Effectiveness of repositioning splints and stabilization splints in the treatment of symptomatic temporomandibular joint disk displacement with reduction

Abstract

Objectives : To evaluate the effectiveness of nighttime use of repositioning splints (ARS) with that of stabilization splints (SS) in the treatment of symptomatic temporomandibular joint disk displacement with reduction. Design : Randomized controlled trial. Setting : Graduate Clinic, Department of Occlusion, Faculty of Dentistry, Chulalongkorn University. Participants : 34 patients with TMJ disk displacement with reduction (DDR) who fulfilled the eligibility criteria. Methodology : Patients were randomly assigned to one of the two groups: anterior repositioning splint group or stabilization splint group using simple randomization. Before treatment, by using visual analog scales, patients assessed their pain VAS and functional VAS on 3 activities which were averaged for composite functional scores. They were also examined for clinical signs. Patients wore their assigned splints only nighttime. After 10 weeks of treatment, evaluation was performed using the same method as the pretreatment. Those who demonstrated at least 50% reduction of both pain and functional scores were counted as important improvement. Results : At 10-week appointment, the ARS group demonstrated higher number of patients with important improvement (7 of 17, 41%) than did the SS group (4 of 17, 23%). However, no significant difference was found between groups (Chi-square test, p=0.271). Conclusion : The nighttime use of ARS tends to provide better clinical outcome in the treatment of symptomatic TMJ DDR than that of the SS., but no statistical significant difference is demonstrated between these two treatment groups