Cory R Herman1, Eric L Schiffman, John O Look, D Brad Rindal. 1. University of Minnesota, School of Dentistry, TMJ/Orofacial Pain Division, 6-320 Moos Health Science Tower, 515 Delaware Street South East, Minneapolis, MN 55455, USA. herm0024@gold.tc.umn.edu
Abstract
AIMS: To compare the relative effectiveness of a benzodiazepine (clonazepam), a muscle relaxant (cyclobenzaprine), and a placebo for the treatment of jaw pain upon awakening, when each is combined with the recommended nonpharmacological components of initial medical management. METHODS:Forty-one subjects were recruited with a diagnosis of myofascial pain based on the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). All subjects were given education about TMD and a self-care program. Subjects were randomized into 1 of 3 groups: clonazepam (0.5 mg/night), cyclobenzaprine (10 mg/night), or placebo. The primary outcome measure was the subjects' average intensity of jaw pain upon awakening over the prior week. This was recorded with a visual analog scale at pretreatment and at the completion of the 3-week trial. A secondary outcome measure was sleep quality based on the Pittsburg Sleep Quality Index. RESULTS: Within-group changes showed a statistically significant (P < .001) decrease in jaw pain upon awakening for all 3 groups. Between-group differences demonstrated a statistically significant difference (P < .016) between cyclobenzaprine and placebo, and between cyclobenzaprine and clonazepam. There was no significant effect on sleep quality in any group. CONCLUSION: This study suggests that cyclobenzaprine is statistically superior to either placebo or clonazepam when added to self-care and education for the management of jaw pain upon awakening. Based on the subjects' report of sleep quality, these medications failed to significantly improve sleep in the short term.
RCT Entities:
AIMS: To compare the relative effectiveness of a benzodiazepine (clonazepam), a muscle relaxant (cyclobenzaprine), and a placebo for the treatment of jaw pain upon awakening, when each is combined with the recommended nonpharmacological components of initial medical management. METHODS: Forty-one subjects were recruited with a diagnosis of myofascial pain based on the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). All subjects were given education about TMD and a self-care program. Subjects were randomized into 1 of 3 groups: clonazepam (0.5 mg/night), cyclobenzaprine (10 mg/night), or placebo. The primary outcome measure was the subjects' average intensity of jaw pain upon awakening over the prior week. This was recorded with a visual analog scale at pretreatment and at the completion of the 3-week trial. A secondary outcome measure was sleep quality based on the Pittsburg Sleep Quality Index. RESULTS: Within-group changes showed a statistically significant (P < .001) decrease in jaw pain upon awakening for all 3 groups. Between-group differences demonstrated a statistically significant difference (P < .016) between cyclobenzaprine and placebo, and between cyclobenzaprine and clonazepam. There was no significant effect on sleep quality in any group. CONCLUSION: This study suggests that cyclobenzaprine is statistically superior to either placebo or clonazepam when added to self-care and education for the management of jaw pain upon awakening. Based on the subjects' report of sleep quality, these medications failed to significantly improve sleep in the short term.
Authors: Ksenija Rener-Sitar; Mike T John; Snigdha S Pusalavidyasagar; Dipankar Bandyopadhyay; Eric L Schiffman Journal: Sleep Med Date: 2016-08-30 Impact factor: 3.492
Authors: Ana M Velly; Eric L Schiffman; D Brad Rindal; Joana Cunha-Cruz; Gregg H Gilbert; Maryann Lehmann; Allan Horowitz; James Fricton Journal: J Am Dent Assoc Date: 2013-01 Impact factor: 3.634
Authors: Ksenija Rener-Sitar; Mike T John; Dipankar Bandyopadhyay; Michael J Howell; Eric L Schiffman Journal: Health Qual Life Outcomes Date: 2014-01-21 Impact factor: 3.186