Appliance of Interocclusal Splint as Initial Treatment of TMJ Dysfunction

Yoon, Dae Young; Lee, Jong Rag; Lee, Eun Ho

Abstract

TMJ dysfunction has difficulties for diagnosing and treating, and its symptoms are variable. TMJ dysfunction is classified as muscular problem, capsular problem, ligamentous problem, internal derangement, or condylar dislocation etc. Treatment modalities for TMJ dysfunction are surgical or conservative one, but they haven't be standardized. Because of anatomical complexities and difficulties of surgical approaches, conservative treatment have been preferred. We've had 30 cases having impressed capsular tightness or internal derangement. They have made an appeal for pain on TMJ area, ROM limitation of joint, clicking etc. We have used the interocclusal splint as treatment modality. In general, the interocclusal splint is classified as the stabilization splint, the repositioning splint, the pivot splint, the soft splint etc. We have applied the stabilization splint or the repositioning splint to the patients according to diagnosis or symptoms. The interocclusal splint is reported to induced the changing activities of muscle, altering the stress or loading of the joint and recapturing or changing condyle- disc-fossa position. As a result, the pain has become reduced and ROM limitation of joint was improved, clicking is eliminated initially. From January 2001 to May 2002, we treated 30 patients who having TMJ dysfunction. Our treatment modality was performed that the interocclusal splints were worn full time for one to four weeks, then phased out. During the mean 10.5 months of follow-up period there had been significant improvements in pain, ROM limitation of joint and clicking. After 6 months, there had been no recurrence in pain and ROM limitation of joint, but 2 cases recurred in clicking that has disappeared. The appliance of interocclusal splint has been an effective method for the initial nonsurgical treatment of the symptoms of TMJ dysfunction. However, more in-depth study by long term follow-up is needed to evaluate recurrence.