Assessment of Occlusal Appliance for the Reposition of Temporomandibular Joint Anterior Disc Displacement With Reduction

The aim of our study was to evaluate the success rates and prognoses of patients treated with occlusal appliances used to reposition the temporomandibular joint anterior disc displacement with reduction (ADDWR). A sample of 144 consecutive patients (210 joints) diagnosed with ADDWR based on MRI were included in our study. Disc recapture was confirmed in a mandible-anterior position to eliminate joint clicking based on magnetic resonance imaging (MRI). Anterior repositioning appliance (ARS) was applied to keep the mandible in this position. The occlusal surface of the ARS was ground down by 1 mm approximately every 4 weeks for bite reconstruction. MRI was carried out before treatment, 6 months after the start of treatment, at the end of the treatment, and at their last follow-up visit. A Cox regression model was used to estimate the risk of failure of the treatment. The mean treatment duration was 9.5±2.6 months. A total of 177 joints (84.3%) were successfully repositioned at the end of splint treatment according to MRI. Regular follow-up indicated that almost 53% of the patients had normal disc-condyle relationships after 2 years. Sex, age, treatment duration, and orthodontics used were included in the final Cox regression model, with hazard ratios of 1.375, 1.141, 0.396, and 0.364, respectively. ARS is inferior for recapturing ADDWR in the long-term. It is thus better to explore other more effective methods to reposition the displaced disc in patients with ADDWR.