Occlusal Splint Therapy for a Dysfunctional Temporomandibular Joint

Abstract

Splint therapy is an effective form of treatment for the pain of many types of temporomandibular disorders and bruxism. There are many unanswered questions as to how splints work. This article is a review of the literature which focuses on an effective splint design for the different degrees of temporomandibular problems.

The use of occlusal splints in temporomandibular disorders - an overview.

“…The anterior midpoint contact permissive splints are believed to determine the release of the lateral pterygoid muscle on closure, as well as neck positioning muscles, to remove the occlusal interferences, and to allow the mandibular condyles freedom for full seating during the closure [11].…”

“…Full contact permissive splints will eliminate any discrepancies between seated joints (in centric relation -CR) and occlusion (during maximum intercuspal position -MI), and will offer the opportunity to observe occlusion and joint stability over time, distribute the occlusal forces evenly while eliminating the occlusal interferences [11].…”

“…The mandible is guided into a forward posture on closure into the occlusal splint [10]. This is the reason why those types of splints are useful in two clinical situations: severe trauma with retrodiscal edema, and in case of chronic painful disk displacements [10,11].…”

“…Although there is no significant scientific evidence, some authors reported that this type of splint may enhance the athletic performance, increasing the physical strength. This type of splint is also indicated in cases of severe loss of vertical dimension of occlusion or when major changes are required in anterior positioning of the mandible [3,11].…”

“…If the disk displacement is complete (without reduction) then the same type of splint (full arch permissive appliance) would be indicated for a minimum of 3 months. In this situation, occlusion on the splint should be adjusted weekly, until it stabilizes [10,11].…”