The treatment of temporomandibular disorders through repositioning splint therapy: a follow-up study.

The purpose of this study was to investigate the effectiveness of repositioning splint therapy as a conservative treatment modality for TMD patients. The treatment sequence of 160 randomly sampled TMD patients was monitored in order to assess different aspects of the patients' response to splint therapy. Included among these aspects were the pretreatment symptoms; the treatment duration required for initial and final alleviation of symptoms; the number of patients requiring surgery; and the particular appliance and its wear pattern utilized to maintain the treatment results. The treatment success was based on the remission of symptoms including but not limited to pain to palpation, headaches, earaches, jaw locking, and joint noises. Eighty-nine and four tenths percent (89.4%) of the patients experienced a complete remission of symptoms and did not require any surgical intervention. The average time for initial improvement was 22.3 days, while the average time for complete remission of symptoms was 4.3 months. The results of the study indicate that repositioning splint therapy is an effective treatment modality for the conservative treatment of temporomandibular disorders.

A comparison of electromyographic activity between anterior repositioning splint therapy and a centric relation splint.

The purpose of this study was to compare the electromyographic activity of masticatory muscles (temporal and masseter) with the use of an anterior repositioning splint and a centric relation superior repositioning splint. Twenty-six consecutive patients, who referred with the chief complaint of temporomandibular pain and/or headache were selected from one of the author's practices. All these subjects were diagnosed as having internal derangement of the temporomandibular joint. Ten normal subjects were used as controls. Surface electromyographic recordings were taken of each subject prior to the beginning of clinical therapy for the patients. The results show significantly less masseter and temporal muscle activity with anterior repositioning splint therapy compared to the centric relation superior repositioning splint therapy.

Swallowing patterns in human subjects with and without temporomandibular dysfunction.

Recent clinical impressions have suggested that tongue-thrust swallowing may often occur in patients with internal derangement of the temporomandibular joint(s) and may represent an unconscious effort to avoid temporomandibular joint (TMJ) dysfunction by minimizing noxious stimuli from the joints. The purpose of this study, therefore, was to determine the swallowing patterns in human subjects with and without TMJ dysfunction. The swallowing patterns of 25 adult orthodontic patients already known to have TMJ dysfunction and 25 adult control subjects without such dysfunction were examined with the aid of kinesiographic and electromyographic recordings taken while the subjects were sipping water. Analysis of the data revealed that 19 patients with TMJ dysfunction used a tongue-thrust open-jaw swallowing pattern, while only nine control subjects used such a swallowing pattern. Furthermore, six of the patients with TMJ dysfunction had an anterior open bite, while none of the control subjects had an anterior open bite. The results suggest that patients with aberrant swallowing patterns should be examined for temporomandibular joint dysfunction.

Interrelationship of internal derangements of the temporomandibular joint, headache, vertigo, and tinnitus: a survey of 25 patients.

Twenty-five patients presenting with a chief complaint of pain around the temporomandibular joints, along with symptoms of internal derangements, i.e., clicking or crepitus, and concomitant vertigo were treated successfully with jaw repositioning orthotics. All had been examined by physicians for otalgic disorders and were considered negative. Vertigo was remitted with orthotic therapy in all cases and returned with the removal of the appliance. Anatomic and physiologic hypotheses are presented as potential etiologies.

Correction of mandibular asymmetry with the ligated anterior repositioning splint.

Mandibular asymmetry may be the result of unequal ramus height, unequal corpus length, or a combination of both problems. The diagnosis of asymmetry is essential in treatment planning, since a number of therapeutic options must be considered in the treatment to a seated condylar position in the glenoid fossa. When asymmetry exists, it may be necessary to: accept finished treatment with the mandibular midline to the right or left of the maxillary midline, finish the molars and canines in an end-to-end relationship on the short side, treat with asymmetric extractions, intervene surgically, or use functional appliances to enhance greater growth or remodeling of the mandible on the short side. The purpose of this study was to assess the effect of the ligated anterior repositioning splint, or LARS, in the correction of mandibular asymmetry in Class II patients.