Controlled Mandibular Repositioning: A Novel Approach for Treatment of TMDs

Temporomandibular joint disorders (TMDs), particularly disc displacement with reduction (DDwR), are prevalent musculoskeletal conditions characterized by symptoms such as joint clicking, pain, and sometimes limited jaw movements. Accurate diagnosis requires a multidisciplinary approach, including clinical examination, imaging (MRI), and functional analysis. Among conservative treatment modalities, anterior repositioning splints (ARSs) are widely used to recapture the displaced discs and reposition the mandibular condyles. Determining the optimal therapeutic position (Th.P) for anterior repositioning splint fabrication remains challenging due to individual anatomical variability and a lack of standardized guidelines. This study introduces the controlled mandibular repositioning (CMR) method, which integrates clinical examination, imaging (MRI), computerized cephalometry, computerized condylography, neuromuscular palpation, and the Condylar Position Variator (CPV) to define an individualized Th.P. After treatment with CMR stabilizers (splints), the control MRI confirmed that in 36 out of 37 joints, the discs were repositioned to their normal position. There was a reduction in pain, as shown by VAS scores at the 6-month follow-up. This study demonstrated the effectiveness of the CMR method to find a precise therapeutic position, resulting in a 97.3% joint luxation reduction in DDwR. This study underscores the importance of precise, individualized Th.P determination for effective anterior repositioning.