Affiliation:
1. Department of Oral Surgery, Ninth People's Hospital, College of Stomatology Shanghai Jiao Tong University School of Medicine, and Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology Shanghai China
2. School of Stomatology Qingdao University Qingdao China
3. Biostatistics Office of Clinical Research Unit, Shanghai Ninth People's Hospital Shanghai Jiao Tong University School of Medicine Shanghai China
Abstract
AbstractBackgroundDigital occlusal splint is a novel approach in the treatment of temporomandibular disorders (TMD) and there is a lack of evaluation.ObjectiveTo introduce Kovacs digital occlusal splint (KDOS) and evaluate its clinical and magnetic resonance imaging (MRI) outcomes and influencing factors in the treatment of TMD.Patients and MethodsPatients diagnosed of TMD by MRI and treated with KDOS from June 2020 to December 2021 were retrospectively reviewed. They were divided into three groups: anterior disc displacement with reduction (ADDwR), anterior disc displacement without reduction (ADDwoR) and ADDwoR + osteoarthritis (ADDwoR + OA). Visual analogue scales (VAS) scores of pain, diet, mandibular function, quality of life (Qol) and maximum interincisal opening were compared before and at least 8 weeks after treatment. Binary logistic regression was used to analyse the influence of four factors including age, gender, Wilkes stage and the severity of symptoms on treatment. MRI was used to evaluate the condylar bone status and disc length after at least 3 months treatment.ResultsOne hundred and eighty‐four patients were included in the study. The average age was 30.9 ± 14.2 years and the average follow‐up was 19.8 ± 10.0 weeks. Pain, diet, mandibular function and Qol were all significantly improved after KDOS treatment (p < .05), with the effective rates of 71.6%, 56.4%, 55.3% and 54.1%. Binary logistic regression showed that higher probabilities of improvement were related to the patients with older age, ADD without OA and higher VAS scores before treatment. MRI showed that 94.1% of the condylar bone status remained stable or improved and the disc length was unchanged after treatment.ConclusionKDOS is effective for the treatment of TMD. Older age, ADD without OA and higher VAS scores before treatment had better results.