- Volume 40 Issue 1
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A Study on the Change of Occlusal Contacts and Lateral Cephalometric Variables after Stabilization Splint Therapy in Temporomandibular Disorders Patients
- Na, Hyojung (Department of Oral Medicine and Oral Diagnosis, School of Dentistry, Seoul National University) ;
- Lee, Jeong-Yun (Department of Oral Medicine and Oral Diagnosis, School of Dentistry, Seoul National University)
- Received : 2015.01.22
- Accepted : 2015.02.09
- Published : 2015.03.30
Purpose: The aim of this study is to assess the relationship between possible occlusal change after stabilization splint therapy and the research diagnostic criteria for temporomandibular disorders (RDC/TMD) Axis I diagnoses and lateral cephalometric variables. Methods: Clinical and radiographic records of 47 TMD patients wearing stablization splint were reviewed. The number of occluding teeth was recorded and lateral cephalogram was taken at pre-treatment and 6-month post-treatment. They were divided into two groups. The control group consists of patients with the unchanged number of occluding teeth throughout 6-month splint therapy (19 females and 4 males), and occlusal-loss group with the number of occluding teeth decreased (19 females and 5 males). The difference of RDC/TMD diagnoses and cephalometric variables were compared between two groups. Results: In the control group, RDC group I, muscle disorders, was 39.1% (9/23), group II, disc displacements, was 17.4% (4/23), group III OA, osteoarthritis/osteoarthrosis, was 73.9% (17/23), and group III pain, arthralgia, was 82.6% (19/23). In the occlusal-loss group, group I was 41.7% (10/24), group II was 41.7% (10/24), group III OA was 70.8% (17/24), and group III pain was 83.3% (20/24). The frequency of RDC groups was not different between two groups, analyzed by binomial logistic regression. Pre-treatment cephalometric variables were not different between two groups. However, articular angle, AB to mandibular plane and ODI decreased and gonial angle increased significantly in the occlusal-loss group, implying clockwise rotation of the mandible, between pre-treatment and 6-month post-treatment, while none of cephalometric variables showed any statistical difference in the control group. Conclusions: Change in the number of occluding teeth was not related to the RDC/TMD diagnoses. Cephalometric values changed only in the occlusal-loss group as a result of mandibular clockwise rotation. None of cephalometric variables before the stabilization splint therapy was statistically different between the control and occlusal loss group.
Cephalogram;Occlusal appliance;Occlusion;Temporomandibular joint disorders
- Manfredini D, Piccotti F, Ferronato G, Guarda-Nardini L. Age peaks of different RDC/TMD diagnoses in a patient population. J Dent 2010;38:392-399. https://doi.org/10.1016/j.jdent.2010.01.006
- Pedroni CR, De Oliveira AS, Guaratini MI. Prevalence study of signs and symptoms of temporomandibular disorders in university students. J Oral Rehabil 2003;30:283-289. https://doi.org/10.1046/j.1365-2842.2003.01010.x
- Bagis B, Ayaz EA, Turgut S, Durkan R, Ozcan M. Gender difference in prevalence of signs and symptoms of temporomandibular joint disorders: a retrospective study on 243 consecutive patients. Int J Med Sci 2012;9:539-544. https://doi.org/10.7150/ijms.4474
- Okeson JP. Management of temporomandibular disorders and occlusion. St. Louis: Mosby Elsevier; 2008.
- de Leeuw JR, Steenks MH, Ros WJ, Lobbezoo-Scholte AM, Bosman F, Winnubst JA. Assessment of treatment outcome in patients with craniomandibular dysfunction. J Oral Rehabil 1994;21:655-666.
- Al-Ani MZ, Davies SJ, Gray RJ, Sloan P, Glenny AM. Stabilisation splint therapy for temporomandibular pain dysfunction syndrome. Cochrane Database Syst Rev 2004;(1):CD002778.
- Tallents RH, Katzberg RW, Macher DJ, Roberts CA. Use of protrusive splint therapy in anterior disk displacement of the temporomandibular joint: a 1-to 3-year follow-up. J Prosthet Dent 1990;63:336-341. https://doi.org/10.1016/0022-3913(90)90208-T
- Kai S, Kai H, Tabata O, Tashiro H. The significance of posterior open bite after anterior repositioning splint therapy for anteriorly displaced disk of the temporomandibular joint. Cranio 1993;11:146-152. https://doi.org/10.1080/08869634.1993.11677956
- Al-Ani Z, Davies S, Sloan P, Gray R. Change in the number of occlusal contacts following splint therapy in patients with a temporomandibular disorder (TMD). Eur J Prosthodont Restor Dent 2008;16:98-103.
- Fujii T, Torisu T, Nakamura S. A change of occlusal conditions after splint therapy for bruxers with and without pain in the masticatory muscles. Cranio 2005;23:113-118. https://doi.org/10.1179/crn.2005.016
- de Leeuw R, Klasser GD. Orofacial pain: guidelines for assessment, diagnosis, and management. Chicago: Quintessence; 2008.
- Carossa S, Di Bari E, Lombardi M, Preti G. A graphic evaluation of the intermaxillary relationship before and after therapy with the Michigan splint. J Prosthet Dent 1990;63:586-592. https://doi.org/10.1016/0022-3913(90)90081-M
- Dworkin SF, LeResche L. Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique. J Craniomandib Disord 1992;6:301-355.
- Manfredini D, Chiappe G, Bosco M. Research diagnostic criteria for temporomandibular disorders (RDC/TMD) axis I diagnoses in an Italian patient population. J Oral Rehabil 2006;33:551-558. https://doi.org/10.1111/j.1365-2842.2006.01600.x
- Dahlberg G. Statistical methods for medical and biological students. London: G. Allen & Unwin Ltd.; 1940.
- Humsi AN, Naeije M, Hippe JA, Hansson TL. The immediate effects of a stabilization splint on the muscular symmetry in the masseter and anterior temporal muscles of patients with a craniomandibular disorder. J Prosthet Dent 1989;62:339-343. https://doi.org/10.1016/0022-3913(89)90346-6
- Naeije M, Hansson TL. Short-term effect of the stabilization appliance on masticatory muscle activity in myogenous craniomandibular disorder patients. J Craniomandib Disord 1991;5:245-250.
- Daif ET. Correlation of splint therapy outcome with the electromyography of masticatory muscles in temporomandibular disorder with myofascial pain. Acta Odontol Scand 2012;70:72-77. https://doi.org/10.3109/00016357.2011.597776
- Scopel V, Alves da Costa GS, Urias D. An electromyographic study of masseter and anterior temporalis muscles in extra-articular myogenous TMJ pain patients compared to an asymptomatic and normal population. Cranio 2005;23:194-203. https://doi.org/10.1179/crn.2005.028
- Helkimo M, Ingervall B. Recording of the retruded position of the mandible in patients with mandibular dysfunction. Acta Odontol Scand 1978;36:167-174. https://doi.org/10.3109/00016357809004666
- Gateno J, Anderson PB, Xia JJ, Horng JC, Teichgraeber JF, Liebschner MA. A comparative assessment of mandibular condylar position in patients with anterior disc displacement of the temporomandibular joint. J Oral Maxillofac Surg 2004;62:39-43.
- Ren YF, Isberg A, Westesson PL. Condyle position in the temporomandibular joint. Comparison between asymptomatic volunteers with normal disk position and patients with disk displacement. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1995;80:101-107. https://doi.org/10.1016/S1079-2104(95)80025-5
- Badel T, Marotti M, Kern J, Laskarin M. A quantitative analysis of splint therapy of displaced temporomandibular joint disc. Ann Anat 2009;191:280-287. https://doi.org/10.1016/j.aanat.2008.12.004
- Ekberg EC, Vallon D, Nilner M. Occlusal appliance therapy in patients with temporomandibular disorders. A double-blind controlled study in a short-term perspective. Acta Odontol Scand 1998;56:122-128. https://doi.org/10.1080/00016359850136102
- Farella M, Michelotti A, Iodice G, Milani S, Martina R. Unilateral posterior crossbite is not associated with TMJ clicking in young adolescents. J Dent Res 2007;86:137-141. https://doi.org/10.1177/154405910708600206
- Iodice G, Danzi G, Cimino R, Paduano S, Michelotti A. Association between posterior crossbite, masticatory muscle pain, and disc displacement: a systematic review. Eur J Orthod 2013;35:737-744. https://doi.org/10.1093/ejo/cjt024
- Thilander B, Bjerklin K. Posterior crossbite and temporomandibular disorders (TMDs): need for orthodontic treatment? Eur J Orthod 2012;34:667-673. https://doi.org/10.1093/ejo/cjr095