Effects of splint therapy in TMJ dysfunction: a study using magnetic resonance imaging

This pilot study was undertaken to correlate clinical and MRI diagnoses in seven symptomatic TMJ dysfunction patients and to account, if possible, for the clinical improvement in the signs and symptoms after the use of a maxillary stabilizing splint. The symptomatic TMJs were evaluated by means of MRI prior to splint insertion. Sagittal open/closed, and coronal closed images were obtained with a 0.3 T Fonar MR Scanner. A follow-up MRI was taken after three months of splint therapy for the purposes of a comparative study. All subjects responded positively even at the early phase of splint treatment. By the end of the three month period, six subjects experienced full remission of pain in the TMJ and associated masticatory muscles with one subject experiencing only partial remission following therapy. Baseline MRI study revealed that only three subjects had anterior disc displacement while the other four subjects had normal disc/condyle relationships and morphology. In the follow-up MRI study, there were no signs of recapture of the three anteriorly displaced discs despite there being evidence of improved jaw movement and remission of pain symptoms. The use of MRI in this preliminary study indicates that some but not all TMJ pain dysfunction syndromes are caused by internal derangements of the joint. A larger MRI study using the same clinical parameters is indicated for future research.