Preliminary evaluation of modified anterior splint combined with anterior repositioning splint after successful mandibular manipulation in treatment of acute anterior disc displacement without reduction of temporomandibular joint

doi:10.7518/hxkq.2025.2024317

Abstract

Abstract:

Objective Magnetic resonance imaging (MRI) was used to study the efficacy of modified anterior splint (MAS) combined with anterior repositioning splint (ARS) in maintaining the normal disk-condyle relationship. Methods We obtained clinical and imaging data of 10 patients with acute anterior disk displacement without reduction (ADDwoR) of the temporomandibular joint undergoing successful mandibular manipulation in the Affiliated Stomatological Hospital, Nanchang University from January to June 2024. The MAS and ARS were used for subsequent treatment. Maximum active mouth opening (MMO) and visual analogue score (VAS) were recorded before treatment and 2 weeks, 1 month, and 3 months after treatment. The changes in the disk-condyle relationship, disk-condyle angle, joint effusion, and double contour sign before and after treatment were analyzed through MRI. Results Three months after treatment, the MMO increased from 28.90 mm to 46.85 mm, VAS decreased from 4.68 to 0.61, and the disk-condyle angle decreased from 58.84° to 25.99°. MRI analysis found that 6 patients showed normal disk-condyle relationship, 2 patients exhibited displacement with reduction, and 2 patients exhibited ADDwoR. The disk-condyle angle was 58.84° before treatment and 25.99° after treatment. Conclusion The MAS combined with ARS could further stabilize the coordinated disk-condyle relationship and reduce the recurrence rate.

Key words: temporomandibular joint disorders, mandibular manipulation, anterior repositioning splint, anterior disk displacement without reduction

CLC Number:

R782.6

Huang Chao, Wu Xingsheng, Zhan Zhen, Zhang Lin, Shi Lianshui. Preliminary evaluation of modified anterior splint combined with anterior repositioning splint after successful mandibular manipulation in treatment of acute anterior disc displacement without reduction of temporomandibular joint[J]. West China Journal of Stomatology, 2025, 43(2): 262-268.

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序号	MMO/mm				VAS
序号	治疗前	治疗后2周	治疗后1月	治疗后3月	治疗前	治疗后2周	治疗后1月	治疗后3月
1	24	47	47.5	48	4	0.8	0.3	0
2	23	44	46	49	6.5	2	0.9	0.2
3	35	51.5	51.7	52	5	1.8	0.8	0
4	28	41.8	41	38.5	2	1.5	0.7	1.6
5	25.3	46	45.5	48	3.8	1.8	1.2	0.3
6	36.3	46.5	46.3	45	3.8	1.3	0.6	0
7	30.4	47.7	45	54	6.8	1.4	0	0
8	26	46	46.5	44	3.9	0.4	0	0
9	34.5	41	40.5	41	5.4	4.4	4.2	3
10	26.5	49.5	51	49	5.6	0.4	0.8	1

序号	盘-髁角度/°		关节积液		双线征	盘-髁关系
序号	治疗前	治疗后3月	治疗前	治疗后3月	双线征	盘-髁关系
1	60.64	13.78	是	否	否	正常
2	63.31	13.82	是	否	否	正常
3	51.40	2.78	是	否	是	正常
4	67.78	76.55	是	否	否	不可复
5	47.85	64.77	是	是	否	不可复
6	51.36	24.65	否	否	是	可复
7	92.35	32.40	是	否	是	可复
8	64.49	3.74	是	否	是	正常
9	44.85	14.87	是	否	是	正常
10	44.32	12.55	是	否	是	正常