J Korean Assoc Maxillofac Plast Reconstr Surg.
1998 Feb;20(1):11-18.
CLINICAL, RADIOGRAPHIC EVALUATIONS OF INTERNAL DERANGEMENT OF TEMPOROMANDIBULAR JOINT TREATED BY CENTRIC RELATION AND ANTERIOR REPOSITIONING SPLINTS
Abstract
- The study evaluated the change of the condylar position and superior joint space in 20 patients, 40 joints treated with occlusal appliance therapy. Before and after treatment, their clinical symptoms and transcranial radiographs were compared and evaluated. Comparisons were made between condylar position in centric occlusion and in maximum opening state. Pre - and postoperative superior joint space(3 points -2, 12, 10's clock positions)also were recorded in centric occlusion. 1. Centric relation splint was effective in patients with disc displacement with reduction, subluxation on opening. Anterior repositioning splint was useful in patients with disc displacement without reduction, locking on opening. The click could be auscultated on guided closing movement as nearly condylar retruded position and then anterior repositioning splint was effectively designed. The type of occlusal appliance was chosen to improve dysfunction of jaw, especially according to mouth opening limitated state. 2. Superior joint spaces were increased after appliance treatment in patients with disc displacement without reduction, locking. The rate of the space widening of affected joint was more greater than that of unaffected site. The space was not changed in patients with disc displacement with reduction, disc displacement without reduction and no mouth opening state. Pre - and postoperative superior joint spaces was increased in disc displacement without reduction. 3. The main symptoms of temporomandibular disorder were shown as 35% of pain, 45% of click, 20% of mouth opening limitation. The number of patients with disc displacement with reduction on unilateral joint site and disc displacement without reduction on bilateral joints was the greatest in this group. 4. The symptoms were improved within 3-5 weeks in patients treated with an anterior repositioning splint, but within 6-19 weeks in patients treated with centric relation splint.