Oral appliances in the management of temporomandibular disorders.
Various types of oral appliances (OAs) have been used for over half a century to treat temporomandibular disorders (TMDs), but there has been considerable debate about how OAs should be designed, how they should be used, and what they actually do therapeutically. However, there is enough information in the scientific literature at this time to reach some evidence-based conclusions about these issues. The main focus of this review is on the materials and designs of various OAs in terms of their proposed mechanisms of action and their claimed clinical objectives. Based on current scientific evidence, an analysis is presented regarding the role that OAs can or cannot play in the management of TMDs. Finally, the concept that OAs may be an effective treatment modality for some TMDs owing to their potential for acting as an elaborate placebo rather than any specific therapeutic mechanism is considered.
Klasser
Gary D
GD
Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, University of Illinois at Chicago, 801 South Paulina Street, Chicago, IL 60612-7213, USA. gklasser@uic.edu
Greene
Charles S
CS
D001676:Biofeedback, Psychology; D006801:Humans; D008310:Malocclusion / Q000628:therapy; D019186:Mandibular Advancement / Q000295:instrumentation; D020247:Myofunctional Therapy / Q000295:instrumentation; D017090:Occlusal Splints; D016382:Orthodontic Appliance Design; D015990:Placebo Effect; D020186:Sleep Bruxism / Q000628:therapy; D013705:Temporomandibular Joint Disorders / Q000628:therapy*; D018781:Tension-Type Headache / Q000628:therapy; D014716:Vertical Dimension