Oral appliances in the management of temporomandibular disorders

Types of Occlusal Splint in Management of Temporomandibular Disorders (TMD)

“…Now day there are recent advance in materials, designs and using occlusal appliances as therapeutic devices [4].…”

“…Unfortunately, these concepts are defective for the following reasons: firstly, their underlying assumptions that both muscular and TMG pain and dysfunction primarily arise from the strain of dealing with improper occlusal ;secondly, their failure to recognize the multiple effects that occlusal appliances can produce; and finally, their presumption that, the symptomatic improvement if occur as a result temporary occlusal changes produced by the occlusal appliances, permanent alterations to the patient's occlusion through extensive and irreversible dental treatments must be followed [4].…”

“…Form economic point of view the soft occlusal appliance compared with the hard appliances are of low cost [4]. Soft occlusal appliances recommended by some investigators for the reduction of both muscular and arthrogenous TMD symptoms [8,9].…”

“…Advocates for using such appliances to treat TMDs based on their ability to prevent clenching, as posterior teeth are not engaged in functional or in Para-functional activities. However, an adverse effect may occur in the form of overeruption of posterior teeth which is extremely unlikely if worn only at night and without posterior support the TMJs will be overloaded [4].…”

“…These appliances reduce intra-articular pressure by condylar distraction as the mandible fulcrums around the pivot, resulting in an unloading of the articular surfaces of the joint. The pivoting appliance was suggested for patients with internal derangements or with osteoarthritis [4]. Nevertheless, studies [31,32] have concluded that there is no distractive effect on the TMJ by occlusal pivots and instead of that can actually lead to compression of the joint.…”