DYSFUNCTIONAL PATIENTS WITH TEMPOROMANDIBULAR DISORDERS - EVALUATING THE EFFICACY OF A TAILORED TREATMENT PROTOCOL

Forty-eight dysfunctional patients (i.e., high levels of pain, interfe rence, and affective distress and low levels of perceived control) wit h temporomandibular disorders (TMDs) were randomly assigned either to a treatment consisting of an intraoral appliance (IA) and stress manag ement with biofeedback (SM) plus nondirective, supportive counseling ( SC)-IA + SM + SC-or to a customized treatment that included cognitive therapy (CT) with the IA and SM-IA + SM + CT. Both treatment groups re ported statistically significant reductions on a set of physical, psyc hosocial, and behavioral measures posttreatment and at a 6-month follo w-up. However, the intervention that included CT demonstrated signific antly greater reductions in pain, depression, and medication use. Only the groups receiving the treatment that included the CT demonstrated continued improvements to the follow-up on pain associated with muscle palpation, self-reported pain severity, depression, and use of medica tions. These results support the efficacy of the tailored treatment fo r dysfunctional TMD.