Evaluation of the effectiveness of occlusal splints in the complex treatment of patients with internal disorders of the temporomandibular joint

INTRODUCTION. The present study reports the outcomes of using occlusal splints in the comprehensive treatment of patients with internal temporomandibular joint (TMJ) disorders. The diagnosis of mandibular movement disorders was performed using an optical axiograph Dentograf Prosystom (Russia). The obtained axiographic data were utilized for the fabrication of myorelaxing and distraction splints. Axiography was repeated every three weeks to monitor treatment effectiveness. The position and function of the TMJ articular disc (AD) were evaluated by ultrasonography (US) one to two times per month.

AIM. To evaluate the effectiveness of various types of occlusal splints fabricated using mechanical and virtual articulators in the comprehensive treatment of patients with subluxation and chronic dislocation of the TMJ articular disc.

MATERIALS AND METHODS. Myorelaxing and distraction splints for patients with subluxation and chronic dislocation of the AD were fabricated using two approaches: (1) The classical method, involving a mechanical facebow and a mechanical articulator; (2) The CAD/CAM technology, employing a virtual articulator.

RESULTS. The effectiveness of myorelaxing splints fabricated with the mechanical articulator was 81.8%, while for those produced using the virtual articulator it reached 88.0%. The effectiveness of distraction splints fabricated with the mechanical articulator was 55.6%, whereas modeling with the virtual articulator yielded 68.8%. Based on the obtained data, an algorithm was developed for the clinical use of occlusal splints fabricated by different methods (using mechanical or virtual articulators) in patients with internal TMJ disorders.

CONCLUSIONS. Following the diagnosis confirmed by magnetic resonance imaging (MRI), axiography, and ultrasonography, patients were divided into two groups: (1) In Group I (patients with articular disc subluxation), myorelaxing splints were applied at the initial treatment stage and subsequently remodeled into separating (discluding) splints after disc repositioning to consolidate the therapeutic outcome; (2) In Group II (patients with chronic disc dislocation), distraction splints were used at the first stage with subsequent occlusal correction. After the normalization of mandibular movements and TMJ disc repositioning, the distraction splints were remodeled into separating splints to stabilize the new maxillomandibular relationship. The use of a virtual articulator demonstrated higher treatment effectiveness compared to the mechanical method, confirming its clinical relevance and potential integration into complex TMJ disorder management protocols.

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