Clinical and cone-beam CT analysis of the effectiveness of anterior repositioning splint therapy in the management of temporomandibular joint click in different age groups

Abstract

Abstract Background: Joint click is a typical symptom for TMD and can be treated by anterior repositioning splint (ARS) therapy. However, the effect of treatment in different age groups has not been evaluated. To analysis of the effectiveness of ARS therapy in the management of TMJ click in different age groups based on the results of clinical and CBCT examination. Methods: Patients with TMJ click admitted to TMJ Diagnosis and Treatment Center in 2021 were included in this study. They divided into 2 groups according to ages: ≤22Y and >22Y. Clinical features included click severity, symptom duration and CBCT imaging characteristics (condylar position and condylar ratio) were analyzed. Results: 169 patients with 338TMJs were studied in this study. The mean age of paitents was 18.78±2.8 in the ≤22Y group (78 patients) and 30.53±10.6 in the >22Y group (91 patients). Sex distribution, CSV, ratio of CSV=1, ratio of CSV=2, symptom duration showed no statistical differences between the two groups. Before ARS treatment, there was no significant difference in AJS, PJS and condylar ratio, but the proportion of posteriorly positioned condyle in ≤22Y group (72, 46.2%) was significantly smaller than that in the >22Y group (100, 54.9%). After ARS treatment, there was no statistically significant difference in AJS, PJS, condylar ratio and condylar position, but the change of condylar ratio in ≤22Y group (0.03±0.10) was significantly higher than that in >22Y group (-0.02±0.11). The positive results (39.7%) in ≤22Y group were greater than >22Y group (17.9%). The time required for CSV=0 in ≤22Y group (2.03±1.14) was significantly shorter than that in >22Y group (2.66±1.41). In the first and second months of follow-up, the ratio for CSV=0 (46.1%, 65.8%) in ≤22Y group was significantly higher than that in >22Y group (22.5%, 50.0%).Conclusions: ARS is more effective in joint clicking treatment in the group ≤22Y. Although AJS, PJS, condylar ratio and condylar position did not change significantly after ARS treatment, the rate of positive results in condylar position was higher in the ≤22Y group.Trial registration: This study was retrospectively registered On 28/03/2022 and endorsed by the Ethics committee (LCYJ2022014).