[The therapy of anterior disk dislocation in craniomandibular disorders. A clinical case report]

The authors discuss the outcomes of therapy for CMDs and present a clinical case reporting an alternative method for the treatment of disc displacement. The orthopaedic therapy for CMDs is based on the use of interocclusal splints. Two kind of splints are prescribed to patients with CMDs: stabilization or repositioning splint. The former is used for a conservative treatment, the latter for irreversible treatment. In view of the poor long-term success of repositioning therapy, the cost of subsequent dental treatment, and the great potential for iatrogenic occlusal and muscular problems, the authors believe that the initial treatment approaches should be, in any case, conservative, reversible, and non invasive. The authors prescribe to their patients the repositioning splint for use either part-time or full time use. Part-time use is effective for preventing disc displacement without reduction. If used full time, once joint noises, pain, and displacement are decreased, the appliance should be adjusted to/or replaced with a stabilization appliance to allow posterior positioning of the mandible into a more physiologically stable position. The authors present a clinical case, a 27 yo female with disc displacement with reduction was treated with stabilization splint. After 6 weeks of therapy she returned reporting a temporary closed lock and sharp pain in the left TMJ. An anterior repositioning splint was fabricated in order to position the mandible forward. After 10 weeks of this treatment the patient reported absence of joint/muscle symptoms and of joint noise.(ABSTRACT TRUNCATED AT 250 WORDS)