Study On The Bone Remodeling Efficacy Of Stabilization Splint For The Treament Of Juvenile Condylar Resorption

Objective:TMD is one of the most common non-infectious diseases in stomatology,and the incidence is the fourth category of oral diseases.Nowadays,More and more people with condylar resorption have abnormal facial and occlusal problems,which has become a major problem for orthodontists.Due to the complexity of TMJ,the evaluation of efficacy is limited to the relief of subjective symptoms in patients.To study therapeutic effects of different types of juvenile condylar resorption patients from cone-beam CT(CBCT)imaging changes after stabilization splint treatment,analyzing the clinical efficacy of condylar resorption at different types,providing reference for clinical treatment measures.Methods:Fifty-nine(114 sides of condylar)juvenile condylar resorption patients from Jan,2012 to May,2018 in Department of Temporomandibular Joint,Stomatological Hospital of Chongqing Medical University were selected to receive the treatment of stabilization splint as splint group while twenty-four patients(48 sides of condylar)who underwent natural remodeling after 6-12 months of treatment without stabilization splint were as control group.Pre-treatment CBCT should be taken of each patient,which could be generally divided into three types,such as typeⅠ,typeⅡand typeⅢ.After treatment,there were four types comparing with three types before treatment,including progression,no changes,stable without new bone and remodeled with new bone.Among them,progression and no change were considered as poor curative effect,stable without new bone and remodeled with new bone types were considered to be effective.Besides,the proportion of progress should also be listed.At the same time,the vertical distance of the condylar height should be measured as well as compared before and after treatment in the two groups.Results:The effect of typeⅠand typeⅡwas statistically significant between the two groups(Z=―2.874,P=0.004;Z=―3.874,P=0.000),splint group was always better than the control group.There was no significant difference in the efficacy of typeⅢbetween the two groups(Z=―0.617,P=0.537).Condylar progression percentage(splint group:43%,control group:80%)was statistically significant between the two groups in typeⅡ(Х~2=7.139,P=0.011),splint group was remarkable smaller than control group,while there was no statistically significant in typesⅠas well as typeⅢbetween two groups(Х~2=0.103,P=0.748;Х~2=1.249,P=0.540).Contrasting with before treatment,the height of the condyle in both two groups showed a downward trend.In two groups,the condylar height difference before and after treatment of typeⅡcondylar resorption was statistically significant(P<0.05).Whereas,no matter what type the condylar resorption was,there always had no significant difference in condylar height changes between two groups(P>0.05).Conclusions:There are significant effects of different types of juvenile condylar resorption patients after stabilization splint treatment,especially in typeⅠ.Juvenile condylar resorption patients should be adopted conservative treatment-stabilization splint,to gradually remodel the condylar bone earlier.However,it is difficult to reverse the height reduction of the condylar bone regardless of treatment.