Efficiency of pivot splints as jaw exercise apparatus in combination with stabilization splints in anterior disc displacement without reduction: a retrospective study

Abstract

ObjectiveTo evaluate efficiency of pivot splints in jaw exercises, in combination with stabilization splints, in cases of anterior disc displacement without reduction of temporomandibular joint.Subjects and methodsTwenty-three patients who referred to the prosthodontics clinic in 1995–1997 were included in the study, where anterior disc displacement without reduction of temporomandibular joint was diagnosed using magnetic resonance imaging and clinical examination. Pivot splints were used for jaw exercises for five minutes long; five times/day and stabilization splints were used at all other times. The patients were followed for 24 weeks. Lateral and protrusive excursions along with maximum mouth opening and were evaluated at each control. Bilateral palpation of temporal, masseter, sternocleidomastoid muscles and TMJ was assessed for pain perception before and after treatment. Data were statistically analyzed using Paired sample t-test and Independent Samples t-test (p < .05).ResultsMean mandibular range of motion measurements increased from 28.74 mm prior to 49.17 mm on maximum opening; right/left lateral excursion from 7.61 mm to 12.04 mm and 4.09 mm to 7.3 mm on protrusion after treatment. All changes observed before and after treatment were found to be statistically significant. (p < .001) Pain symptoms were eliminated at the end of 24 weeks of treatment in all patients.ConclusionUsing pivot splints as an exercise regimen along with a stabilization splint may be a viable treatment option for patients with anterior disc displacement without reduction; as normal mandibular range of motion was established and pain was eliminated.

“RA.DI.CA.” Splint for the Management of the Mandibular Functional Limitation: A Retrospective Study on Patients with Anterior Disc Displacement without Reduction

“…Some authors suggest the use of the occlusal pivot appliances, as described by Sears [28], with an action similar to the distraction splints [29]. Compared to the previous type of splint, the distraction/pivot splints are supposed to have the additional benefit of mobilizing the condyle with a greater effect of condylar distraction and possibility of reducing joint disc [30]. However, which kind of splint has a greater effectiveness is a debated issue among researchers, as emerged from the study of Schmitter et al [11] which reported that the stabilization splint seems to be more effective than the distraction splint in the closed lock therapy.…”

Conservative Treatment Approaches of Temporomandibular Joint Disc Displacement Without Reduction

“…splint tedavisi uyguladıkları hastalarda ağrının azaldığını ve ağız açıklığının arttığını bildirmişlerdir ve redüksi-yonsuz disk deplasmanlı hastalarda bu tedavi protokolünün uygulanmasını önermişlerdir. 26 Anterior repozisyon splinti fizyolojik diskkondil ilişkisinin yeniden düzenlenmesi amacı ile kullanılmaktadır. Bununla beraber diskin tekrar eski durumuna gelmesi TME internal düzensizliği aşamasına ve disk deplasmanının derecesine bağlı-dır.…”

Magnetic resonance and sonographic imagings of masticatory muscle myalgia in temporomandibular disorder patients

“…In the recent years, studies using MRI and sonography in patients with masticatory muscle myalgia have frequently been reported, and the newly developed technologies have been introduced [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] . Muscles after treatment in those patients also have been evaluated using MRI and sonography [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] .…”