Effect of brief cognitive therapy on clinical outcomes and treatment compliance among patients with temporomandibular disorders

Background: Pain has been described as the main chief complaint among patients with Temporomandibular Disorders (TMDs). A variety of treatment modalities to manage TMDs and other pain conditions have been presented in the literature. One of these is the use of brief cognitive therapy (BCT) in the patient population. Aim: The purpose of this retrospective study was to evaluate the effect of brief cognitive therapy in combination with standard treatment compared to standard treatment (ST) alone on the following outcomes: 1) increase in mandibular range of motion for both unassisted opening without pain and maximum unassisted opening and 2) treatment compliance among patients with TMD. Material and methods: A total of 123 charts from patients who had received treatment at the TMD and Orofacial Pain clinic at the University at Buffalo School of Dental Medicine were considered for this study. All of the patients had been evaluated using the Research Diagnostic Criteria for TMD (RDC/TMD) during their clinical visits. Of these, 66 patients met the inclusion criteria and had complete data. Twenty-nine were patients who had received brief cognitive therapy (BCT) in addition to standard treatment and 37 were patients that had only received standard treatment. Measurements of unassisted opening without pain and maximum unassisted opening were obtained at the initial and subsequent visits. In addition, the number of appointments scheduled, canceled, disappointed, and completed were obtained from the School of Dental Medicine database. Results: At baseline, there were statistically significant differences in the mandibular range of motion parameters between the two intervention groups; the patients in the intervention group who received BCT in addition to their standard treatment had lower values associated with unassisted opening without pain and maximum unassisted opening. The differences between baseline and after treatment mandibular range of motion were calculated for all participants. There were no statistically significant differences in these clinical variables between the groups. In regard to the compliance measurements, both groups presented with approximately 75% compliance and the differences between them were not statistically significant. Conclusions: In this retrospective study the addition of BCT to standard treatment did not increase mandibular range of motion or compliance compared to standard treatment alone among patients with temporomandibular disorders.