The treatment of painful temporomandibular joint clicking with oral splints: a randomized clinical trial |
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| Authors: | Conti Paulo César Rodrigues dos Santos Carlos Neanes Kogawa Evelyn Mikaela de Castro Ferreira Conti Ana Claudia de Araujo Carlos dos Reis Pereira |
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| Affiliation: | 1. Department of Anthropology, University of Florida, 1112 Turlington Hall, Gainesville, FL 32611-7305, USA;2. Department of Chemistry, University of Arkansas, Fayetteville, AR 72701, USA;3. Tribology Research Institute, School of Mechanical Engineering, Southwest Jiaotong University, Chengdu 610031, Sichuan, China;4. Department of Anthropology, University of Arkansas, Fayetteville, AR 72701, USA;1. Graduate student, Esthetic Restorative and Implant Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand;2. Associate Professor and Program Director, Esthetic Restorative and Implant Dentistry, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand;1. Assistant Professor, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash;2. Clinical Associate Professor, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Wash;3. Master Dental Technician, Aesthetic Dental Creations, Mill Creek, Wash;4. Research Associate Professor, Department of Oral Health Sciences, School of Dentistry, University of Washington, Seattle, Wash;5. Professor, Department of Restorative Dentistry, School of Dentistry, School of Dentistry, University of Washington, Seattle, Wash;1. Student, Department of Chemistry, University of Alabama at Birmingham, Birmingham, Ala;2. Resident, Department of Biomaterials, University of Alabama at Birmingham School of Dentistry, Clinical and Community Sciences, Birmingham, Ala;3. Associate Professor, Department of Prosthodontics, University of Alabama at Birmingham School of Dentistry, Restorative Sciences, Birmingham, Ala;4. Professor and Assistant Dean, Clinical Research, Department of Biomaterials, University of Alabama at Birmingham School of Dentistry, Clinical and Community Sciences, Birmingham, Ala;5. Assistant Professor, Department of Biomaterials, University of Alabama at Birmingham School of Dentistry, Clinical and Community Sciences, Birmingham, Ala;1. Assistant Professor, Department of Diagnostic Sciences, Oral Medicine Division, Tufts University School of Dental Medicine, Boston, MA, USA;2. Resident, Advanced Education in General Dentistry, Tufts University School of Dental Medicine, Boston, MA, USA;3. Professor and Chairman Emeritus, Department of Oral and Maxillofacial Surgery, Virginia Commonwealth University School of Dentistry, Richmond, VA, USA |
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| Abstract: | BACKGROUND: The authors compared the efficacy of bilateral balanced and canine guidance (occlusal) splints in the treatment of temporomandibular joint (TMJ) pain in subjects who experienced joint clicking with a nonoccluding splint in a double-blind, controlled randomized clinical trial. METHODS: The authors randomly assigned 57 people with signs of disk displacement and TMJ pain into three groups according to the type of splint: bilateral balanced, canine guidance and nonoccluding. The authors followed the groups for six months using analysis of a visual analog scale (VAS), palpation of the TMJ and masticatory muscles, mandibular movements and joint sounds. They used repeated analysis of variance and a chi(2) test to test the hypothesis. RESULTS: The type of guidance used did not influence the pain reduction, yet both occlusal splints were superior to the nonoccluding splint, on the basis of the VAS. Despite similar outcomes in relation to opening, left lateral and protrusive movements, TMJ and muscle pain on palpation, subjects who used the occlusal splints had improved clinical outcomes. The frequency of joint noises decreased over time, with no significant differences among groups. Subjects in the groups using the occlusal splints reported more comfort. CONCLUSION: The type of lateral guidance did not influence the subjects' improvement. All of the subjects had a general improvement on the VAS, though subjects in the occlusal splint groups had better results that did subjects in the nonoccluding splint group. |
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| Keywords: | Temporomandibular disorders occlusion occlusal splints |
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