Effectiveness of Protrusive Splint in Disc Displacement with Reduction. A Systematic Review
https://orcid.org/0009-0007-1656-7529
David Orlando Calvopiña Nogales
https://orcid.org/0009-0007-7299-2423
Stephanie Marie Jaramillo Chagerben
https://orcid.org/0000-0001-8931-8223
Edgar Humberto Güiza Cristancho
https://orcid.org/0000-0001-6883-8094
Oscar de León Rodríguez
https://orcid.org/0000-0002-0170-0506
Adriana Rodríguez Ciódaro
https://orcid.org/0000-0002-6640-3975
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Background: Disc displacement with reduction is a condition of the temporomandibular joint (TMJ) characterized by joint noises, pain, and limited mandibular mobility. Treatments include protrusive splints aimed at repositioning the articular disc and alleviating symptoms. Purpose: To evaluate the efficacy of protrusive splints in repositioning the disc with reduction in the TMJ, diagnosed through magnetic resonance imaging, via a systematic literature review. Methods: A search was conducted in PubMed, Cochrane Library, Medline, and SciELO between June and July 2021, identifying 10 studies: 1 randomized controlled trial, 1 systematic review, and 8 cohort studies. Results: Five studies showed immediate success in disc repositioning, with success rates ranging from 83 % to 100 %. However, efficacy decreased over time: 75.5 % at 2 weeks, 74.5 % at 2 months, 25 % to 100 % at 3 months, 40.6 % to 84.3 % at 6 months, 75 % at 1 year, and 53.1 % at 2 years. Conclusions: Protrusive splints are effective in the short term for treating this condition, but evidence is insufficient to determine their long-term efficacy using magnetic resonance imaging.
articulación temporomandibular, desplazamiento anterior con reducción, oclusión, odontología, placa oclusal, placa protrusiva, prostodoncia, resonancia magnéticaanterior displacement with reduction, dentistry, magnetic resonance, occlusion, occlusal splint, protrusive splint, prosthodontics, emporomandibular jointarticulação temporomandibular, deslocamento anterior com redução, oclusão, odontologia, placa oclusal, placa protrusiva, prótese dentária, ressonância magnética
2. Gauer RL, Semidey MJ. Diagnosis and treatment of temporomandibular disorders. Am Fam Physician. 2015 Mar 15; 91(6): 378-386
3. Liu MQ, Lei J, Han JH, Yap AU, Fu KY. Metrical analysis of disc-condyle relation with different splint treatment positions in patients with TMJ disc displacement. J Appl Oral Sci. 2017 Sep-Oct; 25(5): 483-489. https://doi.org/10.1590/1678-7757-2016-0471
4. Hosgor H, Bas B, Celenk C. A comparison of the outcomes of four minimally invasive treatment methods for anterior disc displacement of the temporomandibular joint. Int J Oral Maxillofac Surg. 2017 Nov; 46(11): 1403-1410. https://doi.org/10.1016/j.ijom.2017.05.010
5. Chantaracherd P, John MT, Hodges JS, Schiffman EL. Temporomandibular joint disorders' impact on pain, function, and disability. J Dent Res. 2015 Mar; 94(3 Suppl): 79S-86S. https://doi.org/10.1177/0022034514565793
6. Pihut M, Gorecka M, Ceranowicz P, Wieckiewicz M. The Efficiency of Anterior Repositioning Splints In The Management Of Pain Related To Temporomandibular Joint Disc Displacement With Reduction. Pain Res Manag. 2018 Feb 21; 2018: 9089286. https://doi.org/10.1155/2018/9089286
7. Zhu H, He D, Yang Z, Song X, Ellis E 3rd. The effect of disc repositioning and post-operative functional splint for the treatment of anterior disc displacement in juvenile patients with Class II malocclusion. J Craniomaxillofac Surg. 2019 Jan; 47(1): 66-72. https://doi.org/10.1016/j.jcms.2018.09.035
8. Lin SL, Wu SL, Huang HT, Lung FW, Chi TC, Yang JW. Can a 10-Minute questionnaire identify significant psychological issues in patients with temporomandibular joint disease? J Oral Maxillofac Surg. 2017 Sep; 75(9): 1856-1865. https://doi.org/10.1016/j.joms.2017.02.024
9. Chen HM, Liu MQ, Yap AU, Fu KY. Physiological effects of anterior repositioning splint on temporomandibular joint disc displacement: a quantitative analysis. J Oral Rehabil. 2017 Sep; 44(9): 664-672. https://doi.org/10.1111/joor.12532
10. Ma Z, Xie Q, Yang C, Zhang S, Shen Y, Abdelrehem A. Can anterior repositioning splint effectively treat temporomandibular joint disc displacement? Sci Rep. 2019 Jan 24; 9(1): 534. https://doi.org/10.1038/s41598-018-36988-8
11. Al-Moraissi EA, Al-Otaibi K, Almaweri AA, Bastos RM, Haas Junior OL, Amran AG. Treatment of painful temporomandibular joint disc displacement without reduction: network meta-analysis of randomized clinical trials. Int J Oral Maxillofac Surg. 2024 Jul; 53(7): 584-595. https://doi.org/10.1016/j.ijom.2024.02.004
12. CASP UK. (n.d.). Critical Appraisal Skills Programme (CASP). Oxford. https://casp-uk.net/
13. Kurita H, Ohtsuka A, Kurashina K, Kopp S. A study of factors for successful splint capture of anteriorly displaced temporomandibular joint disc with disc repositioning appliance. J Oral Rehabil. 2001 Jul; 28(7): 651-657. https://doi.org/10.1046/j.1365-2842.2001.00710.x
14. Simmons HC 3rd, Gibbs SJ. Recapture of temporomandibular joint disks using anterior repositioning appliances: an MRI study. Cranio. 1995 Oct; 13(4): 227-237. https://doi.org/10.1080/08869634.1995.11678073
15. Kurita H, Kurashina K, Ohtsuka A, Kotani A. Change of position of the temporomandibular joint disk with insertion of a disk-repositioning appliance. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998 Feb; 85(2): 142-145. https://doi.org/10.1016/s1079-2104(98)90416-4
16. Kurita H, Kurashina K, Baba H, Ohtsuka A, Kotani A, Kopp S. Evaluation of disk capture with a splint repositioning appliance: clinical and critical assessment with MR imaging. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998 Apr; 85(4): 377-380. https://doi.org/10.1016/s1079-2104(98)90060-9
17. Simmons HC 3rd, Gibbs SJ. Initial TMJ disk recapture with anterior repositioning appliances and relation to dental history. Cranio. 1997 Oct; 15(4): 281-295. https://doi.org/10.1080/08869634.1997.11746022
18. Shen P, Chen X, Xie Q, Zhang S, Yang C. Assessment of occlusal appliance for the reposition of temporomandibular joint anterior disc displacement with reduction. J Craniofac Surg. 2019 Jun; 30(4): 1140-1143. https://doi.org/10.1097/SCS.0000000000005210
19. Guo YN, Cui SJ, Zhou YH, Wang XD. An overview of anterior repositioning splint therapy for disc displacement-related temporomandibular disorders. Curr Med Sci. 2021 Jun; 41(3): 626-634. https://doi.org/10.1007/s11596-021-2381-7
20. Fayed MMS, El-Mangoury NH, El-Bokle DN, Belal AI. Occlusal splint therapy and magnetic resonance imaging. World J Orthod. 2004 Summer; 5(2): 133-140
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