Occlusal Appliance and Isometric Exercise for Myofascial Pain with Referral in Fixed Orthodontic Patient
Rikmasari R., Pramudita S., Sunnah T.D.
Abstract
Myofascial pain with referral is one of the temporomandibular joint (TMJ) pain that has a trigger point causing continuous muscle pain in the face, neck, and head area. It is caused by multifactorial etiology such as occlusal disturbance. Occlusal appliance, and physical self-regulation (PSR), such as isometric exercise, can be alternative treatments for patients with referral pain. This case report aims to explain the management of myofascial pain with referral using an occlusal appliance and isometric exercise in fixed orthodontic patient. A 21-year-old female dental co-assistant came to the prosthodontic department of RSGM Universitas Padjadjaran complaining of open mouth pain, and muscle soreness around her neck. It has been 4 years since the occlusion changed due to orthodontic treatment and being worse in the last 2 years. Dental history class III Angel occlusion and has been using fixed orthodontic treatment for 6 years. The digital impression and the stabilization appliance were made with digital printing for the mandibular jaw. Splint is worn every day during activities except eating, bad habit elimination instructions, and TMJ isometric exercise as PSR. Every 2-3 weeks, patients called for splint adjustment and progress evaluation. Pain score assessment of the facial and neck muscle areas decreased every control. At the 4th control, palpation of the trigger point area, no pain was referred. The patient was referred to the orthodontic department for further management. Occlusal appliance combined with isometric exercise as PSR can be an option in managing cases of myofascial pain with referral in patients with fixed orthodontic treatment.
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