| Temporomandibular disorders (TMD) is a familiair and multiple disease of the stomatognathic system. It happens easily to young people, and the incidence is increasing gradually. TMD is characterized by a pain, mandibular movement limited and temporomandibular joint's (TMJ) soufflés. Moreover the pain that becomes aggravated with jaw movement and function happens easily. Since Prentiss reported that occlusal factor could result in TMD in 1918, a great deal of animal experiments and clinical trials had showed that occlusal factor played an important role in TMD. In fact, articulation is affinity with TMJ and masticatory muscles in the same function system, relating and influencing each other. No matter at rest or functional movement, they should be retained harmonizing each other in order to maintain physiological balance of the body. However, if occlusal interferences destroy this balance, preponderating over the compensation capability of the body, it may cause TMD. Although there is no evidence to testify the direct consequence between TMD and occlusal factor as yet, the most studies have reported the high rate of clinical success achieved with splints. Occlusal splint was used primely to fix the injured jaw and loosened teeth in order to decrease the looseness and disperse occlusal force. It was known gradually in applying that occlusal splint may improve the function of masticatory muscles as well as adjust the function and the structure of TMJ indirectly by adjusting reflexly the proprioceptor of periodontal membrane. Occlusal splints in treatment of TMD include stabilization splint, respositioning splint, pivot splint and soft vinyl splint ect by the connection of occlusal contact. The etiology of TMD has been considerd to be multifactorial. Because of the difficulty in determining the etiology and the possibility that the symptoms are secondary to some other disorder of the TMJ or the masticatory muscles , the initial treatment should be reversible. Several types of occlusal splints are used in the treatment of TMD. However, only stabilization splint is consideredto be conveniencest, conservativest, safest, no-hurt, reversible and the simplest in design, and used at best now. Stabilization splint can eliminate occlusal interferences with the smooth occlusal plane, and restore the physiological position of condyle as well as the natural relation between condyle, intercondylar disk, glenoid fossa, and articular tubercle. Simultaneitily, decrease abnormal activity of the masticatory muscles, and restore the physiological balance between masticatory muscles, TMJ and jaw position by increasing interarch distance. In addition, along with increasing interarch distance, condyle displaces adown, articular clearance increases and articular internalstress reduces. Some studies also stressed the psychological effects of the splint therapy. The numerous studies reported that stabilization splint had an active therapeutic value in the treatment of TMD. Several studies found no difference in curative effect between the stabilization splint and the control group. But Hulley et al showed in their retrospective studies that most of these reports did not follow many of the procedures that are now considered to beessential in clinical trials, such as: the inclusion of a control group, randomization, use of reliable outcome variables and measuring methods. This study evaluated the short-term really therapeutic efficacy of a stabilization splint using a randomizied, controlled and an objective criteria of Fricton's Craniomandibular Index(CMI) designed. Although the patients in this study were examined by the clinician who treated them, Fricton Index and VAS score is an unitive, objective and quantificational criterion of examining .Fu et al studies showed that Fricton Index of the same patient was alike by different clinicians. These suggest that the fluence which the patients examined and treated by the same clinician was not of major significance in this study. According to the inclusive and exclusive criteria , thirty-six patients of TMD were assigned to two equally sized groups: a treatment group given a stabilization splint for night using and a control group without a splint. After ten weeks, the intensity of chewing 9-min pain measured on a VAS, muscle and joint tenderness, CMI decreased statistically significantly between groups. There was improvement in active mouth opening,... |
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