Evaluation of the Efficacy of Different Drugs in the Treatment of the Pain in Patients With Temporomandibular Disorder

Study Overview
=================
Brief Summary
-----------------
The most important step in the treatment of TMJ (temporomandibular joint) disease in clinical dentistry is diagnosis and planning. The clinical findings, drug requirement and biological risk of the patients determine the examination methods to be used in the Treatment of Temporomandibular Joint Disorders. In this context, it is thought that studies in the field of dentistry should be increased in order to increase the success in the treatment of TMJ Disorders. The aim of the study is to evaluate the efficacy of of different pain relievers as Dexketoprofen Trometamol + Thiocolchicoside, dexketoprofen trometamol + paracetamol and Dexketoprofen Trometamol in the treatment of pain in TMJ disorders.

Detailed Description
-----------------
The study was carried out on 200 patients aged 18 and over, who applied to Van Yuzuncu Yıl University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery, with complaints of pain due to temporomandibular disease. When patients first applied to the clinic, their anamnesis were taken and they were directed to MR (Magnetic Resonance) imaging after clinical evaluation. Patients who meet the inclusion criteria and volunteer were included in the study. Patients were randomly divided into 4 groups. Medications were given to patients by auxiliary staff and the study was double-blind. Medicines were given as follows. Dexketoprofen Trometamol + Thiocolchicoside (25mg + 4mg, 2x1) in the 1st group, Dexketoprofen Trometamol + Paracetamol (25mg + 300mg, 2x1) in the 2nd group, only Dexketoprofen Trometamol (25mg, 2x1) in the 3rd group and paracetamol 500 mg in the 4th control group (4x1) were given. In addition, patients in each group used occlusal plate for a minimum of 8 hours per day (at night). Medicines were used regularly for 2 weeks. Paracetamol 500 mg was used only if needed for the next 2 weeks. The pain values of the patients was evaluated with the VAS scale, and the amount of mouth opening was evaluated by measuring the distance between the incisal edges of the lower and upper central teeth. Evaluations have been done at the beginning of the treatment and at the 1st week, 2nd week, 1st month and the 3rd month and the findings were recorded. After the 1st month, the patients were followed up to the 3rd month and the treatment of those who need additional treatment were continued. Obtained data will be analyzed and evaluated statistically.

Official Title
-----------------
Evaluation of the Efficacy of Different Drugs in the Treatment of the Pain in Patients With Temporomandibular Disorder

Conditions
-----------------
Temporomandibular Disorder

Intervention / Treatment
-----------------
* Drug: Dexketoprofen Trometamol + Thiocolchicoside
* Drug: Dexketoprofen Trometamol + Paracetamol
* Drug: Dexketoprofen Trometamol (25mg)
* Drug: Paracetamol


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Individuals aged 18 and over Individuals without any systemic disease Individuals without missing teeth Individuals who have not used any medication in the last week Individuals with normal TMJ MR imaging Patients who applied to our clinic and had pain due to temporomandibular disease. Exclusion Criteria: Individuals who do not come to their check-ups regularly Individuals allergic to any of the study drugs Pregnant and lactating individuals

Ages Eligible for Study
-----------------
Minimum Age: 18 Years
Maximum Age: 40 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
Accepts Healthy Volunteers

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Factorial Assignment
Masking: Quadruple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Dexketoprofen Trometamol + Thiocolchicoside<br>(25mg + 4mg, 2x1) | Drug: Dexketoprofen Trometamol + Thiocolchicoside<br>* Dexketoprofen Trometamol + Thiocolchicoside (25mg + 4mg) is a NSAID. It was given to the patients twice a day.<br>|
| Active Comparator: Dexketoprofen Trometamol + Paracetamol<br>(25mg + 300mg, 2x1) | Drug: Dexketoprofen Trometamol + Paracetamol<br>* Dexketoprofen Trometamol + Paracetamol (25mg + 300mg) is a NSAID. It was given to the patients twice a day.<br>|
| Active Comparator: Dexketoprofen Trometamol<br>(25mg, 2x1) | Drug: Dexketoprofen Trometamol (25mg)<br>* Dexketoprofen Trometamol (25mg) is a NSAID. It was given to the patients twice a day.<br>|
| Active Comparator: Paracetamol<br>(500 mg, 4x1) | Drug: Paracetamol<br>* Paracetamol (500 mg) is a mild analgesic and antipyretic. It was given to the patients to take only if needed as max. dose 2000mg.<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Pain Evaluation | Patients were requested to mark their pain intensity on a pain assessment form using a visual analogue scale (VAS) ranging between 0 (no pain) to 10 (most severe pain). | 1st week | 
| Pain Evaluation | Patients were requested to mark their pain intensity on a pain assessment form using a visual analogue scale (VAS) ranging between 0 (no pain) to 10 (most severe pain). | 2nd week | 
| Pain Evaluation | Patients were requested to mark their pain intensity on a pain assessment form using a visual analogue scale (VAS) ranging between 0 (no pain) to 10 (most severe pain). | 1st month | 
| Pain Evaluation | Patients were requested to mark their pain intensity on a pain assessment form using a visual analogue scale (VAS) ranging between 0 (no pain) to 10 (most severe pain). | 3rd month | 
| Trismus Evaluation | Postoperative trismus will evaluated by the maximum distance between the incisive borders of the upper and lower right incisive teeth which was measured with a caliper. | 1st week | 
| Trismus Evaluation | Postoperative trismus will evaluated by the maximum distance between the incisive borders of the upper and lower right incisive teeth which was measured with a caliper. | 2nd week | 
| Trismus Evaluation | Postoperative trismus will evaluated by the maximum distance between the incisive borders of the upper and lower right incisive teeth which was measured with a caliper. | 1st month | 
| Trismus Evaluation | Postoperative trismus will evaluated by the maximum distance between the incisive borders of the upper and lower right incisive teeth which was measured with a caliper. | 3rd month | 
| Pain Evaluation (at masticatory muscles by palpation) | The presence of pain in the masticatory muscles was evaluated by palpation of the muscles. | 1st week | 
| Pain Evaluation (at masticatory muscles by palpation) | The presence of pain in the masticatory muscles was evaluated by palpation of the muscles. | 2nd week | 
| Pain Evaluation (at masticatory muscles by palpation) | The presence of pain in the masticatory muscles was evaluated by palpation of the muscles. | 1st month | 
| Pain Evaluation (at masticatory muscles by palpation) | The presence of pain in the masticatory muscles was evaluated by palpation of the muscles. | 3rd month | 
| Clicking-Crepitus Evaluation | Presence or absence of clicking and/or crepitus sounds detected with auscultation at temporomandibular joint. | 1st week | 
| Clicking-Crepitus Evaluation | Presence or absence of clicking and/or crepitus sounds detected with auscultation at temporomandibular joint. | 2nd week | 
| Clicking-Crepitus Evaluation | Presence or absence of clicking and/or crepitus sounds detected with auscultation at temporomandibular joint. | 1st month | 
| Clicking-Crepitus Evaluation | Presence or absence of clicking and/or crepitus sounds detected with auscultation at temporomandibular joint. | 3rd month |