Pilot study: ETPS therapy effectiveness versus Oral splint

Abstract

Introduction: The temporomandibular disorders (TMD) are a group of diseases involving the masticatory muscles, the temporomandibular joint (TMJ) and other structures of the stomatognathic system. According to Cimmino et al. [1], TMD associated with chronic orofacial painful condition are the most common in general population. They are the most prevalent musculoskeletal pain, and in-between them, myofascial pain is the most frequent one [2]. This myalgia is characterized by the presence of tight and hypersensitive nodes to muscle palpation - trigger points [3]. A non-invasive treatment option is the Electrical Therapy Points Stimulation (ETPS), which promotes the continual stimulation of cutaneous nerve fibers resulting in a relief of musculoskeletal, neuropathic and nociceptive pain. The aim of this study was to assess the effectiveness of ETPS in patients with pain to palpation of Masseter muscles with origin in Temporomandibular Disorder (TMD) and, concomitantly, compare the ETPS with the conventional therapy with oral occlusal splint.

Materials and methods: Random selection of 40 patients between 20 and 63 years, of both sexes. Patients with severe bruxism, periodontal disease, tooth decay, partially or totally toothless without being rehabilitated, with rheumatoid arthritis, osteoarthritis, osteoporosis, patients undergoing drug therapy with painkillers, muscle relaxants and anti-inflammatory drugs within the previous 30 days and patients with pacemaker were excluded. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) was applied always by the same observer (Level II calibrated). The sample was divided into 2 groups (n = 20), being: I-Treatment with ETPS and II- Treatment with Oral splint; Each patient was observed once a week in a total of three sessions. In each session, pain on palpation of masseter using a visual analogue scale (VAS) of 100 mm was performed. This observational study was approved by the Ethics Committee of University Institute Egas Moniz under reg. no. 54.

Results:

Table 1. Means and Standard Deviation for Masseteric pain to palpation using VAS. Student’s Paired t-Test found significant differences between both groups in sessions 2 and 3. *p ≤ 0.010 **p ≤ 0.05

Discussion and conclusions: To our knowledge, these results are new to the literature; This device showed more effectiveness than other types of physical therapy treatments [4,5]. However, time span of this study was short (3 weeks), viz. its results on long term are unknown. Both groups showed a reduction of pain palpation values, yet the ETPS group had always showed lower values, suggesting that in a short-term therapy with ETPS is more effective than the oral occlusal splint.