Usefulness of an occlusal device in the treatment of medication overuse headache and persistent idiopathic facial pain: preliminary results

There is a debate in literature about the therapeutic usefulness of oral devices in patients suffering from Medication Overuse Headache (MOH) or in patients suffering from Persistent Idiopathic Facial Pain (PIFP). From the case histories of 3356 patients, referred to us with a diagnosis of chronic craniofacial pain for assessment of the eventual application of an occlusal device to correct an impaired neuromuscular relationship between the mandible and the maxilla, we selected, following the criteria of the International Classification of Headache Disorders (ICHD-3beta), two groups of patients suffering from MOH and PIFP. All patients of the two groups underwent a Kinesiographic exam and an EMG to evaluate the freeway space (FWS). Patients presenting an impaired FWS were placed in treatment with the application of an occlusal device. At the follow-up after 6 months and after 1 year, we found a significant decrease in pain with regard to the intensity resulting in the reduction of clinical disability. The preliminary data collected using the VAS scale and the MIDAS questionnaire confirm that the neuromuscular cranio-mandibular system can have an important role in the diagnostic process of the MOH and the PIFP, suggesting the usefulness of treatment with an occlusal device, where there is adequate FWS.