Long-term results of appliance therapies in anterior disk displacement with reduction: a review of the literature.

The diagnosis and management of temporomandibular disorders (TMD) have been a source of controversy in the dental community for decades. This controversy has been especially acute in the management of patients with anteromedial disk displacement (ADD) with reduction. This article presents a review of the literature specifically concerning the long-term results of appliance therapy in ADD with reduction patients. The literature review identified the failure of many past investigators to conduct scientifically well-designed studies or to use comparable criteria. However, from the evidence examined, both appliances seem to be able to decrease muscle and joint pain and increase mandibular function. The anterior repositioning splint seems to be superior to the flat-plane occlusal splint in eliminating reciprocal clicking and palpatory tenderness of the temporomandibular joint. The recapture of the disk is permanent in only a small percentage of patients suggesting that the use of irreversible procedures must be carefully evaluated.