Comparison between Simple Planas Indirect Tracks and occlusal splints for treatment of temporomandibular disorder-related headache: a randomized controlled clinical trial

HIGHLIGHTS

• Planas Indirect Tracks performed better than occlusal splints in the treatment of headache secondary to temporomandibular disorder.

• Planas Indirect Tracks reduced the number of days with headache, the intensity of pain and use of analgesics.

• Planas Indirect Tracks may be a viable alternative for headache control.

ABSTRACT

BACKGROUND AND OBJECTIVES:

Temporomandibular disorder-related headache (TMDH) is a very common clinical condition which manifests as pain around the temples. The treatment recommended in dentistry is occlusal splint. However, there is a device generally used in functional jaw orthopedics, called simple Planas indirect tracks (SPIT), which has been shown to be efficient in managing these headaches. This clinical trial aimed to compare SPIT and occlusal splints in the treatment of TMDH patients.

METHODS:

This randomized clinical trial included thirty-seven women who had TMDH for more than one year into three groups: GPIT treated with SPIT, GSPLINT treated with a Michigan splint, and a control group (CG) submitted to no treatment. The randomization was paired, that is, each new individual was assigned to a group sequentially. The number of headache days per month, average pain intensity, pain response to masseter and temporalis palpation, and days of pain drug use were collected and analyzed. The follow-up lasted for 3 months.

RESULTS:

Thirty-seven patients were included but 4 dropped out during treatment and 33 underwent intervention. Patients in GPIT exhibited superior results compared to GSPLINT and CG, with significant differences between groups for almost all variables. In GPIT, the number of headache days was reduced by 87.43%, pain intensity by 66.67%, and days of drug use by 88.42%, with significant improvement in all parameters compared to CG. In GSPLINT, the number of headache days decreased by 44.46% and days of drug use by 36.63%, while pain intensity increased by 46.67%; however, there was no significant difference in any of the parameters compared to CG.

CONCLUSION:

SPIT may be a good treatment option for patients with TMDH since these appliances have shown much more consistent results than occlusal splints. Further studies and with more individuals will be needed to confirm these findings.

Keywords
Headache; Headache disorders; Occlusal splints; Planas Indirect Tracks; Secondary headache disorders; Temporomandibular joint dysfunction syndrome