“RA.DI.CA.” Splint for the Management of the Mandibular Functional Limitation: A Retrospective Study on Patients with Anterior Disc Displacement without Reduction

Abstract

The study aimed at assessing the effectiveness of the RA.DI.CA. splint in the management of temporomandibular joint disc displacement without reduction (ADDwoR) and jaw functional limitation. The authors developed a retrospective clinical study. A total of 2739 medical records were screened. One hundred and forty-one patients with chronic unilateral disc displacement without reduction and jaw limitation, treated with a multifunctional RA.DI.CA. splint, were enrolled. Temporomandibular pain, headache, familiar pain, neck pain, and emotional strain, maximum spontaneous mouth opening, and lateral excursions were evaluated at baseline (T0), after therapy (T1), and during the follow-up (T2). Descriptive statistical analysis was performed. Wilcoxon test assessed changes in symptomatology and functional aspects before and after treatment and between T1 and T2, with p < 0.05. Ninety-nine patients (70%) declared themselves “healed” from jaw functional limitation with no residual painful symptoms, 31 (22%) improved their symptoms and jaw function, 11 (8%) reported no changes compared to T0 and no one worsened. As for all parameters analyzed, the comparison between the ones before and after treatment was statistically significant (p < 0.05). The RA.DI.CA. splint proved to be highly performing and promoting functional and symptomatologic recovery, also in the medium and long term, through the restoration of the functional disc-condyle relationship and the healing of joint tissues.

Orthodontic management of anterior disc displacement without reduction

“…Several attempts have been made in the literature to recapture the anterior disc displacement without reduction,[ 2 7 8 9 10 11 ] such as mandibular manipulation to recapture the displaced disc by pulling the condyle of the affected side downward and forward. Arthroscopic disc fixation to the condylar head uses resorbable pins for internal derangement of the temporomandibular joint (stage II–IV).…”

Treatment protocol for temporomandibular joint derangement using an anterior repositioning splint with modification (one year prospective study).

“…Also, Sousa BM et al (117) , reported an improved VAS, started at 7.1 and reached 1.4 & 0.7 in 1 month and 6 months respectively. Di Paolo et al (118) , reported VAS scores improvement from 63 to 8.32, and 70% of their patients considered themselves healed. Zhigui et al (82) , reported pain VAS of 3.89 ± 1.80, 2.23 ± 1.77, and 1.37 ± 1.57 in baseline, 3months, and 1 year respectively.…”

Headache Because of Problems with Teeth, Mouth, Jaws, or Dentures in Chronic Temporomandibular Disorder Patients: A Case–Control Study

“…It is generally accepted that TMDs have a multifactorial etiology and that psychosocial components, including oral behaviors and trauma, contribute to the development, exacerbation, and progression to chronic TMD [ 13 , 14 ]. However, the role of psychological factors in the development of TMD disorders is still not entirely clear [ 15 ].…”

“…Psychopathology may also discriminate between myogenous and arthrogenous groups of TMD patients [ 14 ]. According to Gatchel et al, depression is more common among individuals with chronic tension-type headaches than with TMD [ 21 ].…”