Splint therapy evaluation with direct sagittal computed tomography

Manco, Lawrence G.; Messing, Steven

doi:10.1016/0030-4220(86)90193-3

Cited by 24 publications

(6 citation statements)

References 13 publications

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“…In an MRI study involving 18 patients and 30 clicking joints treated with the Sved-type splint, Kirk (1991) reported that disc repositioning occurred in only three joints. Similarly, Manco and Messing (1986) found that 41.8% of the discs evaluated with direct sagittal computed tomography were not repositioned after ARSplint therapy. Manzione et al (1984) reported that 46% of the patients with painful DD treated with ARSplints still had anterior DD.…”

Section: (C) Clinical Efficacy/effectivenessmentioning

confidence: 99%

“…For instance, in an MRI study involving 30 clicking joints treated with the Sved-type splint, it was reported that although joint noises were eliminated in 27 joints, disc repositioning occurred in only three joints (Kirk, 1991). Similarly, Manco and Messing (1986) found that even though joint noises were eliminated, 41.8% of the discs evaluated with direct sagittal computed tomography were not repositioned after ARSplint therapy. Taken together, these data suggest that subjective reports of improvements following ARSplint therapy do not generally occur as the result of disc recapturing.…”

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confidence: 99%

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Oral Splints: the Crutches for Temporomandibular Disorders and Bruxism?

Dao

Lavigne

1998

Critical Reviews in Oral Biology & Medicine

257

143

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Despite the extensive use of oral splints in the treatment of temporomandibular disorders (TMD) and bruxism, their mechanisms of action remain controversial. Various hypotheses have been proposed to explain their apparent efficacy (i.e., true therapeutic value), including the repositioning of the condyle and/or the articular disc, reduction in the electromyographic activity of the masticatory muscles, modification of the patient's "harmful" oral behavior, and changes in the patient's occlusion. Following a comprehensive review of the literature, it is concluded that any of these theories is either poor or inconsistent, while the issue of true efficacy for oral splints remains unsettled. However, the results of a controlled clinical trial lend support to the effectiveness (i.e., the patient's appreciation of the positive changes which are perceived to have occurred during the trial) of the stabilizing splint in the control of myofascial pain. In light of the data supporting their effectiveness but not their efficacy, oral splints should be used as an adjunct for pain management rather than a definitive treatment. For sleep bruxism, it is prudent to limit their use as a habit management aid and to prevent/limit dental damage potentially induced by the disorder. Future research should study the natural history and etiologies of TMD and bruxism, so that specific treatments for these disorders can be developed.Key words. Oral splints, temporomandibular disorders, bruxism, myofascial pain, disc displacement disorders. (I) IntroductionAmong the treatments provided for temporomandibular disorders (TMD), intra-oral dental appliances, whether with full or partial occlusal coverage, and referred to in this paper as oral splints, have been repeatedly reported as being the most widely adopted choice. Introduced by Karolyi in 1901 (see Ramfjord and Ash, 1994) for the treatment of bruxism, it is striking to see the versatility of their current applications. Other than their use in the prevention of dental injuries and oral soft-tissue trauma potentially induced by bruxism, sports, cheek biting (Walker and Rogers, 1992), and electroconvulsive therapy (Minneman, 1995), oral splints of various designs have been prescribed in the management of diverse disorders including: (a) motor disorders such as Parkinson's disease (Durham et al., 1993) and oral tardive dyskinesia (Kai et al., 1994); (b) sleep disorders such as snoring (George, 1993) and sleep apnea (George, 1993;Athanasiou et al., 1994;Lowe, 1994;Yoshida, 1994;Osseiran, 1995); (c) sensitive teeth related to chronic sinusitis (Dawson, 1974); (d) various headaches, from the tension-type to migraine (Ouayle et al., 1990;Lamey and Steele, 1996); and (e) all subgroups of TMD, e.g., myofascial pain, disc displacement disorders, and the arthritides (Table 1).It is also surprising to see the wide acceptance of oral splints and their "multi-purpose usage", while little is known about the mechanisms by which they exert their effect. For the TMD, a survey of 10,000 members of...

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Section: (C) Clinical Efficacy/effectivenessmentioning

confidence: 99%

mentioning

confidence: 99%

Oral Splints: the Crutches for Temporomandibular Disorders and Bruxism?

Dao

Lavigne

1998

Critical Reviews in Oral Biology & Medicine

257

143

View full text Add to dashboard Cite

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“…The treatment goals of splint for DDwR of TMJ are to (1) reposition the condyle downward and recapture the disc anteriorly; (2) correct the relationship between the glenoid fossa, articular disc, and condyle; (3) improve jaw function; (4) reduce joint pain and sounds; (5) eliminate mechanical interference; and (6) prevent progression of the disorder [1,19,21]. The results of splint therapy have been evaluated by clinical assessment, arthrotomography [17], CT [14], and MRI [3,8,9,15]. These studies confirmed the possibility of disc recapture.…”

Section: Discussionmentioning

confidence: 99%

“…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]. In general, the goals of splint therapy are to correct the relationship between the glenoid fossa, articular disc and condyle, decrease joint pain and sounds, improve jaw function, and eliminate any mechanical interference.…”

Section: Introductionmentioning

confidence: 98%

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

Huang

Kao

et al. 2011

The Kaohsiung J of Med Scie

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The aims of this preliminary study were to present a modified mandibular splint together with a treatment regimen and to evaluate their effects on the treatment of reciprocal joint sounds of the temporomandibular joint (TMJ). The study participants were recruited from 312 consecutive patients in the temporomandibular disorder clinic of a medical center in Taiwan from January 2003 to December 2003. From among these, 59 cases with typical reciprocal clicking were selected for this study. All participants were treated with a modified mandibular splint and then followed up for 6 months. Successful treatment was defined as leading to the disappearance of the joint sounds of TMJ, as described by patients. Based on clinical evaluation, the overall success rate was 71.2% (42/59) with minimal temporary complications. Patients with clicking at less than 3.5 cm of interincisal opening had a success rate of 92.5%, which was higher than the success rate of patients with clicking at a mouth opening of 3.5 cm or more. This study showed that a modified mandibular splint can be used to treat reciprocal clicking of the TMJ effectively and encouraged us to conduct further study on the efficacy of this splint to treat disc displacement with reduction of TMJ using magnetic resonance imaging examination.

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“…In the same period, by means of arthrograpy Manzione et al . (1984 ), and by means of the CT (computed tomography) Manco and Messing (1986), both demonstrated that 46 and 42%, respectively, of the articulations in which the meniscus had successfully been clinically recaptured actually did not show a correct condylo‐meniscal relation. In a recent study ( De Leeuw et al .…”

Section: Introductionmentioning

confidence: 99%

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

Santacatterina

Paoli

Peretta

et al. 1998

J of Oral Rehabilitation

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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.

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Splint therapy evaluation with direct sagittal computed tomography

Cited by 24 publications

References 13 publications

Oral Splints: the Crutches for Temporomandibular Disorders and Bruxism?

Oral Splints: the Crutches for Temporomandibular Disorders and Bruxism?

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

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

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