Fixed orthodontic therapy in temporomandibular disorder (TMD) treatment: an alternative to intraoral splint. 2010

Simona Tecco, and Stefano Teté, and Vito Crincoli, and Mario Armando Festa, and Felice Festa
Department of Orthodontics and Gnathology, School of Dentistry, University of Chieti, Italy. simtecc@unich.it

This study evaluated the use of a fixed orthodontic appliance in treatment of temporomandibular disorder (TMD) compared to the use of an intra-oral splint. Fifty (50) adult patients, with confirmed anterior disk displacement with reduction in at least one temporomandibular joint (TMJ), were divided into three groups: 20 patients treated with AR splint (Group I); 20 patients treated with a fixed orthodontic appliance (Group II) and 10 patients who underwent no treatment (Control Group). Joint pain, joint noise, muscle pain, and subjective relief were evaluated monthly before the treatment began (T0) and for six months thereafter. Subjects in Group I and Group II displayed a significant decrease in joint pain (p < 0.01) from T2 and in muscle pain from T1 (p < 0.01) to T6. Subjects in Group I showed a higher decrease in the frequency of joint noise (p < 0.05) from T1 to T6, compared with Group II. At T2 and T3, the patients in Group II reported a significantly lower discomfort level associated with the devices than subjects treated with the AR splint (p < 0.05). However, at T5 and T6, this observation was inverted. The use of a fixed orthodontic appliance seems to be as efficacious as the use of an AR maxillary splint in the treatment of joint pain and muscle pain, but not in the treatment of joint noise. These results are valid, at least for the short-term clinical results (first six months of treatment). Clinical implications for long-term use are not clarified by these results.

UI MeSH Term Description Entries
D008297 Male Males
D008310 Malocclusion Such malposition and contact of the maxillary and mandibular teeth as to interfere with the highest efficiency during the excursive movements of the jaw that are essential for mastication. (Jablonski, Illustrated Dictionary of Dentistry, 1982) Angle's Classification,Crossbite,Tooth Crowding,Cross Bite,Angle Classification,Angles Classification,Bite, Cross,Bites, Cross,Classification, Angle's,Cross Bites,Crossbites,Crowding, Tooth,Crowdings, Tooth,Malocclusions
D008410 Masticatory Muscles Muscles arising in the zygomatic arch that close the jaw. Their nerve supply is masseteric from the mandibular division of the trigeminal nerve. (From Stedman, 25th ed) Masticatory Muscle,Muscle, Masticatory,Muscles, Masticatory
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009967 Orthodontic Appliances Devices used for influencing tooth position. Orthodontic appliances may be classified as fixed or removable, active or retaining, and intraoral or extraoral. (Boucher's Clinical Dental Terminology, 4th ed, p19) Appliance, Orthodontic,Appliances, Orthodontic,Orthodontic Appliance
D009969 Orthodontic Wires Wires of various dimensions and grades made of stainless steel or precious metal. They are used in orthodontic treatment. Orthodontic Wire,Wire, Orthodontic,Wires, Orthodontic
D010147 Pain Measurement Scales, questionnaires, tests, and other methods used to assess pain severity and duration in patients or experimental animals to aid in diagnosis, therapy, and physiological studies. Analgesia Tests,Analogue Pain Scale,Formalin Test,McGill Pain Questionnaire,Nociception Tests,Pain Assessment,Pain Intensity,Pain Severity,Tourniquet Pain Test,Visual Analogue Pain Scale,Analog Pain Scale,Assessment, Pain,McGill Pain Scale,Visual Analog Pain Scale,Analgesia Test,Analog Pain Scales,Analogue Pain Scales,Formalin Tests,Intensity, Pain,Measurement, Pain,Nociception Test,Pain Assessments,Pain Intensities,Pain Measurements,Pain Questionnaire, McGill,Pain Scale, Analog,Pain Scale, Analogue,Pain Scale, McGill,Pain Severities,Pain Test, Tourniquet,Questionnaire, McGill Pain,Scale, Analog Pain,Scale, Analogue Pain,Scale, McGill Pain,Severity, Pain,Test, Analgesia,Test, Formalin,Test, Nociception,Test, Tourniquet Pain,Tests, Nociception,Tourniquet Pain Tests
D004204 Joint Dislocations Displacement of bones from their normal positions at a joint. Inferior Dislocation,Joint Subluxations,Luxatio Erecta,Dislocation, Joint,Dislocations, Joint,Inferior Dislocations,Joint Dislocation,Joint Subluxation,Subluxation, Joint,Subluxations, Joint
D005157 Facial Pain Pain in the facial region including orofacial pain and craniofacial pain. Associated conditions include local inflammatory and neoplastic disorders and neuralgic syndromes involving the trigeminal, facial, and glossopharyngeal nerves. Conditions which feature recurrent or persistent facial pain as the primary manifestation of disease are referred to as FACIAL PAIN SYNDROMES. Craniofacial Pain,Myofacial Pain,Orofacial Pain,Pain, Facial,Face Pain,Neuralgic Facial Pain,Facial Pain, Neuralgic,Pain, Craniofacial,Pain, Face,Pain, Myofacial,Pain, Neuralgic Facial,Pain, Orofacial
D005260 Female Females

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