Evaluation Of The Effect Of T-scan As An Adjunct To Stabilization Splint In The Treatment Of Temporomandibular Disorders

Temporomandibular disorders are a group of oral and maxillofacial dysfunctional disorders caused by a variety of factors,mainly manifested by localized pain,articular sounds,and limited mouth opening.Various studies have shown that the prevalence of temporomandibular j oint disorders varies widely,ranging from 7%to 84%;the clinical prevalence is higher in females,approximately 2.37 times that of males;and the prevalence is higher in adolescents and middle-aged populations.Temporomandibular disorders have adversely affect the daily lives and mental health of patients.Currently,there are several methods for treatment of temporomandibular disorders.Among them,the stabilization splint,a type of non-invasive oral orthodontic appliance,is widely used in clinical practice due to its high safety profile.Previous studies have found that the stabilization splint had positive effects temporomandibular disorder with myofascial pain and arthralgia.During the treatment of stabilization splint,the adjustment of occlusion is crucial for its efficacy.Articulating paper is still the most common method for detecting occlusal interference in clinical practice,relying on the subjective judgment of physician for the adjustment of occlusal interference points based on the depth and size of the articulating paper marks.However,Kerstein et al.showed that it is unreliable for clinicians to distinguish occlusal interference points simply by observing the shade size of articulating paper marks.In contrast,computerized occlusal analysis systems provide more accurate information on occlusal contacts.T-scan system can be used to record the chronological distribution of occlusal contacts and the distribution of occlusal forces.T-scan is a suitable device for evaluating occlusal processes,especially when combined with other methods.In summary,the aim of this study is to investigate whether the use of the T-scan contributes to the treatment of temporomandibular disorder with myofascial pain.The details are as follows.Objective:Stabilization splint is currently a commonly used method in clinical treatment of temporomandibular disorders.In this study,T-scan-assisted stabilization splint was used for occlusal adjustment,and the therapeutic effect of patients was evaluated in three different periods of treatment.To explore the effectiveness of the stabilization splint combined with the T-scan in the treatment of temporomandibular disorders.Methods:40 patients diagnosed as myofascial pain of temporomandibular disorder were collected from the Department of Hospital of Stomatology,Jilin University by an experienced chief physician.All patients were randomly divided into two groups:Tscan-guided stabilization splint group and articulating paper group.The therapeutic effects of the two groups were recorded at baseline,1 month and 3 months.Mandibular Function Impairment Questionnaire,Maximum Comfortable Opening,Visual analog Scale and Patient Health questionnaire-9 were used as the outcome variables.Results:1.The occlusal force distribution loaded on the splint of the 20 patients before and after T-scan-aided occlusal adjustment:The difference of Occlusal Time,Disocclusion Time and Assymetry index of occlusal force after T-scan-aided bite adjustment was smaller than that of articulating paper,and the above results revealed significant statistical differences between the two groups(p<0.001).2.The therapeutic effect of patients before and after stabilization splint treatment:No matter articulating paper alone or T-scan-guided,Mandibular Function Impairment Questionnaire,Maximum Comfortable Opening,Visual Analog Scale,and Patient Health Questionnaire-9 score were significantly improved at 1 and 3 months after wearing stabilization splint.3.Comparison of therapeutic effects of occlusal paper guided stabilization splint group and T-scan-guided stabilization splint group at 1 and 3 months:At 1 month,the T-scan-guidance group achieved better therapeutic effect than the control group,but there was no statistically significant difference.At 3 months,the Mandibular Function Impairment Questionnaire,Maximum Comfortable Opening scores of the T-scanguided group were significantly improved compared with the control group,and the difference was statistically significant(P<0.05).Conclusion:1.The T-scan analysis system can accurately detect the abnormal occlusal interference points,and the occlusal balance can be significantly improved by lowering the occlusion under its guidance.2.Stabilization splint has a good therapeutic effect on temporomandibular disorders patients with myofascial pain at 1 and 3 months.3.At 3 months,the Mandibular Function Impairment Questionnaire,Maximum Comfortable Opening scores of the T-scan-guided group were significantly improved compared with the control group.T-scan as an adjunct can improve the indicators associated with Axis I physical assessment.