Stabilisation splint therapy for temporomandibular pain dysfunction syndrome

Al‐Ani, M. Ziad; Gray, RJM; Davies, Steffan; Sloan, Philip

doi:10.1002/14651858.cd002778

Cited by 19 publications

(19 citation statements)

References 5 publications

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“…Cochrane analysis has shown that no type of bite splint delivers a better outcome, so an inexpensive, simple, lower occlusal soft splint made by the dentist is sufficient (31).…”

Section: Management Medical Therapymentioning

confidence: 99%

Management of the temporomandibular joint in inflammatory arthritis: Involvement of surgical procedures

O’Connor¹,

Fawthrop

Salha

et al. 2017

Eur J Rheumatol

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IntroductionThe incidence of temporomandibular joint (TMJ) involvement in inflammatory arthritis is often underestimated, and experience in treatment among rheumatologists is limited. Three conditions have an affinity toward the TMJ: Rheumatoid arthritis (RA), psoriatic arthritis (PA), and ankylosing spondylitis (AS). The prevalence is the highest in RA, followed by PA (1-5).The disease processes differ from those seen in osteoarthritis or following trauma, which are characterized by degeneration or ankylosis, respectively, as joint destruction occurs. Furthermore, inflammatory arthropathies are systemic diseases that can lead to a relapse in symptoms, despite initially successful treatment, as TMJ inflammation continues. Immunosuppressive therapies used to ameliorate systemic inflammation may also complicate treatment responses, particularly if surgical management is required, as there is a theoretical increased risk of infection. In contrast, osteoarthritis symptoms may stabilize, previous joint trauma tends not to deteriorate unless TMJ ankylosis ensues, and immunosuppression is not required. Therefore, a different management approach is required in patients with inflammatory arthropathy that addresses both the systemic illness and localized TMJ disease.Pain, reduced mouth opening, joint noises, locking, and difficulty eating are the predominant symptoms and can be debilitating if left untreated. Pain originates from the TMJ itself, the associated masticatory muscles, or from both these areas, and it is manifested by tenderness on palpation of the respective anatomical area. Mouth opening is measured as the gap between the tips of the upper and lower incisors at maximal opening (interincisal distance) with less than 35 mm considered abnormal (6). Joint noises and locking result from the internal derangement of the joint mechanism, which consists of the mandibular condyle, intra-articular disc, and glenoid fossa, or from inflammatory debris deposited as part of the disease process. Combined with pain and restricted opening, these contribute toward problems in eating. 151Many conditions may affect the temporomandibular joint (TMJ), but its incidence in individual joint diseases is low. However, inflammatory arthropathies, particularly rheumatoid and psoriatic arthritis and ankylosing spondylitis, appear to have a propensity for affecting the joint. Symptoms include pain, restriction in mouth opening, locking, and noises, which together can lead to significant impairment. Jaw rest, a soft diet, a bite splint, and medical therapy, including disease-modifying antirheumatic drugs (DMARDs) and simple analgesia, are the bedrock of initial treatment and will improve most symptoms in most patients. Symptom deterioration does not necessarily follow disease progression, but when it does, TMJ arthroscopy and arthrocentesis can help modulate pain, increase mouth opening, and relieve locking. These minimally invasive procedures have few complications and can be repeated. Operations to repair or remove a damaged in...

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“…Cochrane analysis has shown that no type of bite splint delivers a better outcome, so an inexpensive, simple, lower occlusal soft splint made by the dentist is sufficient (31).…”

Section: Management Medical Therapymentioning

confidence: 99%

Management of the temporomandibular joint in inflammatory arthritis: Involvement of surgical procedures

O’Connor¹,

Fawthrop

Salha

et al. 2017

Eur J Rheumatol

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“…41 Literatürde splint tedavisi; gevşeme tedavisi, psikolojik tedavi, düşük lazer tedavisi, akupunktur, ısırma plakları, stres yönetimi, çene egzersizleri, plasebo splintleri ile karşılaştırılmıştır. 39,40,[42][43][44][45][46] Kapsamlı bir derleme çalışmasında; stabilizasyon splintinin ağız açıklığını artırma ve kas ağrısını azaltmadaki etkinliği; kontrol grubu, plasebo splinti, akupunktur, ısırma plağı ve çene egzersizi uygulamaları ile karşılaştırılmış, aralarında anlamlı bir fark bulunmadığı sonucuna varılmıştır. 42 Oklü-zal splint tedavisi ile yumuşak splint, plasebo splinti, fizik tedavi ve akupunkturun temporomandibuler bozukluklardaki etkisinin değerlendirildiği bir çalışmada, stabilizasyon splintinin diğer yön-temlerden daha etkin olduğuna dair yeterli bir kanıtın bulunmadığı bildirilmiştir.…”

Section: Posteri̇or Isirma Plağiunclassified

“…39,40,[42][43][44][45][46] Kapsamlı bir derleme çalışmasında; stabilizasyon splintinin ağız açıklığını artırma ve kas ağrısını azaltmadaki etkinliği; kontrol grubu, plasebo splinti, akupunktur, ısırma plağı ve çene egzersizi uygulamaları ile karşılaştırılmış, aralarında anlamlı bir fark bulunmadığı sonucuna varılmıştır. 42 Oklü-zal splint tedavisi ile yumuşak splint, plasebo splinti, fizik tedavi ve akupunkturun temporomandibuler bozukluklardaki etkisinin değerlendirildiği bir çalışmada, stabilizasyon splintinin diğer yön-temlerden daha etkin olduğuna dair yeterli bir kanıtın bulunmadığı bildirilmiştir. 45 Wahlund ve ark., hastalara stabilizasyon splinti ile terapist rehberliğinde gerçekleştirilen gevşeme tedavisi uyguladıkları bir çalışmada, stabilizasyon splintinin tedavide daha etkili olduğunu gözlemlemişlerdir.…”

Section: Posteri̇or Isirma Plağiunclassified

Splint Therapy in Temporomandibular Joint Disorders: Review

Türker¹,

Büyükkaplan²

2017

Turkiye Klinikleri J Dental Sci

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Ö ÖZ ZE ET T Toplumda yüksek oranda gözlemlenen temporomandibuler eklem (TME) rahatsızlıkları çene, boyun ve baş ağrıları, eklem sesleri gibi pek çok semptomla bireylerin yaşam kalitesini düşürmek-tedir. Bu rahatsızlıklar tedavi edilmediği takdirde ilerlemekte ve TME'de kalıcı hasara sebep olabilmektedir. TME rahatsızlıkları için pek çok tedavi yöntemi bildirilmiştir. Bu tedavi yöntemleri geri dönüşümlü (noninvaziv) ve geri dönüşümsüz (invaziv) tedaviler olmak üzere ikiye ayrılmıştır. Geri dönüşümlü tedaviler arasında bilgilendirme yöntemi, fizik tedavi yöntemleri, farmakolojik tedavi, psikiyatrik destek tedavisi ve oklüzal splint tedavileri yer alır iken; geri dönüşümsüz tedaviler oklüzal uyumlama ve cerrahi girişimleri içermektedir. TME rahatsızlıklarında geri dönüşümsüz tedavilerden önce daha konservatif yöntemler olan geri dönüşümlü tedaviler denenmesi temel prensiptir. Tavsiye edilen tedavi yöntemlerinin etkinliklerini araştırmak amacıyla pek çok çalışma yapılmıştır. Bununla birlikte, tedavi etmede ya da semptomları azaltmada hangi tedavi yönteminin ya da hangi splint tipinin daha etkin olduğuna dair kesin bir kanıt mevcut değildir. Etki mekanizmaları ve tedavi başarıları tartışmalı olmasına rağmen, TME rahatsızlıkları tedavisinde en çok kullanılan yöntem oklüzal splint tedavisidir. Diş hekimliğinde her biri farklı özel durumlar için olmak üzere birçok oklüzal splint kullanılmaktadır. Splint endikasyonları TME inflamasyonu, eklem içi dü-zensizlik, cerrahi sonrası tedavi, hipertonik yüz kasları, diş sıkma ve gıcırdatma olarak belirtilmektedir. Bu çalışmada, oklüzal splint çeşitleri ele alınmış ve güncel literatür bilgisine dayanılarak TME rahatsızlıklarının tedavisinde kullanılan geri dönüşümlü yöntemlerin etkinliklerinin değer-lendirilmesi amaçlanmıştır.A An na ah ht ta ar r K Ke el li im me el le er r: : Temporomandibuler eklem bozuklukları; oklüzal splintler A AB BS ST TR RA AC CT T Temporomandibular joint (TMJ) disorders are highly prevalent in the community and reduces the quality of life with many symptoms such as jaw and neck pain, headache and joint sounds. These disorders progress when they are not treated and may cause permanent damage to the TMJ. Many treatment modalities have been reported for TMJ disorders. These treatment methods are divided into two as non-invasive treatments and invasive treatments. Non-invasive treatments include informative methods, physical therapy, pharmacological treatment, psychiatric support therapy and occlusal splint therapies and invasive treatments include occlusal adjustment and surgical interventions. Non-invasive treatments, which are more conservative methods should be employed before invasive treatments for TMJ disorders. Many studies have been conducted to investigate the effectiveness of recommended treatment modalities. However, there is no definitive evidence of which treatment method or splint type is more effective in treating or reducing symptoms. Although the mechanisms of influence and treatment success are controversial, the most common method of tre...

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“…Rest, occlusal support, non-steroidal anti-inflammatory drugs (NSAID) in combination can be used to treat majority of patients. Occlusal splints of all types have shown to reduce TMJ pain but the results are not significant [12,13]. These should cover the whole of the dental arch as localised devices can cause otrthodontic tooth movements.…”

Section: Conservative Managementmentioning

confidence: 99%

Current Management of Temporomandibular Joint (TMJ) Disease

Farook¹

2014

J Arthritis

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Temporomandibular joint (TMJ) disorder (TMD) is a collection of medical and dental conditions affecting the joint and muscles of mastication, as well as contiguous tissue components. This leads to pain and altered oral function and can lead to a poor quality of life. The majority of the population can be affected to some degree. Management of TMD is often simple in the first instance, but may involve complex decision making. This article summarizes the current investigative and treatment options available.Magnetic Resonance Imaging is the recommended radiological investigation of choice for soft tissue assessment whilst TMJ arthroscopy supersedes most other invasive treatments available in relation management of symptoms and more accurate diagnosis. Should arthroscopy fail to achieve satisfactory resolution of symptoms a standardised treatment pathway based on arthroscopic findings involves appropriate assessment, possible open surgery or even TMJ replacement. This latter procedure is governed by NICE guidelines and delivers an excellent short and medium term outcome up to 20 years.

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Stabilisation splint therapy for temporomandibular pain dysfunction syndrome

Cited by 19 publications

References 5 publications

Management of the temporomandibular joint in inflammatory arthritis: Involvement of surgical procedures

Management of the temporomandibular joint in inflammatory arthritis: Involvement of surgical procedures

Splint Therapy in Temporomandibular Joint Disorders: Review

Current Management of Temporomandibular Joint (TMJ) Disease

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