Effect of Flat Plane Splint Vertical Thickness on Disc Displacement without Reduction—A Retrospective Matched Cohort Study

Publication date: Available online 5 January 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Shang-Lun Lin, Shang-Liang Wu, Shun-Yao Ko, Ching-Yu Yen, Jung-Wu Yang
PurposeThe efficacy of occlusal splints for treating temporomandibular disorders (TMDs) remains controversial. This study aimed to evaluate and compare the effectiveness of flat plane splints (FPSs) with a vertical thickness of 3 mm (VT3) and 5 mm (VT5) in treating disc displacement without reduction (DDWOR).MethodsThis retrospective matched cohort study selected the study subjects from 400 TMD patients treated in the Department of Oral and Maxillofacial Surgery of Tainan Sin-Lau Hospital between August 2013 and July 2015. The thickness of occlusal splints was the predictor variable. The outcome variables included joint crepitus sound, deviation of the mandible during opening (DoM), TMD-associated headache, myofascial pain with referral, temporomandibular joint (TMJ) arthralgia, and maximum assisted opening (MAO). The case and control groups were matched with (1:1) by propensity scoring to ensure that there were no statistical differences in the categorical variables and continuous variables. The analysis used χ2 tests, t tests, and multiple regression analyses.ResultsOne-hundred-sixty-two patients were allocated into two groups: the VT3 group and the VT5 group, with 81 patients each. Both VT3 FPSs and VT5 FPSs effectively improved the DDWOR. At 12 months post-treatment (post-Tx), the VT5 group demonstrated remarkable improvement in joint crepitus sound and TMJ arthralgia compared with the VT3 group. No statistical differences in other TMJ-associated symptoms such as DoM, TMD-associated headache, and myofascial pain with referral were observed between the two groups.ConclusionsBoth VT3 and VT5 FPSs can effectively improve various clinical symptoms of DDWOR. The authors suggested that VT5 FPS treatment for at least one year is a suitable option to DDWOR patients with joint crepitus sound and TMJ arthralgia. For DDWOR patients without joint crepitus sound and TMJ arthralgia, there are no differences between the VT3 and VT5 FPSs.



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