Mathew Abin, Cr Vivek, Ka Alexander, Goswami Dwijesh, Antony Tony, Bharat Rakhi
Department of Orthodontics and Dentofacial Orthopaedics, Grace Dental Care, Kottayam, IND.
Department of Orthodontics and Dentofacial Orthopaedics, Maaruti College of Dental Sciences & Research Centre, Bengaluru, IND.
Cureus. 2024 Mar 31;16(3):e57300. doi: 10.7759/cureus.57300. eCollection 2024 Mar.
Background Temporomandibular joint disorders (TMD) represent a prevalent group of conditions impacting the temporomandibular joint. Among the therapeutic interventions, occlusal splint therapy has gained recognition for its potential to address TMD symptoms, particularly in cases involving joint displacement. Objective This study aims to investigate the effectiveness of occlusal splint therapy in cases of moderate TMD with joint displacement, focusing on changes in condylar position, joint morphology, and patient-reported outcomes. Methods A retrospective analysis was conducted involving 148 participants who underwent occlusal splint therapy between January 2018 and December 2020. Data were collected through cone beam computed tomography (CBCT) imaging for precise assessments of condylar position and joint morphology. Ethical approval was obtained, and participants provided informed consent. Baseline characteristics, medical history, and TMD severity were recorded. Occlusal splint therapy included individualized fabrication, occlusal analysis, adjustments for optimal fit, and prescribed wear schedules. Follow-up included CBCT scans at specified intervals (three months and six months), with participant-reported outcomes collected. The data analysis was conducted using IBM SPSS Statistics for Windows, Version 22.0 (Released 2013; IBM Corp., Armonk, NY, USA). Paired t-tests or nonparametric equivalents were employed to assess changes in condylar position and joint morphology. Subgroup analyses were conducted to explore potential factors influencing treatment outcomes. The significance level was set at p < 0.05 for all statistical tests. Results The entire cohort (n = 148) had a mean age of 32.5 years (± 8.1), with a balanced gender distribution. Changes in condylar position revealed a statistically significant improvement (p = 0.03), with a mean decrease of 0.2 mm posttreatment. Joint morphology changes indicated increased joint space width (p = 0.01), improved disc position (p = 0.02), and nonsignificant alterations in bony structures (p = 0.10). Patient-reported outcomes demonstrated significant improvements in pain levels, jaw functionality, and satisfaction (all p < 0.001). Age and gender subgroup analyses showed consistent improvements in condylar position, joint morphology, and patient-reported outcomes across different groups. Conclusion Occlusal splint therapy demonstrated effectiveness in improving condylar position, joint morphology, and patient-reported outcomes in cases of moderate TMD with joint displacement. The findings underscore the potential of occlusal splint therapy as a viable intervention for managing TMD, providing valuable insights for clinicians and researchers.
颞下颌关节紊乱病（TMD）是一组影响颞下颌关节的常见病症。在治疗干预措施中，咬合板治疗因其缓解TMD症状的潜力而受到认可，尤其是在涉及关节移位的病例中。
本研究旨在探讨咬合板治疗对中度TMD伴关节移位病例的有效性，重点关注髁突位置、关节形态变化以及患者报告的结果。
对2018年1月至2020年12月期间接受咬合板治疗的148名参与者进行回顾性分析。通过锥形束计算机断层扫描（CBCT）成像收集数据，以精确评估髁突位置和关节形态。获得伦理批准，参与者提供了知情同意书。记录基线特征、病史和TMD严重程度。咬合板治疗包括个性化制作、咬合分析、调整以达到最佳贴合度以及规定的佩戴时间表。随访包括在特定时间间隔（三个月和六个月）进行CBCT扫描，并收集参与者报告的结果。使用IBM SPSS Statistics for Windows 22.0版（2013年发布；IBM公司，美国纽约州阿蒙克）进行数据分析。采用配对t检验或非参数等效检验评估髁突位置和关节形态的变化。进行亚组分析以探索影响治疗结果的潜在因素。所有统计检验的显著性水平设定为p < 0.05。
整个队列（n = 148）的平均年龄为32.5岁（± 8.1），性别分布均衡。髁突位置的变化显示出统计学上的显著改善（p = 0.03），治疗后平均下降0.2毫米。关节形态变化表明关节间隙宽度增加（p = 0.01），盘位置改善（p = 0.02），骨结构无显著改变（p = 0.10）。患者报告的结果显示疼痛水平、下颌功能和满意度有显著改善（均p < 0.001）。年龄和性别亚组分析表明，不同组在髁突位置、关节形态和患者报告的结果方面均有一致的改善。
咬合板治疗在改善中度TMD伴关节移位病例的髁突位置、关节形态和患者报告的结果方面显示出有效性。这些发现强调了咬合板治疗作为管理TMD的可行干预措施的潜力，为临床医生和研究人员提供了有价值的见解。
