EFFECTS OF INTRAORAL APPLIANCE AND BIOFEEDBACK STRESS MANAGEMENT ALONE AND IN COMBINATION IN TREATING PAIN AND DEPRESSION IN PATIENTS WITH TEMPOROMANDIBULAR DISORDERS

To assess the differential efficacy of two commonly used treatments fo r temporomandibular disorders (TMD), intraoral appliances (IAs) and bi ofeedback (BF), separately and in combination, two studies were conduc ted. The first study directly compared IA treatment, a combination of biofeedback and stress management (BF/SM), and a waiting list control group in a sample of 80 TMD patients. Both treatments were determined to be equally credible to patients, ruling out this potential threat t o the validity of the results obtained. The results, demonstrated that the IA treatment was more effective than the BF/SM treatment in reduc ing pain after treatment, but at a 6-mouth follow-up the IA group sign ificantly relapsed, especially in depression, whereas the BF/SM mainta ined improvements on both pain and depression and continued to improve . The second study examined the combination of IA and BF/SM in a sampl e of 30 TMD patients. The results of this study demonstrated that the combined treatment approach was more effective than either of the sing le treatments alone, particularly in pain reduction, at the 6-month fo llow-up. These results support the importance of using both dental and psychologic treatments to successfully treat TMD patients if treatmen t gains are to be maintained.