Comparative Evaluation of the Effects of Diclofenac Sodium and Vitamin D Supplementation on Symptoms in Individuals With Myofascial Pain and Vitamin D Deficiency: A Randomized Controlled Clinical Trial

Abstract

Background: Temporomandibular joint disorders are significant health issues characterized by dysfunctions in the masticatory muscles and the temporomandibular joint. These disorders are often associated with stress, oral parafunctions, and habits such as bruxism. Treating bruxism and other parafunctional habits can reduce symptoms of myofascial pain. While the etiology of bruxism remains unclear, psychological factors like stress and anxiety, along with central nervous system, are thought that it will provoke. Additionally, a significant relationship has been reported between low serum vitamin D levels and bruxism. The aim of this study is to comparatively evaluate the effectiveness of nonsteroidal anti-inflammatory drug treatment and vitamin D supplementation on symptoms in individuals with myofascial pain and vitamin D deficiency. Methods: This study included patients aged 18–40, diagnosed with myofascial pain (MP) according to DC/TMD criteria, and individuals with vitamin D deficiency. Two different treatment methods were applied to the patients. One group received medical treatment with diclofenac sodium and an occlusal splint. The other group received vitamin D supplementation and an occlusal splint. The patients’ mouth opening and pain scores were evaluated at four stages; before treatment, and 1 week, 4 weeks, 12 weeks after the initiation of treatment. Results: The study ultimately included 40 participants, with 20 patients per group. Of the participants, 3 (7.5%) were male and 37 (92.5%) were female. At the end of the study, the changes in mouth opening and VAS scores were homogeneous in both groups. Conclusions: Vitamin D may serve as an alternative with anti-inflammatory and analgesic effects compared to NSAIDs. Trial registration: This randomised trial was approved by the Van Yüzüncü Yıl University Faculty of Medicine Clinical Research Ethics Committee (May 18, 2022, decision no: 05). The trial was registered with the Clinical Trial Registry (Number and date: NCT06111573, 10/31/2023). © 2025 Elsevier B.V., All rights reserved.