## 4 Discussion  
Myofascal pain is the most common TMD and its etiology is multifactorial. Several therapies and appliances have been developed to try to diagnose it and relieve the associated symptoms [34,35]. Reversible treatments should be preferred to invasive procedures (i.e., occlusal adjustment, through selective grinding of the tooth surfaces) for the rehabilitation of patients with myofascal disease, and generally for TMD [14,36]. Among the successful conservative therapies, occlusal splint therapy has been demonstrated to be effective in the management of pain in patients with TMD [17]. The aim of occlusal \begin{table}
\begin{tabular}{c c c c} \hline \hline
**PI-NRS** & **Mean \(\pm\) SD** & **Median** & \(p\)**-Value \({}^{\text{a}}\)** \\ \hline t0 & 6.45 \(\pm\) 2.03 & 6.5 & \\ t1 & 4.48 \(\pm\) 1.73 & 4 & \\ t2 & 2.86 \(\pm\) 2.12 & 2.5 & \\ \hline \hline \end{tabular} Legend: SD, standard deviation;\({}^{\text{a}}\) Friedman test.  
\end{table} 
Table 1: Mean and Median of Group Test (42 subjects) at t0, t1 (4 months) and t2 (8 months). \begin{table}
\begin{tabular}{c c c c} \hline \hline
**PI-NRS** & **Mean \(\pm\) SD** & **Median** & \(p\)**-Value \({}^{\text{a}}\)** \\ \hline t0 & 6.71 \(\pm\) 1.98 & 7 & \\ t2 & 7.21 \(\pm\) 1.73 & 7 & \\  & & & \(p>0.01\) \\ \hline \hline \end{tabular} Legend: SD: standard deviation;\({}^{\text{a}}\) [PERSON] test.  
\end{table} 
Table 2: Mean and Median of Group Control (44 subjects) at t0 and t2 (8 months). split therapy is to establish neuromuscular harmony in the masticatory system by jaw repositioning and to create a mechanical disadvantage for parafunctional forces trough removable appliances [37]. In this study, we evaluated the effectiveness of splint therapy in determining a reduction in myofascal pain, using two anterior repositioning splints in a complementary way (MORA, during daytime, and SVED during the night). The splints design was based on a posture-stabilometric evaluation to find out if a mandibular repositioning could both improve the postural arrangement of the body and reduce myofascal pain in the orofacial region. The possibility that mandibular repositioning could affect body posture has been previously investigated and the aim of our study to obtain a personalized splint is literature-based [38]. In their randomized clinical trial, [PERSON] et al. [39] demonstrated a reciprocal influence between mandibular position and body posture observing that experimental changes in one of the two system consequently affect the other one. The postural system including both body and head posture is narrowly regulated by a sophisticated information network in which mandibular joint and muscles proprioceptors and periodontal ligament mechanoreceptors are of primary importance through the trigeminal nerve [40]. TMDs typically affect these trigeminal inferences and proprioception mechanisms. This could provoke, with a descending action, an unbalance of the whole postural muscles chains and finally posture alterations. Since occlusal therapy could induce a re-equilibrium of masticatory muscles, this re-equilibrium could influence, with a descending action, the whole body postural muscles, resulting in an improved posture [41]. Mandibular position which allows the best bilateral occlusal contact and ideally overbite and overjet results in reducing disharmony between muscle systems of the right and left sides, regarding both masticatory and neck muscles, such as stemocleidomastoid [39; 42; 43]. Bilateral disharmonies of the neuromuscular system may lead to the instability of the head position and consequently body posture, but at the same time causing MP. In this study, PI-NRS scores for pain showed significant improvement throughout all study intervals in the group treated with MORE and SVED splints, while no pain score reduction or even increase was observed in control group without any treatment for 8 months, confirming the reliability of the treatment and the absence of a spontaneous correction of the symptoms.