Comprehensive Three-Dimensional Evaluation of Temporomandibular Joint Changes Following Stabilization Splint Therapy.

Abstract

<h4>Introduction and aims</h4>While stabilization splints (SSs) have shown promising therapeutic effects for temporomandibular disorders (TMDs), comprehensive studies evaluating temporomandibular joint (TMJ) changes following SS therapy are necessary. This study aimed to assess TMJ structural, positional, and condylar remodelling changes in TMD patients by using advanced three-dimensional assessment and shape correspondence analysis.<h4>Methods</h4>This retrospective study included 80 adult TMD (arthralgia) patients treated with SS. Pre- and post-treatment cone beam computed tomography scans were analysed using three-dimensional Slicer software. The following measurements were evaluated: (1) volumetric condylar changes, (2) bone mineral density, (3) joint spaces, (4) condylar position, (5) condylar rotation, and (6) condylar remodelling (resorption or apposition). Statistical comparisons between time points and condylar sides were performed via paired t tests and Wilcoxon rank-sum tests.<h4>Results</h4>Treatment duration was 6 to 12 months (mean: 9.8 months). Study results indicated a slight increase in condylar volume and bone mineral density, but no statistically significant changes were observed. However, significant differences were noted in the anterior joint space on both sides. Condylar positional changes demonstrated inferior, lateral, and anterior translation, along with forward rotational movement on both sides. Localized condylar remodelling revealed bone formation predominantly in the posterior and superior regions, while slight bone resorption was mainly observed in the anteromedial and medial regions.<h4>Conclusions</h4>SS therapy promotes favourable condylar remodelling and TMJ realignment, as evidenced by reduced anterior joint space, anterior-inferior condylar displacement, and forward rotational changes, along with localized bone apposition. These findings highlight its role in facilitating adaptive changes in patients with TMD.<h4>Clinical relevance</h4>This study demonstrates that SS therapy improves TMJ function and condylar dynamics, offering a noninvasive treatment option that reduces mechanical stress and enhances patient outcomes. These insights provide clinicians with valuable evidence for incorporating SS therapy into TMD management strategies.