Biometric Assessment of Temporomandibular Disorders in Orthodontics: A Multi-arm Randomized Controlled Trial.

Abstract

This randomized controlled trial aimed to evaluate the role of fixed orthodontic treatment in the aggravation, precipitation, or alleviation of temporomandibular disorders in young adults. Sixty patients were randomly assigned to 4 groups of 15 patients each (group I, orthodontic treatment in temporomandibular disorder-free orthodontic patients; group II, orthodontic treatment in patients with mild symptoms of temporomandibular disorders; group III, splint therapy accompanied by orthodontic treatment in patients with moderate symptoms; and group IV, control with no treatment). The biometric equipment used were the T-scan, to analyze the occlusal component; the BioEMG for muscular analysis; BioJVA for temporomandibular joint acoustic analysis; and JT3D for mandibular kinematic analysis. The paired t-test and ANOVA were used for intragroup and intergroup comparisons, respectively. The difference between groups was assessed using post hoc Tukey's test. Groups I and III showed significant difference in the occlusal, muscular, temporomandibular joint vibration, and kinematic mandibular assessment variables. Group II showed significant improvement in occlusal variables only. Group IV did not show improvement in any of the variables except for certain muscular components. Successful practical utilization of biometric equipment revealed that fixed orthodontic treatment does not aggravate temporomandibular disorders. It was also found that temporomandibular disorders due to malocclusion can be treated successfully with orthodontic treatment, whereas temporomandibular disorders due to multifactorial temporomandibular joint and muscular components might require splint therapy before orthodontic intervention.