***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The aim of the present study was to compare the effect of transcutaneous electric nerve stimulation ( TENS ) with the flat occlusal splint in the treatment of temporom and ibular joint ( TMJ ) disk displacement without reduction . Thirty-one patients were included and r and omly selected to be treated 6 weeks with either TENS ( 90 Hz , 30 min , three times/day ) or with a flat occlusal splint ( 24 h/day . Those selected for the TENS group had one electrode placed over the painful TMJ and another electrode over the anterior temporal muscle . The splint group used a conventional flat occlusal splint with cuspid guidance . Both treatment groups visited the clinic once a week . Symptoms and signs were registered before and after treatment . The intensity of pain was recorded with a visual analogue scale ( VAS ) and with an electronic pocket-sized recorder ( Pain-Track ) carried 1 week before and also the last week of treatment for continuous registration of pain . Measured with the VAS , half of the patients treated with splints became pain-free or their TMJ pain improved at least 50 % both at rest and with jaw function compared with only 6 % in the TENS-treated group . With regard to strictly chewing pain , the VAS-registered pain improved in two-thirds of the splint group , compared with 50 % of the TENS group . With the Pain-Track device it was found that in most individuals pain was aggrevated at mealtimes . The conclusion was that flat occlusal splints in several respects are better than TENS in the treatment of symptoms associated with TMJ disk displacement without reduction A r and omized clinical trial which included a follow-up of one year was applied to 118 myogenous TMD- patients . The therapies investigated were : physiotherapy of the masticatory system or splint therapy for patients without occlusal interferences , and occlusal adjustment therapy or the combination of splint and occlusal adjustment therapy for patients with pronounced occlusal interferences . Counseling , which yielded a reduction of 27 % of the scored pain intensity , will most likely eliminate any further need for treatment of patients with a low level of myogenous TMD signs and symptoms . Otherwise , physiotherapy might be preferred as a starting option with respect to splint therapy because of 1 . A similar efficacy ; 2 . A shorter treatment duration so that either chronic facial pain is earlier relieved or a patient can undergo a second type of therapy earlier ; and 3 . Lower costs . One third of the patients selected had pronounced occlusal interferences . Using stringent criteria it might be possible to apply occlusal adjustment therapy without involvement of splint therapy yielding a similar therapy efficacy and with advantages of a shorter treatment duration and lower costs . All types of therapy diminished not only facial pain but also pain of neck and shoulder areas In order to evaluate and compare the effects of biofeedback and occlusal splint therapy on m and ibular dysfunction , 30 patients were r and omly divided into two treatment groups . The patients were women aged 20 - -40 years without any obvious organic reasons for their symptoms . There were no significant differences between the two groups before the start of treatment in respect of signs and symptoms of m and ibular dysfunction . One group used full coverage splints at night for 6 weeks . The other group received biofeedback training up to six times , 30 min per session . One month after completion of the therapy the patients were re-examined . Both groups showed a significant reduction in symptoms , both subjectively and clinical ly . No significant differences between the groups were found . The two treatments were thus equally effective in the short-term perspective in patients with signs and symptoms of m and ibular dysfunction Sixty-three patients with an arthrographic diagnosis of disk displacement with reduction were r and omly assigned to three treatment groups : ( I ) onlays to maintain disk repositioning , ( II ) flat occlusal splint , or ( III ) untreated controls .  Guidance for construction of the disk-repositioning onlays was established during arthrography to obtain a recaptured disk position relative to the condyle . The onlays were cemented to the teeth and maintained the new intercuspal position anteriorly and inferiorly . The flat occlusal splint was used at night only and was adjusted to maintain a maximal occlusal contact in centric relation and centric occlusion . Clinical examinations were performed before and after 6 months of treatment . The disk-repositioning onlays  improved joint function and reduced joint and muscle pain when compared with the flat occlusal splint and with nontreatment . The signs and symptoms in the flat occlusal splint group were no different from those in the control group . It is concluded that disk-repositioning onlays are effective in reducing pain and dysfunction associated with disk displacement with reduction in patients in whom the disk can be maintained in a normal relationship to the condyle with the aid of such onlays . The symptoms , however , returned when the onlays were removed after 6 months ; this raises the question of whether a permanent change in the intercuspal position is necessary for long-term success Forty-five individuals with long-st and ing facial pain or headache of muscular origin were r and omly allocated into three groups . The first group was treated with acupuncture , the second group received an occlusal splint , and the third group served as controls . Both acupuncture and occlusal splint therapy significantly reduced subjective symptoms and clinical signs from the stomatognathic system . No differences between these two groups were found with regard to treatment effects . It is concluded that acupuncture is an alternative method to conventional stomatognathic treatment for individuals with craniom and ibular disorders of muscular origin Twenty-four patients were selected to participate in this study . Twelve patients were r and omly selected to receive occlusal splint therapy and the other 12 to receive a simplified relaxation therapy technique .  Observable pain scores , maximum comfortable interincisal distance , and maximum interincisal distances were recorded for each group before and after treatment . The occlusal splint group showed a significant decrease in total mean observable pain scores ( decrease score of 10.5 , t = 3.124 ; P less than 0.1 ) . The relaxation group showed no significant decrease in total mean observable pain scores ( decrease score of 1.8 , t = 0.888 ; P = ns ) . The occlusal splint group showed a significant increase in the mean maximum comfortable opening ( an increase of 12.4 mm , t = 5.085 ; P less than .01 ) . The relaxation group showed no significant increase in the mean maximum comfortable opening ( an increase of 2.3 mm , t = 0.734 ; P = ns ) . The occlusal splint group showed a significant increase in the mean maximum opening ( an increase of 6.0 mm , t = 2.471 ; P less than .05 ) . The relaxation group showed no increase in the mean maximum opening ( decrease of 0.7 mm , t = 0.343 ; P = ns ) . This study suggests that occlusal splint therapy is a more effective treatment for the pain , tenderness , and limited m and ibular opening associated with temporom and ibular disorders than relaxation therapy . In this study , the relaxation technique used had no significant effect on the patients ' pain , tenderness , or limited opening To assess the differential efficacy of two commonly used treatments for temporom and ibular disorders ( TMD ) , intraoral appliances ( IAs ) and biofeedback ( BF ) , separately and in combination , two studies were conducted . The first study directly compared IA treatment , a combination of biofeedback and stress management ( BF/SM ) , and a waiting list control group in a sample of 80 TMD patients . Both treatments were determined to be equally credible to patients , ruling out this potential threat to the validity of the results obtained . The results demonstrated that the IA treatment was more effective than the BF/SM treatment in reducing pain after treatment , but at a 6-month follow-up the IA group significantly relapsed , especially in depression , whereas the BF/SM maintained improvements on both pain and depression and continued to improve . The second study examined the combination of IA and BF/SM in a sample of 30 TMD patients . The results of this study demonstrated that the combined treatment approach was more effective than either of the single treatments alone , particularly in pain reduction , at the 6-month follow-up . These results support the importance of using both dental and psychologic treatments to successfully treat TMD patients if treatment gains are to be maintained Stabilization appliances are commonly used in the treatment of temporom and ibular disorders ( TMD ) , although the treatment effects are not fully understood . This study evaluated the short-term efficacy of a stabilization appliance in patients with TMD of arthrogeneous origin , using a r and omized , controlled , and double-blind design . Sixty patients were assigned to two equally sized groups : a treatment group given a stabilization appliance and a control group given a control appliance . Improvement of overall subjective symptoms was reported in both groups but significantly more often in the treatment group than in the control group ( P = 0.006 ) . Frequency of daily or constant pain showed a significant reduction in the treatment group ( P = 0.02 ) compared with the control group . The results of this short-term evaluation showed that both the stabilization appliance and the control appliance had an effect on temporom and ibular joint ( TMJ ) pain . It is improbable that the difference observed between the groups is due to chance alone From a total of 1344 consecutive patients referred to a TMD clinic , twenty-six patients fulfilled the strict inclusion criteria s of TMD of mainly muscular origin . Half of the patients were assigned to receive treatment with an interocclusal appliance , the treatment being performed by a dentist . The other half was instructed to perform individualized therapeutic jaw exercises , and this treatment was managed by a dental assistant . The treatment result was evaluated after six months . The two treatments had a positive and equal effect upon both signs and symptoms of TMD . A further follow-up by question naire one to four years after the final clinical examination showed a lasting treatment result in most patients . Many patients , however , continued to perform jaw exercises and /or to wear their appliances . This indicates that these two treatments are mostly symptomatic and not causal . The conclusion of the present investigation is that therapeutic jaw exercises , managed by a dentist or a dental assistant , is a cost effective treatment with a prognosis comparable to a treatment with an interocclusal appliance and can thus be recommended as the first therapy of choice in patients with TMD of mainly muscular origin STATEMENT OF PROBLEM Soft and hard stabilizing appliances have been used to treat temporom and ibular disorders . No data exist to suggest whether a hard or soft appliance is beneficial . PURPOSE This study compared soft and hard acrylic resin stabilizing appliances in the reduction of masticatory muscle pain in patients with temporom and ibular disorders . MATERIAL S AND METHODS Twenty-three patients with at least one clinical sign from the list of diagnostic subgroups of temporom and ibular disorders were alternately assigned a hard or soft appliance for temporom and ibular disorder treatment . No other temporom and ibular disorder treatment ( self-care , physical therapy , biofeedback , or muscle or joint injections ) was rendered . Each patient was seen by two dentists at each visit . One dentist initially fabricated the appliance and adjusted the appliance on each visit and an examining dentist examined the patient each visit and recorded signs of temporom and ibular disorders . The appliance material ( soft or hard ) was not disclosed to the examining dentist , only to the dentist who fabricated and adjusted the appliance . Patients were examined and appliances were adjusted every 2 to 3 weeks for a minimum of 10 weeks . Masticatory muscles were palpated and charted on each visit . Data were analyzed and subjected to nonparametric Mann-Whitney test . RESULTS Eighteen of the initial 23 patients , 7 in the hard appliance group and 11 in the soft appliance group finished the study over 10- to 15-week period . Soft and hard appliances performed the same in reduction of masticatory muscle pain . CONCLUSION This study suggests , based on the limited number of participants , that soft and hard stabilizing appliances may be equally useful in reducing masticatory muscle pain in short-term appliance therapy Objective : To examine whether the stabilisation splint is a suitable treatment for pain dysfunction syndrome and to determine the most appropriate pattern of usage . Design : Prospect i ve r and om control clinical trial . Setting : Dental school clinic unit . Subjects : 70 patients diagnosed with pain dysfunction syndrome were treated with a stabilisation splint for 3 months . Group 1 ( 23 patients ) wore the splint 24 hours/day . Group 2 ( 19 patients ) wore the splint only during the day . Group 3 ( 28 patients ) wore the splint only at night . Results : There was no statistically significant advantage to any pattern of splint usage ; all groups showed a marked improvement by subjective and objective assessment . Conclusions : Patients being treated for pain dysfunction syndrome by a stabilisation splint need wear the splint only at BACKGROUND Hypnorelaxation has a potentially beneficial effect in the treatment of masticatory myofascial pain disorders ( MPD ) . However , there are no data regarding the efficacy of hypnorelaxation in the treatment of MPD compared with other accepted modes of treatment ( such as occlusal appliance ) or with the mere effect of time . OBJECTIVE AND SUBJECTS The purpose of the present study was to evaluate the effectiveness of  hypnorelaxation  in the treatment of MPD compared with the use of occlusal appliance and /or to minimal treatment . The study population consisted of 40 female patients with myofascial pain who were allocated to 1 of 3 possible treatment groups : ( 1 ) hypnorelaxation ( n = 15 ) , ( 2 ) occlusal appliance ( n = 15 ) , and ( 3 ) minimal treatment group ( n = 10 ) . RESULTS Both active treatment modes ( hypnorelaxation and occlusal appliance ) were more effective than minimal treatment regarding alleviating muscular sensitivity to palpation . However , only hypnorelaxation ( but not occlusal appliance ) was significantly more effective than minimal treatment with regard to the patient 's subjective report of 
    Output:
    
There was no evidence of a statistically significant difference in the effectiveness of stabilisation splint therapy ( SS )  in reducing symptoms in patients with pain dysfunction syndrome compared with other active treatments .
There is weak evidence to suggest that the use of SS for the treatment of PDS may be beneficial for reducing pain severity , at rest and on palpation , when compared to no treatment .
REVIEW ER 'S CONCLUSIONS There is insufficient evidence either for or against the use of stabilisation splint therapy for the treatment of temporom and ibular pain dysfunction syndrome .