Splint Treatment For Anterior Disc Displacement Without Reduction: 1 Case

Temporomandibular disorders (TMDs) present significant therapeutic challenges. Chronic anterior disc displacement without reduction (ADDwoR), a common subtype, manifests as joint clicking, temporomandibular/masticatory muscle pain, limited mouth opening, and potential disc perforation or osteoarthrosis. While current management employs conservative or surgical approaches, this case reports stabilization splint therapy for chronic ADDwoR, though long-term outcomes require further evaluation. A 20-year-old female presented with left temporomandibular joint (TMJ) clicking for 3 years, progressing to preauricular pain (1-year duration) refractory to pharmacotherapy and worsened by chewing. Clinical examination revealed right facial fullness, limited mouth opening (30mm, zigzag trajectory) and joint locking. Bilateral step-like crepitus were palpated with clicking during mouth opening, with marked left TMJ tenderness. DC/TMD criteria and MRI confirmed left TMJ anterior disc displacement without reduction (ADDwoR) and right TMJ ADD with reduction(ADDwR). Stabilization splint therapy was initiated: (1) taking full-arch dental impressions and jaw relationship records; (2) digitally designing the splint based on jaw movement; (3) clinical fitting and occlusal adjustments: centric, lateral, and protrusive positions. Partial pain relief was observed after 2 months; long-term efficacy requires monitoring. The pathogenesis of chronic ADDwoR remains unclear, and treatments remain controversial. As a conservative approach, stabilization splints induce anteriorly and inferiorly condylar movement to increase TMJ space and reduce joint cavity pressure, thereby relieving pain symptoms. Stabilization splints effectively relieve pain in chronic ADDwoR patients. Conservative intervention should be prioritized in clinical practice.