Application of a systematic protocol in the treatment of TMDs with occlusal appliances: Effectiveness and efficiency in a longitudinal retrospective study with medium-term follow up

Abstract

Objectives: This study aimed to assess effectiveness, efficiency, and feasibility of a systematic protocol for the choice and management of occlusal splints (OA) in the treatment of temporomandibular disorders (TMDs). Materials and Methods: A longitudinal retrospective study was conducted. Two different samples, G1 + G2 (337 patients), between January 2011 and January 2014, were selected according to inclusion and exclusion criteria. G1 was composed of patients visited at Policlinico Umberto I, Head-Neck Department, Sapienza University of Rome, Italy, and patients in G2 visited at a private structure in Rome. Pain records and functionality were compared before (T0) and at the end of therapy (T1). A follow-up group, composed of 100 patients randomly selected among those who completed treatment for at least 1 year (T2), was analyzed and symptomatology records were compared. Descriptive statistical analysis was performed. Results: In the entire sample, joint and muscular pain, joint noises and mandibular functionality, headache, and neck pain improved from T0 to T2. The average time for articular and muscular recovery was 6.4 months. Comparing treatment outcomes, there were not statistically significant differences between the two groups. Conclusions: Treatment outcomes using this setting of protocol showed a positive trend also in the medium term. The use of a systematic protocol seems to reduce operator-dependent factors.

Local Vibratory Stimulation for Temporomandibular Disorder Myofascial Pain Treatment: A Randomised, Double-Blind, Placebo-Controlled Preliminary Study

“…Two different application modalities were applied on both sides of the face to the masseter (deep and superficial) and temporal (anterior, middle, and posterior) muscles and to the TMJ [ 1 ], for a total of 16 minutes per day (Figures 3(b) and 3(c) ): Use of the disc head on button 2 (50 Hz) for 4 minutes/side. The device was used with moderate pressure and rotational movements along the masseter and temporal muscles.…”

“…Temporomandibular disorders (TMD) comprise a large number of pathologies related to the masticatory muscles and/or temporomandibular joint (TMJ) and constitute a part of the musculoskeletal disorder group [ 1 ]. Current indications for treatment of these conditions follow a conservative approach that includes information, reassurance, control of functional excesses, physiotherapy rehabilitation, application of physical therapies, administration of drugs, and intraoral devices [ 1 – 3 ]. Like other musculoskeletal disorders, TMD has been treated in recent years with various physical therapy methods, in cases with different types of TMD pain (pain-related, intraarticular, degenerative groups).…”

A Female Psoriatic Arthritis Patient Involving the TMJ

“…The mandibular repositioning is three-dimensional because other than a sagittal movement, we will have an increase in the vertical and transversal dimension (DITRA) Figures 4 and 5 [ 30 ].…”