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The Clinical Therapeutic Effect of Treating Anterior Disc Displacement with Reduction by Repositioning Splint

Author: ChenBin
Tutor: JiPing
School: Shandong University
Course: Clinical Stomatology
Keywords: Temporomandibular disorders(TMD) anterior disc displacement with reduction(ADDR) VAS repositioning splint EMG
CLC: R782.6
Type: Master's thesis
Year: 2010
Downloads: 66
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Abstract


Objective:Patients of anterior disc displacement with reduction were chosen and treated by repositioning splint. Before and after treatment, the changes of maxillofacial muscle functional parameters were analyzed with EMG, and the effect of repositioning splint was investigated by the clinical examination and EMG of these patients.Methods:According to the clinical indication and x-ray of anterior disc displacement with reduction,4 cases were chosen from the patients (chief complaints were pain in maxillofacial region, joints clicks, and mouth-opening type abnormality). They were guided to do mandibular movement, in order to find out the remedial jaw position at which the joints clicks disappeared and the mandibular moved forward minimally. The patients were asked to practice more and be familiar with the remedial jaw position. They were appointed after one week and treated by repositioning splint, and the changes of VAS, joints clicks and mouth-opening type were observed, and the EMG activities of the maxillofacial muscle was recorded before and after the treatment, in order to discuss the clinical therapeutic effect of repositioning splint.Results:1. VASThe VAS value of all the 4 cases decreased significantly after the treatment (P＜0.05).2. joints clicksAfter the treatment, only 1 patient’s joints clicks appeared again,while other 3 didn’t.3. mouth-opening degree and typeAfter the treatment, mouth-opening type of all the 4 cases changed, while mouth-opening degree didn’t change significantly(P＞0.05).4. EMG(1)After the treatment of repositioning splint, at MPP, the electrical activity of bilateral TA didn’t change significantly(P＞0.05); the electrical activity of bilateral MM reduced significantly(P＜0.05); at remedial jaw position, the electrical activity of bilateral TA reduced significantly(P＜0.05); the electrical activity of bilateral MM increased significantly(P＜0.05).(2)After the treatment of repositioning splint, at remedial jaw position, the symmetry of TA and MM both increased significantly(P＜0.05).5. X-rayAfter the treatment of repositioning splint, the Schuller x-ray showed that the condylar process of 2 cases had returned to normal position, while the anterior space of the other 2 cases were larger than posterior space. However, the joints clicks of all the 4 patients disappeared and the movement of condylar process recovered.Conclusions:1. The repositioning splint was effective in treating patients of anterior disc displacement with reduction. After the treatment, the structure of disc and condylar process was adjusted, and clinical symptoms improved, especially, joints clicks disappeared. Moreover, the functional movement of mandibular was coordinated, which will help to prevent the development of temporomandibular disorders.2. After the treatment of repositioning splint, the EMG results showed that the EMG activities of the maxillofacial muscle of the patients improved partly. However, more investigation may be done after the occlusal reconstruction.

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CLC: > Medicine, health > Oral Sciences > Oral and maxillofacial surgery > Temporomandibular joint disorders
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