Objective:
To study the outcome of oral appliance treatment in myofascial
Temporomandibular disorder (TMD) patients with and without comorbid pain
using pain site drawings.

Material and methods:
This randomized, controlled multicentre study comprised 65 myofascial
TMD patients diagnosed according to the Research Diagnostic Criteria for
Temporomandibular Disorders. Pain-site drawings were filled in at the
baseline examination. The patients were treated with oral appliances.
Treatment outcome was followed up for 1 year and analysed according to
the recommendations by the Initiative on Methods, Measurement and Pain
assessment in Clinical Trials (IMMPACT) on an intent-to-treat basis. The
data were analysed for two pain profiles, localized pain (face and
head, n = 26) versus widespread pain group (pain sites outside the face and head, n = 39).

Results:
Statistically significant improvement was registered within both groups
for all outcome variables (characteristic pain intensity, 30% pain
reduction of worst reported pain, graded chronic pain, depression, and
somatization scores) during the follow-up with only small differences
between the groups.

Conclusions: Oral appliance treatment had a positive effect on
all outcome measures during the 1-year follow-up in patients suffering
from myofascial TMD pain, regardless of whether the pain was localized
or widespread. Multiple pain sites seemed to have surprisingly little
influence on the outcome variables. However, some indications of more
challenges when treating patients with widespread pain compared to local
pain could be observed. Pain-site drawings seem to be useful in the
clinical situation and could support the clinicians in decision-making
regarding treatment planning.