The Role of Orthodontic Appliances in Alleviating Temporomandibular Joint Disorders - An Overview

Abstract

The mandibular joint is a condyloid synovial joint, that is formed between the head of the mandible and the petrous temporal bone. Temporomandibular disorders (TMDs) occur in roughly one out of four people; they are degenerative musculoskeletal diseases that cause morphological and functional alterations, characterized by pain, restricted mouth opening, and clicking sounds. Basically, the causes of TMD are genetic predisposition, trauma, arthritis, and dental malocclusion. TMD is rooted in early Egypt manual therapy, Hippocrates, and early surgeons such as Annandale, Lanz, Pringle, and Wakeley. The National Institutes of Health sponsored an international workshop in 1994 to initiate the research and nevertheless consensus of TMD. The American Academy of Orofacial Pain has divided TMD into muscle TMD or myogenous and joint TMD or arthrogenous TMD. Studies are in agreement that orthodontic treatment may help in alleviating TMD. The systematic review showed that patients undergoing orthodontic treatment reported a decrease in their TMD symptoms and headaches. TMD treatment is generally carried out in two stages: Phase I, intraoral orthopedic appliances, phase II, occlusal adjustment, or further large case procedures. They include splints that are commonly used but produce negative effects whenever the splints are designed wrongly or used for an unusually long time. Fixed removable appliances such as stabilization and anterior positioning appliances are applied in treating TMD. Stabilization appliances deal primarily with muscle pain and parafunctional activities, while anterior positioning appliances are useful in cases of disc derangement disorders, they aid in the proper positioning of the condyle and disc. Their usage needs specific criteria to be fulfilled for them to be effective. Although there is continuing controversy and uncertainty about certain aspects of the results of studies for now, oral appliances belong to the most conservative type of TMD therapy. They afford relief from the symptoms and are akin to orthopedic braces without aiming at creating new occlusal erections. Further studies are required to provide more accreditation on treatment regimens and patients’ conditions.