Influence of mouthguard on temporomandibular joint

Abstract

The aim of this study is to examine whether wearing a mouthguard (MG) has an influence on temporomandibular joint (TMJ) components (i.e., the condyle and the articular disk) and whether clenching with a resilient MG has an effect on the same components. Twenty-six healthy volunteers (15 females, 11 males) with an age range of 26-42 years old (median 28 years) participated in this study. Among all 52 joints in the 26 subjects, anterior disk displacement (AntDD) was recognized in 15. Thus, we classified the 52 joints into two groups, the AntDD group and the Normal group. Resilient thermoplastic materials were used to fabricate two types of MG, one that raised the vertical dimension height by 3 mm and another that raised it by 6 mm. Subjects were scanned with/without two types of MG with/without clenching by magnetic resonance imaging (MRI). The movement of the condylar head and articular disk was measured in the magnetic resonance images using the special subtraction technique. Wearing the MG without clenching did not have a negative influence on the TMJ and clenching in the Normal group. In the AntDD group, however, the relationship between the disk and condyle was affected by clenching and the degree of disk displacement was worsened by clenching with the thicker MG. From our results, we recommend that athletes with an internal derangement of the TMJ not wear the thicker MG and attention should be paid to its setting. And the subtraction technique using MRI was thought as a good tool for detecting a slight change in the TMJ.

Effect of Occlusal Splints on the Stress Distribution on the Temporomandibular Joint Disc

“…These changes agreed with another study that found similar changes in joint space during the use of mouthguards (16). Thus, compared with the original model, the condyle was moved downward and forward 0.4 mm and 0.2 mm, respectively, to create models with occlusal splint use.…”

Avaliação dos efeitos da placa estabilizadora de oclusão na distribuição de tensões no disco da articulação temporomandibular, pelo método de elementos finitos

“…These changes were in agreement with another study that found similar changes in joint space during the use of mouthguards (16). Thus, compared with the original model, the condyle was moved downward and forward 0.4mm and 0.2mm, respectively, for create models with occlusal splint use.…”

“…Whereas, in analyses involving large deformations, the use of non-linear elastic behavior would be required. 16 An evolution in disc characterization was the development of a model that represented the interaction between fluid and solid constituents as a biphasic or poro-elastic model that accounted for the shock-absorbing properties of the disc. 7 This type of model was also used to represent hyaline cartilages, however, it was not the best option for modeling the mechanical response of the TMJ disc, because the concentration of glycosaminoglycans (GAGs) in this fibrocartilaginous soft tissues was lower, which could result in reduced drag between the fluid and solid matrix.…”

“…Occlusal splints have been considered to reduce stress in the temporomandibular joint secondary to change in the position of the mandible (12,13). Analysis of stresses and strains on the articular disc in vivo it is not advisable, because the use of experimental devices, such as strain gauges, inside the joint would introduce damage to its tissues and biomechanical behavior (16). Therefore, computational studies of the TMJ have been shown to be a powerful tool to predict the load on this joint (16)(17)(18)(19)(20)(21)(22).…”

“…Analysis of stresses and strains on the articular disc in vivo it is not advisable, because the use of experimental devices, such as strain gauges, inside the joint would introduce damage to its tissues and biomechanical behavior (16). Therefore, computational studies of the TMJ have been shown to be a powerful tool to predict the load on this joint (16)(17)(18)(19)(20)(21)(22). Some authors have simulated physiological mandibular movements and prolonged tooth clenching (17,20).…”