Effect of occlusal appliances and clenching on the internally deranged TMJ space.
OBJECTIVE
Stabilization appliances and mandibular anterior repositioning appliances have been used to treat patients with internal derangement of the temporomandibular joint (TMJ) based on the assumption that these appliances work by decompressing the TMJ. The purpose of this study was to indirectly test this assumption.


METHODS
Bilateral TMJ tomograms of 7 subjects with unilateral anterior disc displacement without reduction (ADDwor) were taken during comfortable closure and during maximum clenching in maximum intercuspation; tomograms were also taken with the 2 types of occlusal appliances in use. Outlines of the condyle and the temporal fossa were automatically determined by an edge-detection protocol, and the minimum joint space dimension of the joints with and without ADDwor was automatically measured for each experimental condition as the outcome variable.


RESULTS
Upon comfortable closure and maximum clenching, the minimum joint space dimensions of the ipsilateral and contralateral joints with the use of stabilization appliances and mandibular anterior repositioning appliances were not significantly different from those seen in maximum intercuspation.


CONCLUSIONS
These findings do not indicate that these appliances induce an increase in joint space during closing and clenching in joints with ADDwor.
Kuboki
T
T
Department of Fixed Prosthodontics, Okayama University Dental School, Japan. kuboki@dent.okayama-u.ac.jp
Takenami
Y
Y
Orsini
M G
MG
Maekawa
K
K
Yamashita
A
A
Azuma
Y
Y
Clark
G T
GT
D000328:Adult; D000704:Analysis of Variance; D001732:Bite Force; D005260:Female; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D009119:Muscle Contraction; D020247:Myofunctional Therapy; D017090:Occlusal Splints; D017063:Outcome Assessment, Health Care; D011856:Radiographic Image Enhancement; D013704:Temporomandibular Joint / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D019224:Temporomandibular Joint Disc / Q000000981:diagnostic imaging / Q000473:pathology*; D013705:Temporomandibular Joint Disorders / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D014056:Tomography, X-Ray