An Innovative Approach to Managing Temporomandibular Disorders Through the Combined Use of Two Oral Devices: A Case Report

Temporomandibular disorders (TMD) are increasingly prevalent in the adult population. Given the multifactorial and often chronic nature of TMD, the ideal therapeutic approach must be multimodal and personalized, with a preference for conservative treatments. However, standardized protocols combining occlusal devices and biobehavioral therapy for internal derangement (ID) are still lacking. Case Presentation: A 20-year-old male patient presented with bilateral anteromedial reducible disc displacement, with intermittent locking on the right. He reported joint noises, difficulty chewing, and occasional painful mouth opening. A comprehensive diagnostic workup, including clinical, functional, and radiographic evaluations, was performed. The patient underwent a biobehavioral gnathological therapy involving two oral devices: RA.DI.CA. and By-Te ® Reali. The protocol included personalized exercises, patient education, and behavioural counselling. Results. The patient achieved full remission of pain, disappearance of joint noises, and restoration of mandibular function, without dental movement. Pre- and post-treatment MRI and condylography confirmed improved condyle-disc relationships, increased intra-articular space, and better symmetry of movements, particularly on the right. Conclusion. The combined use of RA.DI.CA. and by-Te ® Reali devices, supported by a personalized functional programme, appears effective in managing TMD with ID. Further studies on larger populations are needed to confirm the efficacy and safety of this protocol.