MRI-based determination of occlusal splint thickness for temporomandibular joint disk derangement: a randomized controlled clinical trial

Publication date: Available online 12 October 2017
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Ayman F. Hegab, Ahmed Hossni Youssef, Hossam I. Abd Al hameed, Khaled Said Karam
Objective: This prospective study examined a method using magnetic resonance imaging (MRI) to assess the appropriate effective occlusal splint vertical thickness in management of disk derangement. Study Design: Patients were diagnosed as having internal disk displacement of the TMJ and were divided into two groups. Group I (Disk Displacement with Reduction-DDR): This group was subdivided randomly into 2 subgroups. Subgroup IA (control group): patients treated using 3-mm-thick splints. Subgroup IB (study group): patients treated using MRI-based splint thickness. Group II (Disk Displacement without Reduction-DDNR): This group was subdivided randomly into 2 subgroups. Subgroup IIA (control group): patients treated using 3-mm-thick splints. Subgroup IIB (study group): patients treated using MRI-based splint thickness. The primary outcome variables were maximum voluntary mouth opening (MVMO) and visual analogue scale (VAS) for pain. The secondary outcome variable was joint sounds. The final sample was composed of 162 subjects (Group I = 90 and Group II = 72). Results: Statistical analysis showed significant improvement of the clinical outcomes in subgroups IB and IIB as compared to that in subgroups IA and IIA. Conclusion: On the basis of MRI measurements and clinical outcome, the current study recommended 4 mm and 6mm vertical splint thickness for DDR and DDNR respectively for 1 year.



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