和白天的TMD疼痛强度（运动前）和OA插入后2周、1个月和3个月。在所有评估期间，在JE组中均未观察到疼痛相关TMD，尽管PE组中有1例受试者在1个月评价时被诊断为关节痛。在所有评估阶段，JE组的早晨和白天VAS评分均低于PE组，并且在1个月评估时的早晨咀嚼疼痛和下颌张开疼痛以及3个月评估时的白天下颌张开疼痛方面存在显著性组间差异（P
Purpose: There are no studies on the prevention of temporomandibular joint and/or masticatory muscle pain (TMD pain) associated with oral appliance (OA) therapy in patients with obstructive sleep apnea (OSA). The aim of this study was to determine the effect of jaw-opening exercise on TMD pain associated with OA therapy in OSA patients.Methods: Twenty-five OSA patients without pain-related TMD were consecutively enrolled into a two-arm, randomized, double-blind, placebo-controlled trial. One group performed jaw-opening exercise (JE, n= 13), and the other group performed placebo exercise (PE, n=12) for 1-month, and had started 2-weeks prior to insertion of an adjustable OA. TMD sign using the Research Diagnostic Criteria for Temporomandibular Disorders and TMD pain intensity using a visual analog scale (VAS) in the morning and daytime were evaluated at baseline (pre-exercise) and at 2-weeks, 1-month, and 3-months after OA insertion.Results: Pain-related TMD was not observed in the JE-group at all evaluation periods, although one subject in the PE-group was diagnosed with arthralgia at the 1-month evaluation. The JE-group showed lower morning and daytime VAS scores than the those of the PE-group at all evaluation periods, and significant group differences were found in terms of chewing pain and jaw-opening pain in the morning at the 1-month evaluation, and of jaw-opening pain during daytime at the 3-month evaluation (P