Occlusal Appliance Therapy in Temporomandibular Disorder Pain Management: A Literature Review Occlusal Appliance Therapy
Regeneration, Reconstruction & Restoration (Triple R),
Vol. 9 (2024),
1 January 2024
https://doi.org/10.22037/rrr.v9.39707
Abstract
Background and objectives: The second common source of orofacial pain is temporomandibular disorder (TMD). Occlusal splints are prevalently applied to manage symptomatic TMD. This study aimed to discuss the types, characteristics, fabrication, and application of occlusal splints.
Materials and methods: A structured search was carried out, including PubMed and Scopus databases with additional integration from external sources to March 2020. To meet the inclusion criteria, studies published in English involving randomized clinical trials, review articles, and experimental studies, starting from the 215 identified records, 75 items were finally included for the review.
Results: The critical step in treatment of patient with pain, malfunction, and discomfort is to determine the primary etiology. The two most commonly used splints are stabilization and anterior positioning appliances. Other types include anterior or posterior bite plane, pivoting appliance, and soft or resilient appliance.
Conclusion: There are various splints in the literature; a dentist must select the appropriate one with predictive success based on the specific diagnosed TMD type.
- Bruxism, Facial pain, Occlusal splint, Temporomandibular joint disorders
How to Cite
References
2. Leeuw Rd, Klasser GD, American Academy of Orofacial P. Orofacial pain : guidelines for assessment, diagnosis, and management. chapter2. 5th ed2018.
3. Anderson GC, Schiffman EL, Schellhas K, Fricton J. Clinical vs. arthrographic diagnosis of TMJ internal derangement. Journal of Dental Research. 1989;68(5):826-9.
4. John M, Hirsch C, Reiber T. Häufigkeit, Bedeutung und Behandlungsbedarf kraniomandibulärer Dysfunktionen (CMD). Zeitschrift für Gesundheitswissenschaften= Journal of public health. 2001;9(2):136.
5. Schindler H, Hugger A, Kordaß B, Türp J. Splint therapy for temporomandibular disorders: basic principles Grundlagen der Schienentherapie bei Myoarthropathien des Kausystems. Zeitschrift Für Kraniomandibuläre Funktion. 2014;6(3):207-30.
6. Pizolato RA, Gavião MBD, Berretin-Felix G, Sampaio ACM, Trindade Junior AS. Maximal bite force in young adults with temporomandibular disorders and bruxism. Brazilian oral research. 2007;21(3):278-83.
7. Manfredini D, Winocur E, Guarda-Nardini L, Paesani D, Lobbezoo F. Epidemiology of bruxism in adults: a systematic review of the literature. J Orofac Pain. 2013;27(2):99-110.
8. Alkhiary YM, Nassef TM, Yassine IA, Tayel SB, Ezzat A. A new numerical model to analyze stress distribution of TMJ disc from 2-D MRI scans. Advances in Computing. 2012;2(05):66-77.
9. Macfarlane TV, Kenealy P, Kingdon HA, Mohlin BO, Pilley JR, Richmond S, et al. Twenty-year cohort study of health gain from orthodontic treatment: temporomandibular disorders. American Journal of Orthodontics and Dentofacial Orthopedics. 2009;135(6):692. e1-. e8.
10. Bitiniene D, Zamaliauskiene R, Kubilius R, Leketas M, Gailius T, Smirnovaite K. Quality of life in patients with temporomandibular disorders. A systematic review. Stomatologija. 2018;20(1):3-9.
11. Al‐Ani Z, Gray RJ, Davies SJ, Sloan P, Glenny AM. Stabilization splint therapy for the treatment of temporomandibular myofascial pain: a systematic review. Journal of dental education. 2005;69(11):1242-50.
12. Conti PC, de Alencar EN, da Mota Corrêa AS, Lauris JR, Porporatti AL, Costa YM. Behavioural changes and occlusal splints are effective in the management of masticatory myofascial pain: a short-term evaluation. J Oral Rehabil. 2012;39(10):754-60.
13. Kimmel SS. Temporomandibular disorders and occlusion: an appliance to treat occlusion generated symptoms of TMD in patients presenting with deficient anterior guidance. Cranio. 1994;12(4):234-40.
14. Dylina TJ. A common-sense approach to splint therapy. J Prosthet Dent. 2001;86(5):539-45.
15. Deshpande RG, Mhatre S. TMJ disorders and occlusal splint therapy–a review. International Journal of Dental Clinics. 2010;2(2).
16. McNeill C. History and evolution of TMD concepts. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 1997;83(1):51-60.
17. Capp N. Occlusion and splint therapy. British dental journal. 1999;186(5):217-22.
18. Berntsen C, Kleven M, Heian M, Hjortsjö C. Clinical comparison of conventional and additive manufactured stabilization splints. Acta Biomaterialia Odontologica Scandinavica. 2018;4(1):81-9.
19. Okeson JP. Management of temporomandibular disorders and occlusion-E-book: Elsevier Health Sciences; 2019.
20. Dawson PE. Functional occlusion-e-book: from TMJ to smile design: Elsevier Health Sciences; 2006.
21. Checherita L, Beldiman M-A, Stamatin O, Foia L, Forna N-C. Aspects on structure of materials used for different types of occlusal splints. Rev Chim(Bucharest). 2013;64:864-7.
22. Yadav S, Karani JT. The essentials of occlusal splint therapy. Int J Prosthet Dent. 2011;2(1):12-21.
23. Alqutaibi AY, Aboalrejal A. Types of occlusal splint in management of temporomandibular disorders (TMD). J Arthritis. 2015;4(176):2.
24. Longridge NN, Milosevic A. The bilaminar (dual-laminate) protective night guard. Dental Update. 2017;44(7):648-54.
25. Farrar W. Diagnosis and treatment of anterior dislocation of the articular disc. New York J Dent. 1971;41:348-51.
26. Chen HM, Liu MQ, Yap AUJ, Fu KY. Physiological effects of anterior repositioning splint on temporomandibular joint disc displacement: a quantitative analysis. Journal of Oral Rehabilitation. 2017;44(9):664-72.
27. Zamburlini I, Austin D. Long-term results of appliance therapies in anterior disk displacement with reduction: a review of the literature. CRANIO®. 1991;9(4):361-8.
28. Lundh H, Westesson P-L, Kopp S, Tillström B. Anterior repositioning splint in the treatment of temporomandibular joints with reciprocal clicking: comparison with a flat occlusal splint and an untreated control group. Oral Surgery, Oral Medicine, Oral Pathology. 1985;60(2):131-6.
29. Zarb G, Carlsson G, Sessle B, Mohl N. Temporomandibular joint and masticatory muscle disorders. American Journal of Orthodontics and Dentofacial Orthopedics. 1996;110(3):336-.
30. Kurita H, Kurashina K, Ohtsuka A, Kotani A. Change of position of the temporomandibular joint disk with insertion of a disk-repositioning appliance. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 1998;85(2):142-5.
31. Ma Z, Xie Q, Yang C, Zhang S, Shen Y, Abdelrehem A. Can anterior repositioning splint effectively treat temporomandibular joint disc displacement? Scientific Reports. 2019;9(1):1-8.
32. Klasser GD, Greene CS. Oral appliances in the management of temporomandibular disorders. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology. 2009;107(2):212-23.
33. Ito T, Gibbs CH, Marguelles-Bonnet R, Lupkiewicz SM, Young H, Lundeen HC, et al. Loading on the temporomandibular joints with five occlusal conditions. Journal of Prosthetic Dentistry. 1986;56(4):478-84.
34. Seedorf H, Scholz A, Kirsch I, Fenske C, Jüde H. Pivot appliances–is there a distractive effect on the temporomandibular joint? Journal of oral rehabilitation. 2007;34(1):34-40.
35. Stapelmann H, Türp JC. The NTI-tss device for the therapy of bruxism, temporomandibular disorders, and headache–Where do we stand? A qualitative systematic review of the literature. BMC oral health. 2008;8(1):22.
36. Lerman MD. The hydrostatic appliance: a new approach to treatment of the TMJ pain-dysfunction syndrome. The Journal of the American Dental Association. 1974;89(6):1343-50.
37. Lakshmi M, Kalekhan SM, Mehta R, Bhangdia M, Rathore K, Lalwani V. Occlusal splint therapy in temporomandibular joint disorders: an update review. Journal of International Oral Health. 2016;8(5):639.
38. Gray R, Davies S. Occlusal splints and temporomandibular disorders: why, when, how? Dental update. 2001;28(4):194-9.
39. Huettig F, Kustermann A, Kuscu E, Geis-Gerstorfer J, Spintzyk S. Polishability and wear resistance of splint material for oral appliances produced with conventional, subtractive, and additive manufacturing. Journal of the Mechanical Behavior of Biomedical Materials. 2017;75:175-9.
40. Kim JE, Kwon JH, Kim JH, Shim JS. Recording the trajectory of mouth opening and closing for the fabrication of an occlusal splint. J Prosthet Dent. 2017;117(5):597-600.
41. Väyrynen VO, Tanner J, Vallittu PK. The anisotropicity of the flexural properties of an occlusal device material processed by stereolithography. J Prosthet Dent. 2016;116(5):811-7.
42. Xu X, He L, Zhu B, Li J, Li J. Advances in polymeric materials for dental applications. Polymer Chemistry. 2017;8(5):807-23.
43. Prpic V, Slacanin I, Schauperl Z, Catic A, Dulcic N, Cimic S. A study of the flexural strength and surface hardness of different materials and technologies for occlusal device fabrication. The Journal of prosthetic dentistry. 2019;121(6):955-9.
44. Amin A, Meshramkar R, Lekha K. Comparative evaluation of clinical performance of different kind of occlusal splint in management of myofascial pain. The Journal of the Indian Prosthodontic Society. 2016;16(2):176.
45. Algabri RS, Alqutaibi AY, Keshk AM, Alsourori A, Swedan M, El Khadem AH, et al. Effect of hard versus soft occlusal splint on the management of myofascial pain: systematic review and metaanalysis. Indian J Sci Technol. 2017;10:10-6.
46. Graber T. An introduction to functional occlusion: Major M. Ash and Sigurd P. RamfjordPhiladelphia, 1982, WB Saunders Company. 240 pages, illustrated, index. American Journal of Orthodontics. 1985;87(1):83.
47. Hegab AF, Youssef AH, Abd Al Hameed HI, Karam KS. MRI-based determination of occlusal splint thickness for temporomandibular joint disk derangement: a randomized controlled clinical trial. Oral surgery, oral medicine, oral pathology and oral radiology. 2018;125(1):74-87.
48. Ramfjord S, ASH MM. Reflections on the Michigan occlusal splint. Journal of oral rehabilitation. 1994;21(5):491-500.
49. Dylina TJ. A common-sense approach to splint therapy. The Journal of prosthetic dentistry. 2001;86(5):539-45.
50. Clark GT. A critical evaluation of orthopedic interocclusal appliance therapy: design, theory, and overall effectiveness. Journal of the American Dental Association (1939). 1984;108(3):359-64.
51. Akbulut N, Altan A, Akbulut S, Atakan C. Evaluation of the 3 mm thickness splint therapy on Temporomandibular Joint Disorders (TMDs). Pain Research and Management. 2018;2018.
52. Widmalm SE. Use and abuse of bite splints. COMPENDIUM-NEWTOWN-. 1999;20:249-59.
53. Tanaka EE, Arita ES, Shibayama B. Occlusal stabilization appliance: evaluation of its efficacy in the treatment of temporomandibular disorders. Journal of Applied Oral Science. 2004;12(3):238-43.
54. Kuzmanovic Pficer J, Dodic S, Lazic V, Trajkovic G, Milic N, Milicic B. Occlusal stabilization splint for patients with temporomandibular disorders: Meta-analysis of short and long term effects. PloS one. 2017;12(2):e0171296.
55. Simmons III HC, Gibbs SJ. Recapture of temporomandibular joint disks using anterior repositioning appliances: an MRI study. CRANIO®. 1995;13(4):227-37.
56. Ramachandran A, Jose R, Tunkiwala A, Varma R B, M. Shanmugham A, Nair PK, et al. Effect of deprogramming splint and occlusal equilibration on condylar position of TMD patients–A CBCT assessment. CRANIO®. 2019:1-9.
57. Venezia P, Muzio LL, De Furia C, Torsello F. Digital manufacturing of occlusal splint: From intraoral scanning to 3D printing. Journal of Osseointegration. 2019;11(4).
58. Benli M, Gümüş BE, Kahraman Y, Gökçen-Rohlig B, Evlioğlu G, Huck O, et al. Surface roughness and wear behavior of occlusal splint materials made of contemporary and high-performance polymers. Odontology. 2020;108(2):240-50.
59. Yildiz Domanic K, Aslan YU, Ozkan Y. Two-body wear of occlusal splint materials against different antagonists. BMC Oral Health. 2020;20(1):174.
60. Alp G, Murat S, Yilmaz B. Comparison of Flexural Strength of Different CAD/CAM PMMA‐Based Polymers. Journal of Prosthodontics. 2019;28(2):e491-e5.
61. Reyes‐Sevilla M, Kuijs R, Werner A, Kleverlaan C, Lobbezoo F. Comparison of wear between occlusal splint materials and resin composite materials. Journal of oral rehabilitation. 2018;45(7):539-44.
62. Buduru S, Talmaceanu D, Baru O, Buduru R, Szuhanek C, Mesaros A. CAD-CAM Occlusal Splints: Milling and Printing Methods. REVISTA DE CHIMIE. 2018;69(12):3461-3.
63. Al‐Dwairi ZN, Tahboub KY, Baba NZ, Goodacre CJ. A comparison of the flexural and impact strengths and flexural modulus of CAD/CAM and conventional heat‐cured polymethyl methacrylate (PMMA). Journal of Prosthodontics. 2020;29(4):341-9.
64. Dedema P, Türpb J. Digital Michigan splint–from intraoral scanning to plasterless manufacturing Die digitale Michigan-Schiene–Vom intraoralen Scan zur gipsfreien Herstellung. International journal of computerized dentistry. 2016;19(1):63-76.
65. Krohn S, Hampe T, Brack F, Wassmann T, Bürgers R. Intraoral sensor-based monitoring of stabilization splint therapy in patients with myofascial pain. International Journal of Computerized Dentistry. 2020;23(1):11-6.
66. Noguchi T, Kashiwagi K, Fukuda K. The effectiveness of stabilization appliance therapy among patients with myalgia. Clinical and Experimental Dental Research. 2020;6(2):244-53.
67. Jiang X, Fan S, Cai B, Fang ZY, Xu LL, Liu LK. [Mandibular manipulation technique followed by exercise therapy and occlusal splint for treatment of acute anterior TMJ disk displacement without reduction]. Shanghai Kou Qiang Yi Xue. 2016;25(5):570-3.
68. Hasegawa Y, Kakimoto N, Tomita S, Fujiwara M, Ishikura R, Kishimoto H, et al. Clinical study of splint therapeutic efficacy for the relief of temporomandibular joint discomfort. Journal of Cranio-Maxillofacial Surgery. 2017;45(11):1772-7.
69. Muhtarogullari M, Avci M, Yuzugullu B. Efficiency of pivot splints as jaw exercise apparatus in combination with stabilization splints in anterior disc displacement without reduction: a retrospective study. Head & face medicine. 2014;10(1):1-5.
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