学会報告

Clinical effect of three types of occlusal applinaces for the treatment of temporomandiublar disorders
　　　　　　Hiroshi KURITA, Akiko OHTSUKA, Kenji KURASHINA

　The purpose of this retrospective study was to evaluate the clinical effect of three types of occlusal appliance for specific temporomandibular disorders (TMD) and their symptoms/signs. The appliances used are a maxillary full-coverage stabilization type, a mandibular full-coverage disk repositioning type, and a pivot type appliance. The results are as follows:

Stabilization type: The total remission rate of 41% was achieved with the use of stabilization splint alone. And including those reporting some improvement the rate was 84%. The presence of displaced disk significantly decreased the success rate. On the other hand, the presence or not of radiographic changes in TMJ did not influence the treatment outcome.

Disk repositioning appliance: It was showed that about 70% of reducibly displaced disks that showed reciprocal clicking at both middle to late opening and late closing (near maximum cuspation) of the mandible with or without mandibular manipulation were captured with use of disk repositioning appliance. It was also suggested that joints with reducibly displaced disk could be expected to have successful disk recapture with the insertion of the appliance. In joints with non-reducibly displaced disk, presence of inflammatory conditions, changed disk morphology, and extensive disk displacement in medial part of the joint are negative factors.

Pivot appliance: It was suggest that the twelve week-use of pivot appliance is effective in managing limited mouth opening without joint pain. It was also suggest that pivot appliance is less effective in the advanced stages of internal derangement where radiographic changes of condylar bone is observed.