OCCLUSION AND TMJ
SPLINTS IN TMJ DYSFUNCTION. HOW EFFECTIVE? A REVIEW
Mahesh Verma 1a *, Harsimran Kaur 1b, Aditi Nanda 1c
1
Maulana Azad Institute of Dental Sciences, New Delhi, India a
MDS, MBA, PhD, Professor( Director, Principal) b
BDS, MDS( Senior Resident) c
BDS, MDS( Senior Research Associate)
Received: March 10, 2016 Received in revised form: April 23, 2016
Accepted: May 4, 2016 Published online: April 21, 2016
Cite this article: Verma M, Kaur H, Nanda A. Splints in TMJ dysfunction. How effective? A review. Stoma Edu J. 2016; 3( 1): 75-80.
ABSTRACT
Background: Temporomandibular disorders( TMD) are recognized as the most common non-toothrelated chronic orofacial pain conditions that confront dentists and other healthcare providers. Functional disturbances of the masticatory system can be as complicated as the system itself. Although numerous treatments have been advocated, the complex nature of TMD requires a multidisciplinary team. Effective treatment selection begins with a thorough understanding of the disorder & its etiology. Objective: The purpose of this review is to examine the evidence concerning the management of temporomandibular dysfunction using various splints. Data collection: The articles reported in this literature review were searched on PubMed / MEDLINE database, considering only the scientific journals written in English. Outcomes: Occlusal splints must be chosen by dentists as therapeutic appliances based upon appropriate diagnosis, as opposed to a simple cure for all TMD conditions. Occlusal splints, and stabilization splints, in particular, have a positive effect as a treatment option for patients with TMD. Stabilization splints provide temporary and removable ideal occlusion. Providing an ideal occlusion by the use of splint therapy reduces abnormal muscle activity and produces“ neuromuscular balance”. Conclusion: Occlusal splints are effective in many circumstances but not in all. Therefore, an accurate and specific diagnosis of a particular TMD condition is needed to effectively treat patients. In order to make definitive conclusions, the authors suggest a need for more myalgia specific clinical studies with larger sample sizes, which may enable us to evaluate the efficacy of occlusal splints in comparison with other modes of treatments. Keywords: Temporomandibular disorders, occlusal splints, intraoral appliance.
1. Background
Temporomandibular disorders( TMD), according to the American Academy of Orofacial Pain, are defined as‘ a collective term embracing a number of clinical problems that involve the masticatory muscles, the Temporomandibular joint( TMJ) and associated structures, or both’. TMD are a subclassification of musculoskeletal disorders, 1 having a recurrent or chronic course with noticeable fluctuation over time. 2 Patients suffering from TMD often present with pain in the jaws, earache, headache, and myofascial pain. The pain is often aggravated by mandibular movements, like chewing and yawning. It is also frequently associated with disturbed function and limited and / or asymmetric movements of the lower jaw. 3 Myofascial pain represents a neurosensory disorder involving peripheral and centrally sensitized muscle nociceptors. It is characterized by pain and dysfunction that arises from pathologic and functional processes in the masticatory muscles. In 1969, Laskin described the myofascial pain dysfunction syndrome( MPDS) as having certain clinical characterstics and denotes to any muscle disorder( not an intracapsular disorder). 4 Myofacial pain arises from hypersensitive areas in muscles called trigger points. These localized areas in muscle tissues and / or their tendinous attachments are often felt as taut bands when palpated, which elicits pain. The exact nature of the trigger point is not known. 5 In most cases, the symptoms are the reason for the increased tension of the masticatory musculature, and the parafunctions. 6, 7 Due to the large subjectiveness of the symptoms, TMDs are very difficult to diagnose, especially because patients usually search for help from other
* Corresponding author: Prof. Dr. Mahesh Verma, MDS, MBA, PhD( hc), FDSRCS( Eng), FDSRCS( Edin), FDSRPSG( Glas), Director-Principal Department of Prosthodontics Maulana Azad Institute of Dental Sciences MAMC complex, BSZ marg New Delhi 110002, India Phone: + 91-11-23233925, Fax: + 91-11-23217081, e-mail: dpmaids @ gmail. com
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