Purpose:
To study the patient with temporomandibular joint derangement concerning the subjective response and clinical outcome and to a modified splint treatment protocol.
Materials and Methods:
12 patients included with disc displacement with reduction (DDwR). The treatment protocol was initiated using an anterior repositioning splint (ARS) for 3 months and later completed with ARS modification into a stabilizing splint (SS) for the next 9 months. Follow-up was made over one year (6 weeks, 12 weeks, and 1-year intervals). The follow-up included the patient's self-evaluation, clinical examination, and MRI.
Results:
In comparison to the base-line a significant improvement was recorded in the tested parameters; A) in 12 weeks follow up, the subjective data were; the pain frequency (0.41±0.51), the pain degree (0.25±0.45), the modified pain by chewing, movement, para-function, and other parameters were 0.08±0.28, 0.25±0.45, 0.25±0.45, and 0.16±0.38 respectively. B) in 6 & 12 weeks follow-ups the clinical parameters were; MCPS 0.58±0.51, and 0.25±0.45, the MYS 0.58±0.51, 0.25±0.45, the MD 1.91±0.66, 0.58 ±0.51, C) the VAS scores, the mandibular movement range in the maximum opening, protrusive and both lateral directions, and the Helkimo's disability index scores, D) in 3& 12 months follow-ups the complete disc recapture diagnosed by MRI were 66% and 83% respectively.
Conclusion:
There is a positive impact of the ARS on all criteria of patient subjective and clinical outcomes. The improvement continued after splint modification for the successive 9 months.
Within the limitation of this study, and upon literature comparison, this treatment protocol is recommended in DDwR cases.