Occlusal Splints versus Ultrasound therapy in management of Anterior Disc Displacement with Reduction. A Randomized clinical trial.

Abstract

Purpose: To compare the effect of Stabilization Splint (SS), Anterior repositioning splint (ARS), and Ultrasound (US) therapy in improving pain, limited mouth opening and clicking in patients with Anterior Disc Displacement with Reduction (ADDwR).Materials and Methods: 30 subjects were enrolled in this randomized clinical trial. Participants were randomly allocated into one of the three study groups of 10 patients each; Group I received a SS, Group II received ARS and Group III were treated with US. All the patients were recalled at baseline (before treatment), 1m, 3m and 6m follow-up periods to evaluate pain, maximum mouth opening (MMO) and clicking. Pain level was evaluated using Visual Analogue Score (VAS). MMO was measured in mm. as the distance between maxillary and mandibular incisors. Detection of TMJ sounds was performed on opening or closing and was recorded.Results: There was a significant decrease in the pain scores in the three groups with P <0.001. There was a statistically significant improvement in MMO in SS and ARS P < 0.001 while, in US group improvement was below the level of significance P = 0.269. Improvement in clicking was present in SS group and ARS group. 9 patients in the US group still had clicking sound without statistical improvement in clicking throughout the follow-up period. Conclusion:The use of occlusal splints in the management of painful ADDwR is a successful mode of treatment and helps in decreasing pain, improving MMO and clicking yet, is better to be used in combination with other treatment modalities.