Comparison of the Efficacy of Two Different Types of Splint Used in Patients with TemporomandibularJoint Disorders
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2018, Vol 6, Issue 3
Abstract
Objectives: One of the most common treatment modalities for patients with a diagnosis of reduced disc displacement is occlusal splinting. Stabilization splints (SS) and anterior repositioning splints (ARS) are frequently used in such cases. Materials and Methods: The effects of these two splint types on patient satisfaction were evaluated in patients with temporomandibular disorder (TMD). 25 healthy people with no pathology of the temporomandibular joint were included as a control group. ARS’s were used in 18 patients; all patients used the splints for 2 months. The splint was then converted into a stabilization splint for use for 1 further month. In the other 32 patients, a SS was used for 1 month. All the patients filled out the same temporomandibular questionnaire (TQ) again after the ARS was converted into a SS and had been used for 1 month. Results: The use of both types of splint significantly affected scores on the TQ (p < 0.05). There was a significant difference in questionnaire results among the control group, SS group, and ARS group before treatment (p < 0.05). There was no statistically significant difference in questionnaire results among the three groups after treatment (p > 0.05). Conclusion: These results indicate that the use of both ARS and SS significantly increased satisfaction among patients with TMD. The temporomandibular joint plays an important role in the basic functions of the stomatognathic system. It is a morphologically slipping axis compound joint that makes a hinge and slip movement and varies morphologically among individuals, and between left- and right-sided joints [1,2]. Temporomandibular disorder (TMD) is a clinical condition characterized by pain, emission of a sound (clicking or crepitation), and irregular movements in the jaw joint; it is one of the most difficult-to-treat causes of maxillofacial pain [2].There may be unilateral or bilateral irregularity in the temporomandibular joint [3,4]. Certain problems in the temporomandibular joint and neuromuscular system constitute TMD [5,6]. The purpose of treating TMD is to correct etiologic and pathogenic abnormalities, relieve disease symptoms, restore joint mobility, and achieve postural healing [6,7]. TMD is not treated by a single method. Conservative non-surgical treatment options are recommended for initial treatment [5,8]. Commonly used physiotherapy treatment options include an occlusal splint, low-dose laser therapy, physical exercises, and drug therapy to relieve inflammation and pain and stimulate tissue healing [9-12]. One method used to treat dysfunction of the temporomandibular joint and muscles of the chewing system is occlusal splint therapy [13,14]. The aim of occlusal splint therapy is to achieve neuromuscular balance in the chewing system and reduce the damage caused by parafunctional habits [13,15]. Because this therapy is reversible and noninvasive, its use as an initial treatment is recommended. When the occlusal splint is designed according to the etiology of a particular joint disease, symptoms may be reduced [11,16, 17]. Occlusal splints commonly used in the treatment of TMD include stabilization splints and anterior repositioning splints [16]. Stabilization splints are usually preferred for patients with muscle hyperactivity; thus, they can be used in patients with bruxism [15,16]. Other candidate patients are those with local sensitization or chronic myalgia [10]. In addition, this splint can be used to treat patients with retro discitis, which forms after trauma, to reduce the force on the damaged tissue and confer more effective healing [13, 16]. Stabilization splints are also used in patients with condylar disc irregularities [11,16]. With use of anterior repositioning splints, highly effective results can be obtained, especially in disc irregularities [15,18]. In cases of condylar disc irregularity, stabilization can be achieved with an anterior repositioning splint if the stabilization splint proves ineffective [18,19]. The anterior repositioning splint positions the disc and mandible at the anterior region and ensures a better disc-condyle relationship, thus allowing retrodiscaltissues to adapt. It also allows regeneration of retrodiscal tissues and discrete ligaments andalleviate pain by reducing the load on the joint [18]. In this study, the effects of stabilization and anterior repositioning splints on the healing of patients with TMD were evaluated using a questionnaire survey.
Authors and Affiliations
Kilic Kerem, Eraslan Ravza Kurtulus, Leblebicioğlu Ikbal
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