A comparison between horizontal splint and repositioning splint in the treatment of ‘disc dislocation with reduction’. Literature meta‐analysis

Abstract

We reviewed the literature from 1985 to 1996 concerning the preliminary treatment of disc dislocation with reduction (DDWR) by means of occlusal splints, pinpointing two main methods. The conflicting results of many papers induced us to make a literature meta-analysis of those articles with the necessary requirements in order to verify the effectiveness of the two therapeutic means more frequently used in DDWR; the repositioning splint and the bite plane. A statistical comparison between the two kinds of treatment has demonstrated that the repositioning splint is more effective both in the resolution of the articular click and of the pain at a level of P < or = 0.00001, which is noteworthy and highly significant.

Need for occlusal therapy and prosthodontic treatment in the management of temporomandibular disorders.

“…Despite the lack of conclusive evidence, it has often been suggested that treatment of the occlusion and maintaining or restoring molar support may be indicated as a supplement to other treatment for OA. Sato et al (1994) aimed to confirm this hypothesis in 19 OA patients diagnosed clinically and radiographically. Each patient first received a stabilization type of interocclusal appliance.…”

“…Based on a meta‐analysis of the literature, Sanbacatterina et al (1998) concluded that a repositioning splint is the best procedure to follow in cases of disk dislocation with reduction compared with a flat‐plane splint. However, such a meta‐analysis does not provide new experimental data, nor did the study consider other treatment modalities, such as physical therapy.…”

“…Based on a meta-analysis of the literature, Sanbacatterina et al (1998) concluded that a repositioning splint is the best procedure to follow in cases of disk dislocation with reduction compared with a flat-plane splint.…”

Treatment of temporomandibular disorders by stabilising splints in general dental practice: results after initial treatment

“…The relative ineffectiveness of stabilising splints in treating disc displacement with reduction has been described previously. 14 Nevertheless, although these patients had a click on opening and closing, the degree of click reproducibility was not defined and only one patient referred to the dental hospital fell clearly into the category of requiring an anterior repositioning splint (ie elimination of the click and improvement in comfort by forward mandibular posture). 15 In total, six patients were referred for occlusal adjustment.…”

Splint therapy for disc displacement with reduction of the temporomandibular joint. Part I: Modified mandibular splint therapy

“…Previous studies of successful splint therapy have investigated various combinations of splint designs, daily wearing times, therapeutic periods, and even placement in the upper or lower jaw. Some studies showed high success rates in the relocation of the disc by the use of ARS [4,13]. Others reported lower success rates in regaining the normal disc-to-condyle relationship [5,14].…”