Development And Clinical Application Of A Modified Repositioning Splint In ADDWR

Objective: To design a modified anterior repositioning splint based on the theory of repositioning disc,and evaluate its clinical effect in the treatment of anterior disc displacement with reduction(ADDWR).Methods: A randomized controlled,2-year clinical trial with parallel groups was conducted.In accordance with the random number table,120 cases,who had unilateral ADDWR,excluding local infections,rheumatoid arthritis and having treatment before,were divided into splint group(n = 60)and control group(n = 60).Patients in the splint group were treated with modified anterior repositioning splints for 24 hours per day for2 months,whereas those control patients received no treatment,following up for 6months.Clicking of joints,pain,abnormal mandibular movements and disc displacement were recorded and analyzed before and after treatment.Results: There’s no statistical difference(P>0.05)of gender,age and the course of ADDWR between splint group and control group.Using Student t test were compared between the two groups before treatment,stratified and chi square test were compared between the two groups in the joints at different time points in the ring,pain and jaw movement and MRI disc displacement,the results for multiple comparison sample chi square segmentation method based on the rate of.All the subjects were successfully completed the study.There were no significant differences in gender,age,medical history and symptoms before treatment between the two groups(P>0.05).Before treatment,disc displacement(60/60 vs 60/60),clicking of joints(60/60 vs 60/60),pain(15/60 vs 13/60),abnormal mandibular movements(13/60 vs 9/60)showed no significant difference between splint group and control group.Two months later,the significant difference was shown in disc displacement(4/60 vs 58/60,P <0.05),clicking of joints(6/60 vs 60/60,P <0.05),and no significant difference in pain(2/60 vs 6/60,P>0.05)and abnormal mandibular movements(3/60 vs 6/60,P>0.05).Splint group compared to control group after six months following up,disc displacement(3/56 vs53/54,P <0.05),clicking of joints(3/56 vs 53/54,P <0.05),pain(3/56 vs 7/54,P>0.05),abnormal mandibular movements(3/56 vs 7/54,P>0.05).Conclusions: The evidence supporting the use of modified anterior repositioning splint in the treatment of temporomandibular disorders(TMD)is effective,fast and stable.