SPLINTS IN TMJ DYSFUNCTION. HOW EFFECTIVE? A REVIEW
Figure 1. Face bow record transfer for centric stabilization splint
Figure 2. Centric stabilizing splint in use
Figure 3. Occlusal contacts in centric relation position
specialists besides dentists( e. g., neurologist, otolaryngologist or ophthalmologist). 8, 9 Management of TMD aims at relief of pain, reduction of load on masticatory muscles and TMJ, and restoration of normal function. Several different therapies, most of them conservative and reversible, others irreversible, have been advocated for patients with TMD. A number of successful treatment outcomes have been reported. Therapies may include occlusal appliances, pharmacological interventions, physical therapy, physical self-treatment, psychological intervention, acupuncture, and biofeedback. 10 More complex TMD conditions are recommended to be managed using combinations of single therapies. 11, 12 Orthopaedic appliances, also referred to as intraoral appliances, occlusal splints, orthotics, night guards, or bruxism appliances, have reported 70 – 90 % rate of clinical success.
2. Data collection
The articles reported in this literature review were searched on PubMed / MEDLINE database,
Figure 4. Corresponding contacts in mandibular arch during use of centric stabilizing splints
considering only the scientific journals written in English; case reports were excluded. The keywords selected were“ temporomandibular disorders”,“ occlusal splints” and“ intraoral appliances”.
2.1. Occlusal splint therapy To achieve the proper relation of the jaw, the centric relation( CR) should be restored. It is easily performed by occlusal splints. An occlusal appliance is any removable artificial occlusal surface used for diagnosis or therapy affecting the relationship of the mandible to the maxilla. Occlusal appliances may be used for occlusal stabilization, for the treatment of temporomandibular disorders, or for the prevention of dentition wear. 13 Occlusal splints are used in a vast majority of patients with TMDs to restore the static and dynamic symmetry of the stomatognathic system. Most commonly, they are used in cases with disc displacement. 14,
15,16
Different types of splints used in occlusal splint therapy include permissive, nonpermissive, hydrostatic, and soft rubber( silicone) splints. The type of splint utilized is dependent on the diagnosis. One of the most popular occlusal splints is the Michigan-type bite splint( Figs 1- 4),
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