Comparison of Modified Occlusal Splint, Standard Splint Protocol, and Conventional Physical Therapy in Management of Temporomandibular Joint Disc Displacement with Reduction and Intermittent Locking: A Randomized Controlled Trial

Background: Temporomandibular joint disc displacement with reduction is one of the most common types of TMJ arthropathy. This single-blinded, randomized clinical study aimed to evaluate the effectiveness of three different therapeutic methods. Methods: Standard splints (Group 1), modified occlusal s...

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Main Authors: Sandro Prati, Funda Goker, Margherita Tumedei, Aldo Bruno Gianni, Massimo Del Fabbro, Gianluca Martino Tartaglia
Format: Article
Language:English
Published: MDPI AG 2024-12-01
Series:Applied Sciences
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Online Access:https://www.mdpi.com/2076-3417/14/24/11743
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author Sandro Prati
Funda Goker
Margherita Tumedei
Aldo Bruno Gianni
Massimo Del Fabbro
Gianluca Martino Tartaglia
author_facet Sandro Prati
Funda Goker
Margherita Tumedei
Aldo Bruno Gianni
Massimo Del Fabbro
Gianluca Martino Tartaglia
author_sort Sandro Prati
collection DOAJ
description Background: Temporomandibular joint disc displacement with reduction is one of the most common types of TMJ arthropathy. This single-blinded, randomized clinical study aimed to evaluate the effectiveness of three different therapeutic methods. Methods: Standard splints (Group 1), modified occlusal splint (Group 2), and conventional physical therapy with exercises (Group 3). A total of 48 patients were randomly assigned by a computer-generated allocation sequence to receive rehabilitation. The outcome was defined as improvements in pain and intermittent locking episodes. The follow-up visits were scheduled as one month and a long-term evaluation at one (T1), two (T2), three (T3), and four years (T4). Magnetic resonance images were also taken to evaluate each patient before treatment and at one year. Image analysis involved the evaluation of morphology and the function of intra-articular structures. Variables such as age, gender, and pre- vs. post-treatment values of VAS and TMJ locks between the three intervention categories were compared for statistical evaluations. <i>p</i> values ≤ 0.05 were taken as being significant. Results: A total of 16 subjects were allocated to each group. At T1, a decrease in pain and TMJ locking episodes was observed, which was maintained throughout the course of the study for four years of follow-ups, with no statistically significant differences. However, there was a tendency for better outcomes in favor of Group 2, with less clicking of the TMJ at opening. Conclusions: The modified mandibular splint seems to be successful as an effective alternative for the management of temporomandibular joint disc displacement with reductions in intermittent locking.
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spelling doaj-art-574d781eb60045f6bbcdfcb0b327277f2025-08-20T02:00:50ZengMDPI AGApplied Sciences2076-34172024-12-0114241174310.3390/app142411743Comparison of Modified Occlusal Splint, Standard Splint Protocol, and Conventional Physical Therapy in Management of Temporomandibular Joint Disc Displacement with Reduction and Intermittent Locking: A Randomized Controlled TrialSandro Prati0Funda Goker1Margherita Tumedei2Aldo Bruno Gianni3Massimo Del Fabbro4Gianluca Martino Tartaglia5Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, ItalyFondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, ItalyFondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, ItalyFondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, ItalyFondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, ItalyFondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, ItalyBackground: Temporomandibular joint disc displacement with reduction is one of the most common types of TMJ arthropathy. This single-blinded, randomized clinical study aimed to evaluate the effectiveness of three different therapeutic methods. Methods: Standard splints (Group 1), modified occlusal splint (Group 2), and conventional physical therapy with exercises (Group 3). A total of 48 patients were randomly assigned by a computer-generated allocation sequence to receive rehabilitation. The outcome was defined as improvements in pain and intermittent locking episodes. The follow-up visits were scheduled as one month and a long-term evaluation at one (T1), two (T2), three (T3), and four years (T4). Magnetic resonance images were also taken to evaluate each patient before treatment and at one year. Image analysis involved the evaluation of morphology and the function of intra-articular structures. Variables such as age, gender, and pre- vs. post-treatment values of VAS and TMJ locks between the three intervention categories were compared for statistical evaluations. <i>p</i> values ≤ 0.05 were taken as being significant. Results: A total of 16 subjects were allocated to each group. At T1, a decrease in pain and TMJ locking episodes was observed, which was maintained throughout the course of the study for four years of follow-ups, with no statistically significant differences. However, there was a tendency for better outcomes in favor of Group 2, with less clicking of the TMJ at opening. Conclusions: The modified mandibular splint seems to be successful as an effective alternative for the management of temporomandibular joint disc displacement with reductions in intermittent locking.https://www.mdpi.com/2076-3417/14/24/11743TMJ disorderstemporomandibular joint diseasestemporomandibular jointtemporomandibular joint syndromesplint therapy
spellingShingle Sandro Prati
Funda Goker
Margherita Tumedei
Aldo Bruno Gianni
Massimo Del Fabbro
Gianluca Martino Tartaglia
Comparison of Modified Occlusal Splint, Standard Splint Protocol, and Conventional Physical Therapy in Management of Temporomandibular Joint Disc Displacement with Reduction and Intermittent Locking: A Randomized Controlled Trial
Applied Sciences
TMJ disorders
temporomandibular joint diseases
temporomandibular joint
temporomandibular joint syndrome
splint therapy
title Comparison of Modified Occlusal Splint, Standard Splint Protocol, and Conventional Physical Therapy in Management of Temporomandibular Joint Disc Displacement with Reduction and Intermittent Locking: A Randomized Controlled Trial
title_full Comparison of Modified Occlusal Splint, Standard Splint Protocol, and Conventional Physical Therapy in Management of Temporomandibular Joint Disc Displacement with Reduction and Intermittent Locking: A Randomized Controlled Trial
title_fullStr Comparison of Modified Occlusal Splint, Standard Splint Protocol, and Conventional Physical Therapy in Management of Temporomandibular Joint Disc Displacement with Reduction and Intermittent Locking: A Randomized Controlled Trial
title_full_unstemmed Comparison of Modified Occlusal Splint, Standard Splint Protocol, and Conventional Physical Therapy in Management of Temporomandibular Joint Disc Displacement with Reduction and Intermittent Locking: A Randomized Controlled Trial
title_short Comparison of Modified Occlusal Splint, Standard Splint Protocol, and Conventional Physical Therapy in Management of Temporomandibular Joint Disc Displacement with Reduction and Intermittent Locking: A Randomized Controlled Trial
title_sort comparison of modified occlusal splint standard splint protocol and conventional physical therapy in management of temporomandibular joint disc displacement with reduction and intermittent locking a randomized controlled trial
topic TMJ disorders
temporomandibular joint diseases
temporomandibular joint
temporomandibular joint syndrome
splint therapy
url https://www.mdpi.com/2076-3417/14/24/11743
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