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Treatment of Temporo-Mandibular Disorder/TMD

Occlusal Appliance

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Occlusal Appliance

Occlusal appliance for temporomandibular disorder (TMD) treatment is a removable intra-oral appliance, usually fabricated of hard acrylic, designed to cover the occlusal surfaces of the teeth in the upper or lower jaw. The goals for occusal splint treatment are:

    
1. Create stable occlusion to relieve muscle and nerve tension and pain
    
2. Relocate the TMJ back to an orthopedically stable position
    
3. Protect the teeth from cracking or wearing

Early studies reported that the successful rate of occlusal appliance for treating myofascial pain (extra-articular muscle pain) reached 70-90% (Clark GT, 1983; Alencar F Jr., 2009). Clinical evidence showed that occlusal appliance is a reversible and non-invasive treatment choice for treating early stage or chronic TMD. However latest studies revealed that occlusal appliance could not effectively treat TMJ internal derangement (e.g. articular disc dislocation, intra-articular pain).
 

Stabilization appliance is the most common used type of occlusal appliance, which aims to improve signs of myofascial pain disorder (Wahlund K, 2003; Ekberg E, 2004), reduce parafuctions (e.g. bruxism or clenching) and post-traumatic arthritis.
 

Apart from improving myofascial pain disorder, various grounds stand for the therapeutic principles of occlusal appliance to relieve other signs of TMD. It was generally agreed that occlusal appliance reduces muscle movement, which leads to a decrease of TMJ forces (Sheikholeslam A, 1986; Clark GT, 1981). Occlusal appliance plays an important role in treating early stage of TMD and serves as an effective initial therapeutic and diagnostic tool before seeking for other treatment choices.