Three dimensional evaluation of the skeletal and temporomandibular joint changes following stabilization splint therapy in patients with temporomandibular joint disorders and mandibular deviation: a retrospective study

BMC Oral Health

Research

Majedh Abdo Ali Al-Somairi¹  Ning Li²  Abeer A. Almashraqi³  Najah Alhashimi³  Xi Chen⁴  Mazen Musa⁵  Madiha Mohammed Saleh Ahmed⁶  Danli Shi⁷  Maged S. Alhammadi⁸ 

[1] Department of Orthodontics, School of Stomatology, China Medical University (PRC), 110122, Shenyang, Liaoning, People’s Republic of China;Department of Orthodontics, Yantai Stomatological Hospital Affiliated to Binzhou Medical College, 264000, Yantai, People’s Republic of China;Department of Pre-Clinical Oral Health Sciences, College of Dental Medicine, QU Health, Qatar University, Doha, Qatar;Department of Stomatology, The First Affiliated Hospital of Xi’an Jiaotong University, 710061, Xi’an, Shaanxi, People’s Republic of China;Department of Stomatology, The First Affiliated Hospital of Xi’an Jiaotong University, 710061, Xi’an, Shaanxi, People’s Republic of China;Department of Orthodontics, Al Tegana Dental Teaching Hospital, University of Science and Technology, 11111, Omdurman, Khartoum, Sudan;Department of Stomatology, The First Affiliated Hospital of Xi’an Jiaotong University, 710061, Xi’an, Shaanxi, People’s Republic of China;Department of Orthodontics, Faculty of Dentistry, Aden University, Aden, Republic of Yemen;Department of Stomatology, The First Affiliated Hospital of Xi’an Jiaotong University, 710061, Xi’an, Shaanxi, People’s Republic of China;Department of Stomatology, The First Hospital of Ningbo, 315000, Ningbo, Zhejiang, People’s Republic of China;Division of Orthodontics and Dentofacial Orthopedics, Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia;Postgraduate Orthodontic Program, Department of Orthodontics, Pedodontics and Preventive Dentistry, Faculty of Dentistry, Sana’a University, Sana’a, Republic of Yemen;

关键词: CBCT;    Mandibular deviation;    Stabilization splint;    Temporomandibular disorders;    Three-dimensional analysis;   

DOI  :  10.1186/s12903-023-02720-w

 received in 2022-03-29, accepted in 2023-01-05,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThree-dimensional (3D) detailed evaluations of the mandibular mediolateral position, mandibular condylar position, and temporomandibular joint (TMJ) spaces following stabilization splints (SS) therapy in patients with temporomandibular joint disorders (TMD) and mandibular deviation (MD) have not been reported in the available literature. Accordingly, this study aimed to three-dimensionally analyze the skeletal and bony temporomandibular joint changes following stabilization splint therapy in adult patients with temporomandibular joint disorders and mandibular deviation.MethodsThis study is a retrospective clinical study that enrolled 26 adult patients with TMD and MD with a mean age of 24.86 years. The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) was used to diagnose TMD. SS was adjusted weekly until occlusal contact stabilization occurred, and then adjusted monthly, patients were instructed to wear it at night for at least 10 h. The SS was removed after the elimination of TMD symptoms (TMJ/muscle pain on palpation, muscle spasm, and clicking) and having both condyles completely seated in a musculoskeletally stable position. Pre- and post-therapeutic Cone Beam Computed Tomography (CBCT) was analyzed. Mandibular mediolateral position, TMJ spaces, and mandibular condyle position were analyzed three-dimensionally using Mimics 21.0 software. Paired t-test or Wilcoxon rank-sum test was performed, and the significance level was considered at P < 0.05.ResultsThe treatment period with SS therapy was 10.07 ± 3.1 months. The deviated chin was improved in 69.23% of the sample; the range of improvement was > 0 mm ≤ 3.9 mm. The mandibular rotation was significantly decreased from 3.58 ± 2.02° to 3.17 ± 1.60. The deviated side’s superior and posterior joint TMJ spaces were significantly increased from 2.49 ± 0.88 mm and 1.25 ± 0.79 mm to 2.98 ± 1.02 mm and 1.86 ± 0.72 mm, respectively. The value of the difference from the bilateral condyle head position to the X and Z axes significantly decreased from 2.50 ± 1.56 mm and 2.30 ± 1.57 mm to 1.64 ± 1.58 mm and 1.82 ± 1.11 mm, respectively.ConclusionThe main positional effect of the stabilization splint treatment in TMD patients with MD includes considerable correction of mandibular deviation, improving facial asymmetry, and moving the condyle into a stable condylar position; these were done by promoting the mandible to rotate around the Z (roll) and Y (yaw) axes and by forward, downward, and outward condylar movement on the deviated side, respectively.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

41116_2022_35_Article_IEq304.gif

Fig. 3