MRI Study Of The Effect Of Stabilization Splint In The Treatment Of Temporomandibular Joint Anterior Disc Displacement

Objective:By measuring the changes of Fricton index and magnetic resonance images of(thickness of the posterior band of the articular disc,the articular disc-condyle angle,articular disc and condyle position)temporomandibular joint anterior disc displacement patients before and after the treatment with stabilization splint,the efficacy of stabilization splint in the treatment of TMJ was analyzed and evaluated.Methods:1 、 Among the patients diagnosed with anterior temporomandibular joint displacement in the oral surgery department of our hospital,20 cases with a total of 40 joints were identified according to the inclusion criteria and exclusion criteria(these include bilateral reversible disc displacement,one reversible disc displacement and the other irreversible disc displacement or normal),and conservative treatment with stabilization splint was used for them;before and after wearing the stabilization splint,joint related examination was performed by the oral surgeon,Fricton index table was recorded,and the temporomandibular joint magnetic resonance examination was performed.According to the magnetic resonance examination results,40 joints were divided into two groups: reversible anterior disc displacement and non-reversible anterior disc displacement.2、The treatment period is 3-6 months,and the patient shall be instructed to wear it during non-food time and at night;check again every 1-2 weeks to adjust the occlusion3 、 By measuring and analyzing the Fricton index and TMJ magnetic resonance image parameters(including the thickness of the posterior disc band,the articular disc-condyle angle,and the position of the articular disc and condyle)of the patients before and after the treatment of the stabilization splint,the paired students’ test was carried out on the measurement data in accordance with the normality.The statistical difference of each measurement index before and after stabilization splint wearing was analyzed and the conclusion was drawn.Results:1、Fricton index decreased in all 20 patients after treatment with stabilization splint.Further analysis showed that DI,PI,CMI,MM,JN,JP and MP indexes decreased significantly after treatment with occlusal plate compared with before treatment,which was statistically significant(P<0.05).2、Magnetic resonance image measurement data of 40 joints:There was no significant difference in the thickness of the posterior disc band between the reversible anterior disc displacement and the non-reversible anterior disc displacement after stabilization splint treatment,which was not statistically significant(P>0.05);the articular disc-condyle angle of the two groups decreased significantly after treatment,and the difference was significant before and after analysis and comparison(P<0.05);the position of the articular disc and condyle in the MRI images were reflected on the X-Y coordinate axis,respectively.Data analysis showed that the positions of the joint disc and condyle in the reversible anterior disc displacement group moved after treatment,and the difference was statistically significant(P<0.05),while in the irreversible anterior disc displacement group,only the position of condyle was significantly moved,and the position of articular disc was not changed.Conclusion:Stabilization splint can relieve the clinical symptoms of patients with temporomandibular joint anterior disc displacement such as joint snapping,restricted mouth opening,muscle and joint pain,and further affirm the clinical efficacy of SS.The stabilization splint treatment did not significantly affect the thickness of the posterior band of the articular disc in the two groups;while the disc-condyle angle of the two groups became smaller than before,which is beneficial to restore the disc-condyle angle.After SS treatment,the positions of the condyles of the two groups have changed,showing a forward displacement;at the same time,only the position of the joint disc of the reversible anterior disc displacement group has also changed,moving backward and upward compared with the previous position.It can be considered that the treatment of stable occlusal splints may form a relatively stable disc-condyle relationship by temporarily changing the original occlusal relationship,changing the position of the articular disc and condyle,reducing or even restoring the disc-condyle angle.