Effect Of Anterior Repositioning Splint On Patients With Addwr

This study aimed to evaluate morphological changes and biomechanical stress distribution in temporomandibular joints (TMJs) of patients with anterior disc displacement with reduction (ADDwR) before and after anterior repositioning splint (ARS) treatment. Finite element models were constructed for 6 patients who were diagnosed with bilateral ADDwR and treated by ARS. Von-Mises stress and strain distributions were analyzed. Comprehensive morphometric evaluations included sagittal plane, coronal plane and horizontal plane. We evaluated subjects’ changes of disc morphology, disc-condyle angle in magnetic resonance images and condylar bony changes in cone-beam computed tomography images before and after ARS treatment. After ARS treatment, the maximum stress in the disc shifted to the middle and peripheral regions of the intermediate zone. The peak stress and strain were smaller than before. Horizontal condylar angle, coronal condylar angle, and condylar curve width were showed to decrease significantly, while superior joint space, anterior joint space and posterior joint space increased significantly post-treatment. The disc length increased from 7.62±2.21 mm to 9.44±3.28 mm, and disc thickness decreased from 2.98±1.17 mm to 2.66±1.03 mm after ARS treatment. The score of sclerosis decreased from 0.58±0.90 to 0.33±0.65 significantly. The mean bone change scores decreased from 1.75±0.97 to 1.33±0.65 after ARS treatment. The ARS therapy effectively normalized disc pressure distribution and partially restored disc morphology, but demonstrated limited capacity for condylar bone remodeling.