Home > General > Fixed Ortho an alterative to Anterior Repositioning Appliances in TMD?

Fixed Ortho an alterative to Anterior Repositioning Appliances in TMD?

This somewhat surprising conclusion comes from a recent study published in Cranio (The Journal of Craniomandibular Practice) – here: http://tiny.cc/NzyA2

“The use of a fixed orthodontic appliance seems to be as efficacious as the use of an AR maxillary splint in the treatment of joint pain and muscle pain, but not in the treatment of joint noise.”

It’s interesting to speculate why there isn’t a direct link between the pain from a joint and the noises it makes, but I suspect this is something many of us have already noticed. It’s the reason why we don’t treat noises alone of course. The concept of using a fixed appliance in place of an ARA is definitely food for thought and worthy of further study.

Fixed Orthodontic Therapy in Temporomandibular Disorder (TMD) Treatment: An Alternative to Intraoral Splint
Simona Tecco D.D.S., Ph.D.; Stefano Teté, D.D.S.; Vito Crincoli, D.M.D.;Mario Armando Festa, M.A.; Felice Festa, M.D., D.D.S., M.S., Ph.D.
Volume 28 Issue 1 January 2010
Abstract:
This study evaluated the use of a fixed orthodontic appliance in treatment of temporomandibular disorder (TMD) compared to the use of an intra-oral splint. Fifty (50) adult patients, with confirmed anterior disk displacement with reduction in at least one temporomandibular joint (TMJ), were divided into three groups: 20 patients treated with AR splint (Group I); 20 patients treated with a fixed orthodontic appliance (Group II) and 10 patients who underwent no treatment (Control Group). Joint pain, joint noise, muscle pain, and subjective relief were evaluated monthly before the treatment began (T0) and for six months thereafter. Subjects in Group I and Group II displayed a significant decrease in joint pain (p<0.01) from T2 and in muscle pain from T1 (p<0.01)  to T6. Subjects in Group I showed a higher decrease in the frequency of joint noise (p<0.05) from T1  to T6, compared with Group II. At T2 and T3, the patients in Group II reported a significantly lower discomfort level associated with the devices than subjects treated with the AR splint (p<0.05). However, at T5 and T6, this observation was inverted.  The use of a fixed orthodontic appliance seems to be as efficacious as the use of an AR maxillary splint in the treatment of joint pain and muscle pain, but not in the treatment of joint noise. These results are valid, at least for the short-term clinical results (first six months of treatment). Clinical implications for  long-term use are not clarified by these results.

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