A 36-YEAR-OLD FEMALE PATIENT TREATED WITH AN OCCLUSAL SPLINT: A CASE REPORT

  • Frosina Volcheski specialist ortodont
  • Jasna Petrovska
  • Elena Aleksova Noveska
  • Valdeta Osmani
Keywords: temporomandibular joint (TMJ), temporomandibular disorders (TMD), stabilization splint therapy, orthodontics

Abstract


This article describes a case of a 36-year-old female patient who sought help due to long-lasting pain in the temporomandibular joint (TMJ) region. Clinical examination revealed pain on the left side in the region of TMJ, and pain on opening, chewing, and palpation. Also, deviation to the right, and clicking on opening were present. A painful sensation on the left masseter muscle was detected on palpation. The diagnosis was established according to the functional analysis, clinical examination, and obtained anamnestic data. The decision was stabilizing occlusal splint to be administered in combination with exercises, physiotherapy, and symptoms-relieving analgesic treatment if needed.

This protocol aimed to alleviate the painful symptomatology and enable relaxation of the muscles of mastication to some degree, before orthodontic treatment. This would obtain a solid basis for stable orthodontic treatment outcomes.

Based on the case of the presented patient, it can be concluded that temporomandibular joint disorders (TMJD) can be treated with occlusal splint therapy in combination with exercises and physiotherapy.

References

Aqualizer. 2021. Aqualizer for Dentists and Orthodontists. [online] Available at: URL: https://aqualizer.com/where-to-buy/dentists-and-orthodontists/ [Accessed 24 July 2021].

Buchbender M, Keplinger L, Kesting MR, Adler W, Schmitt CM. A clinical trial: Aqualizer ™ therapy and its effects on myopathies or temporomandibular dysfunctions. Part I: Objective parameters. Cranio 2021; 16: 1-9. [CrossRef] [PubMed]

Buchbender M, Keplinger L, Kesting MR, Adler W, Schmitt CM. A clinical trial: Aqualizer ™ therapy and its effects on myopathies or temporomandibular dysfunctions. Part II: Subjective parameters. Cranio 2021; 13: 1-7. [CrossRef] [PubMed]

Conti AC, Oltramari PV, Navarro Rde L, de Almeida MR. Examination of temporomandibular disorders in the orthodontic patient: a clinical guide. J Appl Oral Sci. 2007; 15(1): 77-82. [CrossRef] [PubMed]

Fernández-González FJ, Cañigral A, López-Caballo JL, Brizuela A, Moreno-Hay I, Del Río-Highsmith J, Vega JA. Influence of orthodontic treatment on temporomandibular disorders. A systematic review. J Clin Exp Dent. 2015; 7(2): e320-7. [CrossRef] [PubMed]

Gauer RL, Semidey MJ. Diagnosis and treatment of temporomandibular disorders. Am Fam Physician. 2015; 91(6): 378-86. [PubMed]

Gonzalez YM, Schiffman E, Gordon SM, Seago B, Truelove EL, Slade G, Ohrbach R. Development of a brief and effective temporomandibular disorder pain screening questionnaire: reliability and validity. J Am Dent Assoc. 2011; 142(10): 1183-91. [CrossRef] [PubMed]

Jankelson R. Anatomy and Physiology of the Neuromuscular System. In: Neuromuscular dental diagnosis and treatment. 2 nd ed. St. Louis, Mo: Ishiyaku EuroAmerica; 2005. p. 10–16.

Jankelson R. Neuromuscular dental diagnosis and treatment. 2 nd ed. St..Louis, Mo: Ishiyaku Euro America; 2005. p. 285.

Kandasamy S, Greene CS, Rinchuse DJ, Stockstill JW, editors. TMD and Orthodontics. A Clinical Guide for the Orthodontists. Switzerland: Springer; 2015

Lerman MD. A complete hydrostatically derived treatment procedure for the TMJ pain-dysfunction syndrome. J Am Dent Assoc. 1974; 89(6): 1351-7. [CrossRef] [PubMed]

Mohlin B, Axelsson S, Paulin G, Pietilä T, Bondemark L, Brattström V, Hansen K, Holm AK. TMD in relation to malocclusion and orthodontic treatment. Angle Orthod. 2007; 77(3): 542-8. [CrossRef] [PubMed]

Oral Health Group. 2021. Aqualizer Muscle Directed Bite Registration - A Perfect Bite the First Try - Oral Health Group. [online] Available at: URL: https://www.oralhealthgroup.com/features/aqualizer-muscle-directed-bite-registration-a-perfect-bite-the-first-try/> [Accessed 24 July 2021].

Paknahad M, Shahidi S. Association between mandibular condylar position and clinical dysfunction index. J Craniomaxillofac Surg 2015; 43(4): 432-6. [CrossRef] [PubMed]

Rakosi T, Graber T, Alexander W. Orthodontic and dentofacial orthopedic treatment. Stuttgart [etc.]: Thieme; 2010. p. 4-69.

Ramachandran A, Jose R, Tunkiwala A, Varma R B, M. Shanmugham A, Nair PK, et al. Effect of deprogramming splint and occlusal equilibration on condylar position of TMD patients – A CBCT assessment. CRANIO®. 2019; 39(4): 294–302. [CrossRef] [PubMed]

Thilander B, Bjerklin K. Posterior crossbite and temporomandibular disorders (TMDs): need for orthodontic treatment? Eur J Orthod. 2012; 34(6): 667-73. [CrossRef] [PubMed]

Torii K, Chiwata I. A case report of the symptom-relieving action of an anterior flat plane bite plate for temporomandibular disorder. Open Dent J. 2010; 4: 218-22. [CrossRef] [PubMed]

Yi Y, Zhou X, Xiong X, Wang J. Neuroimmune interactions in painful TMD: Mechanisms and treatment implications. J Leukoc Biol. 2021; 110(3): 553-563. [CrossRef] [PubMed]

Published
2023/11/17
Section
Case report