Abstract
This study aimed at evaluating the effectiveness of partial use of anterior repositioning appliances in the management of TMJ pain and dysfunction when compared to stabilization splints and a control group in a one-year follow-up. Sample was initially constituted by 60 patients, randomly divided into three groups: I- stabilization splints, II- repositioning splints and III- no treatment. The whole sample was evaluated by means of TMJ and muscle palpation, mandibular AROM, analysis of occlusal contacts, joint sounds inspection and Visual Analogue Scale (VAS) for one year; 52 patients composed the final sample. A significant (after 15 days) improvement in pain report (VAS) and palpation index was found for group II (p < or = 0.01). The occurrence of occlusal alterations as posterior open bite or gross interferences after the splint therapy and increased muscle tenderness were not problems in this study. Similar results in joint noises reduction were observed for the entire sample. It was concluded that controlled partial use of repositioning splints is a beneficial tool in the management of intra-articular pain and dysfunction, with no risks of irreversible occlusal changes.
Highlights
Temporomandibular Disorders (TMD) embrace a series of signs and symptoms involving the Temporomandibular Joint (TMJ), masticatory muscles or both[18].TMJ internal derangements constitute one of the most common findings in TMD patients
Sample The sample was initially constituted of 60 patients, with complaints of TMJ pain presented to treatment at the Orofacial Pain Clinic at Bauru Dental School, University of São Paulo, Brazil
Report of pain and TMJ/ muscle palpation Analysis within groups and between groups was performed for this variable
Summary
Temporomandibular Disorders (TMD) embrace a series of signs and symptoms involving the Temporomandibular Joint (TMJ), masticatory muscles or both[18].TMJ internal derangements constitute one of the most common findings in TMD patients. Recommended in the past, the reestablishment of a “normal” condyle/disc relationship as part of a treatment protocol has been discussed, based on studies that demonstrated the capacity of the TMJ to adapt into a pain free condition, even with displaced disc[22,23]. Open TMJ surgery with permanent disc suture to condyle used to be a form of treatment for painful joints refractory to conservative strategies Another protocol recommended the use of protrusive splints followed by a gradual return to the original intercuspal position in order to bring the disc back to the top of condyle[19]. High levels of relapse and return of symptoms were, very frequent12,13 ,which directed researchers to reconsider the need for a reconstructive phase II therapy[30]
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