Role of anterior repositioning splint in management of temporomandibular disorders

ABSTRACT

Myofascial pain dysfunction and temporomandibular joint dysfunction [TMD] are progressively posing challenges to the dental profession. The aetiology has been traced, [apart.from other factors] to psychosomatic disturbances and occlusal anomalies. The treatment includes behavioural modification, physical therapy, pharmacotherapy,, intra oral appliances and surgery. Early intervention by anterior repositioning splint therapy is a non-surgical management of anterior disc displacement with reduction. The aim of this therapeutic intervention is to re-establish a correct disc-condyle relationship to achieve painless and functional mandibular movements. This therapy must be employed with an awareness of potential objectives in carefully selected subjects. It is recommended that patients should undergo a precise evaluation protocol. Diagnostic imaging technique and long term follow up will avoid complications. Intracapsular disorders must be isolated from the extracapsular diseases. Treatment of the cause cannot be overemphasized. Arthrography can be utilized for more accurate repositioning of the displaced disc onto the condyle. MRI has proved to be a useful aid in diagnosing and controlling therapeutic mandibular position by allowing clear evaluation of disc-condyle-fossa relationship. MRI following insertion of anterior repositioning splints has shown successful recapture of partially displaced disc with reduction. The present report describes detailed diagnosis and management of an example patient exhibiting features of TMD. In addition we have also reviewed the literature of this chronologically progressive condition