Anterior repositioning appliance therapy for TMJ disorders: specific symptoms relieved and relationship to disk status on MRI.
Forty-eight consecutive patients seeking treatment in a referral based practice for complex chronic painful temporomandibular joint (TMJ) disease were enrolled in a prospective study to assess specific symptom relief from anterior repositioning appliance (ARA) therapy and the relationship between specific symptom relief and the status of the TMJ disk. Each patient was assessed on 86 symptoms based upon whether each symptom was present before treatment and absent, better, unchanged or worse after Maximum Medical Improvement (MMI). The most common symptom was occipital cephalalgia (94%). The least common symptom was pain and burning of tongue (8%). A profile ofa temporomandibular disorder (TMD) patient was developed. The typical TMD patient has cephalalgia, mainly in the occipital, temporal and frontal region, pain upon chewing food, pain upon opening and closing the mouth, TMJ pain, pain in the back of the neck and difficulty chewing food. Before treatment, patients with bilateral displaced disks had more symptoms than those with unilateral displaced disks and the opposite side normal. After MMI the maximum benefit (percent of pretreatment symptoms relieved) was found in patients with normal or recaptured disks. The minimum occurred in patients whose disks did not recapture with therapy. ARA therapy improved or eliminated symptoms in all patients in the study.
Simmons
H Clifton
HC
Department of Dentistry, Vanderbilt University School of Medicine, USA.
Gibbs
S Julian
SJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D002508:Cephalometry; D005157:Facial Pain / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D005926:Glossalgia / Q000628:therapy; D006261:Headache / Q000628:therapy; D006801:Humans; D004204:Joint Dislocations / Q000628:therapy; D008279:Magnetic Resonance Imaging; D008297:Male; D008335:Mandibular Condyle / Q000473:pathology; D008409:Mastication / Q000502:physiology; D008875:Middle Aged; D017090:Occlusal Splints; D016382:Orthodontic Appliance Design; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology; D019224:Temporomandibular Joint Disc / Q000473:pathology*; D013705:Temporomandibular Joint Disorders / Q000473:pathology / Q000628:therapy*; D016896:Treatment Outcome; D055815:Young Adult