Use of occlusal digital splint for treating the patients with temporomandibular joint dysfunction and planning orthopedic treatment

Objective of the study: to develop and assess the occlusal digital splint for treating patients with temporomandibular joint dysfunction (TMJD). Material and Methods — 17 patients between the ages of 30 and 49 diagnosed with TMJD were admitted for treatment. To normalize mandibular position, an occlusal digital splint for all patients was manufactured in accordance with our original method. An intensity of pain sensations in all patients prior to, and after, the treatment was assessed by a visual analogue scale, along with the changes in the mandibular movements’ amplitude, and the signs of splint wear and stability of occlusal contacts. Results — Patients have adapted themselves well to the splint and found it convenient in use. The study results showed that it was sufficiently effective in treatment of TMJD. Reduction in pain intensity and restoration of mandibular movements’ amplitude were detected with certainty. Only in 2 (11.7%) cases, the signs of wear on the splint were found, as evidenced by the changes in pre-treatment occlusal contacts. In all other cases throughout the study, a stable occlusal contact has been encountered. Conclusion — Our results indicated that proposed occlusal digital splint may be considered as a treatment option for the patients with TMJ disorders.

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Signs of temporomandibular joint dysfunction in individuals with different dentition defects and unequal preservation of antagonist pairs of teeth

Стоматология для всех ◽

10.35556/idr-2021-2(95)52-58 ◽

2021 ◽

pp. 52-58

Author(s):

I.S. Redinov ◽

Ye.A. Pylaeva ◽

O.O. Strakh ◽

B.A. Lysenko

Keyword(s):

Hearing Loss ◽

Early Diagnosis ◽

Temporomandibular Joint ◽

Pathological Process ◽

Orthopedic Treatment ◽

Temporomandibular Joint Dysfunction ◽

Significant Frequency ◽

System A ◽

Lower Jaw ◽

Opening And Closing

As a result of examination and questionnaire of 143 patients who applied for orthopedic treatment of defects of teeth and dental rows, it was found that signs of dysfunction of temporomandibular joint with preserved dental rows are diagnosed in 36—55% cases, and with defects of dental rows — in 45—90% cases. The absence of eighth teeth in the dental row does not significantly change the functional state of the dental-jaw system. A statistically significant frequency of signs of EHS dysfunction has been identified among individuals having terminal dentition defects.In patients with terminal dentition defects, each 3rd patient is diagnosed with cochleovestibular syndrome, and in each 2nd, sounds are determined in the area of VNHS when the lower jaw moves. It has been found that if 15—13 and 12—11 pairs of antagonist teeth are preserved, the signs of dysfunction are determined in 55—45% cases, if the number of teeth having antagonists is reduced to 10—5 (in 90.0% these are patients with preserved 7—8 pairs of antagonist teeth), then the frequency of dysfunction signs increases to 75.0% (t1-3=1.33; t2-3=2.00), in such patients significantly more often — in 75.0% of cases, mandibular deviation is diagnosed when opening and closing the mouth than in persons with a large number of preserved antagonist teeth, respectively 55.0% (t=2.66) and 45.0% (t=3.93) in 1 and 2 groups. Thus, the identification of such signs as crunching, clicking in the joints, hearing loss or tinnitus, suggests the presence of intra-articular disorders in such patients. The deviation of the jaw from its main trajectory when opening the mouth indicates the possible involvement of the masticators muscles in the pathological process. All this requires the dentist to carry out early diagnosis and timely orthopedic treatment.

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