Internet-Based Behavioural Therapy for Adolescents With Temporomandibular Disorder Pain: A Feasibility Multicenter Randomised Controlled Trial.

IF 3.1 3区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE
Tessa Bijelic, Ing-Marie Nilsson, Thomas List, EwaCarin Ekberg
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引用次数: 0

Abstract

Background: Temporomandibular disorder (TMD) pain in adolescents is common, has a negative impact on quality of life, and is a predictor of pain in young adulthood. A common and symptomatic treatment is occlusal appliance therapy (OAT). Internet-based behavioural therapy (IBT) is a novel, multimodal, and patient-centred self-management therapy for adolescents with TMD pain.

Objective: To evaluate the adherence and effect of IBT compared to OAT in adolescents with TMD pain.

Methods: Participants were recruited from public dental care and specialist clinics in orofacial pain in Sweden between January 2016 and March 2020. Screening of adolescents, 13-19 years, was performed using three questions for TMD (3Q/TMD). Eligible subjects were examined according to the DC/TMD and randomly allocated to IBT or OAT. The IBT group performed the 7-week programme online with individualised feedback through phone after each section. The OAT group used a stabilisation splint night time for 3 months. A 3-month questionnaire follow-up on pain intensity, pain disability, and psychosocial outcomes was conducted.

Results: In total, 52 patients were randomised to IBT and 48 to OAT. There was a low adherence to IBT with a 75% drop-out. Positive expectations of treatment were significantly (p = 0.001) greater in the OAT group. OAT was related to better outcomes for characteristic pain intensity (p = 0.047) and pain-related disability (p = 0.049) when compared to IBT. No significant difference within or between the groups regarding the psychosocial outcomes was observed.

Conclusions: The current version of IBT was overly comprehensive for adolescents with TMD pain and needs to be revised.

基于互联网的行为治疗青少年颞下颌紊乱性疼痛:一项可行性多中心随机对照试验。
背景:颞下颌紊乱(TMD)疼痛在青少年中很常见,对生活质量有负面影响,并且是成年早期疼痛的预测因子。一种常见的对症治疗方法是咬合矫治(OAT)。基于网络的行为疗法(IBT)是一种新颖的、多模式的、以患者为中心的青少年TMD疼痛自我管理疗法。目的:评价IBT与OAT治疗青少年TMD疼痛的依从性和效果。方法:参与者于2016年1月至2020年3月期间从瑞典的公共牙科保健和口腔面部疼痛专科诊所招募。对13-19岁的青少年进行TMD筛查,采用三个问题(3Q/TMD)。根据DC/TMD对符合条件的受试者进行检查,并随机分配到IBT或OAT组。IBT组在网上进行了为期7周的课程,每个课程结束后通过电话进行个性化反馈。OAT组夜间使用稳定夹板3个月。对疼痛强度、疼痛残疾和心理社会结局进行了为期3个月的问卷调查。结果:总共52例患者被随机分为IBT组和OAT组。IBT的依从性很低,有75%的人退出。OAT组对治疗的积极期望显著高于对照组(p = 0.001)。与IBT相比,OAT在特征性疼痛强度(p = 0.047)和疼痛相关残疾(p = 0.049)方面的预后更好。没有观察到组内或组间关于社会心理结果的显著差异。结论:当前版本的IBT对青少年TMD疼痛过于全面,需要修订。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of oral rehabilitation
Journal of oral rehabilitation 医学-牙科与口腔外科
CiteScore
5.60
自引率
10.30%
发文量
116
审稿时长
4-8 weeks
期刊介绍: Journal of Oral Rehabilitation aims to be the most prestigious journal of dental research within all aspects of oral rehabilitation and applied oral physiology. It covers all diagnostic and clinical management aspects necessary to re-establish a subjective and objective harmonious oral function. Oral rehabilitation may become necessary as a result of developmental or acquired disturbances in the orofacial region, orofacial traumas, or a variety of dental and oral diseases (primarily dental caries and periodontal diseases) and orofacial pain conditions. As such, oral rehabilitation in the twenty-first century is a matter of skilful diagnosis and minimal, appropriate intervention, the nature of which is intimately linked to a profound knowledge of oral physiology, oral biology, and dental and oral pathology. The scientific content of the journal therefore strives to reflect the best of evidence-based clinical dentistry. Modern clinical management should be based on solid scientific evidence gathered about diagnostic procedures and the properties and efficacy of the chosen intervention (e.g. material science, biological, toxicological, pharmacological or psychological aspects). The content of the journal also reflects documentation of the possible side-effects of rehabilitation, and includes prognostic perspectives of the treatment modalities chosen.
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