Management of temporomandibular dysfunctions using occlusal splints

Abstract

Introduction. Temporomandibular disorders represent a group of dysfunctions that involve the relationship of the mandible to the maxilla, characterized by articular, muscular and orofacial pain, bruxism, locking of the jaw, crepitus and crackles. With a various etiology, this condition is widely treated nowadays by using occlusal splints- removable artificial devices, that affect the mandible position and allow it to reseat in a physiological position, by creating a mechanical impediment for parafunctions. Aim of the study. To determine efficiency of splint therapy in treatment of temporomandibular disorders. Materials and methods. Five patients with temporomandibular dysfunctions were examined clinically and paraclinical, with the following complaints: headache, neck ache and ear ache, signs of orofacial pain, tinnitus and ear fullness, bruxism and teeth abrasion. The clinical examination revealed a set of signs and symptoms: pain in temporomandibular joint (TMJ) and facial muscles, observed during palpation, especially in the lateral pterygoid muscle, limitation in mouth opening up to 18 mm, deviation in mandibular path of motion, pathological sounds: crepitus and crackles. The paraclinical examination was performed for all patients and included: study models, electromyography and CT of TMJ. In order to fabricate occlusal splints, CR was determined using leaf gauge technique and impressions were taken for the upper and lower jaw. The patients were instructed to wear the appliance as long as possible during 1 month. Results. We observed an improvement of pain symptoms, bruxism and muscle tension. CT revealed the reposition of condyles in CR. Conclusions. Splint therapy ensures an efficient treatment of temporomandibular disorders, allow muscle relaxation and guide the condyles in a physiological position, improving the pain symptoms.