ISSN : 0376-4672
Occlusal appliance is a removable device which fits over the occlusal surfaces of the teeth in one arch, devised to provide precise occlusal contact with the opposing teeth. Occlusal appliance is usually made of hard acrylic resin and allows optimum dentition in which condyle may assume in its most orthopedically stable position. Occlusal appliance is used to treat various kinds of temporomandibular disorders, including joint and muscle pain, disc derangements, parafunctional habits like bruxism and clenching, and degenerative joint diseases of TMJ. There are various types of occlusal appliances, but stabilization appliance and anterior positioning appliance are most frequently used. Stabilization appliance is fabricated to provide optimum occlusal relationship for the patient. This appliance is indicated for muscle and joint pain disorders and helpful for reducing parafunctional habits like bruxism. Anterior positioning appliance is designed to protrude mandible to a position that is more anterior than the intercuspal position. It is primarily used to treat disc displacement with reduction, intermittent lock and joint noises but some inflammatory disorders including retrodiscitis can be managed with this appliance. Occlusal appliance therapy is a successful treatment in reducing symptoms, and many previous reports indicates that its success rate is 70-90%. However, controversy exists over the exact mechanism by which occlusal appliance reduce symptoms. Occlusal appliance therapy is reversible, non-invasive therapy and effective therapeutic modalities for temporomandibular disorders. For the successful outcome, careful selection of the patient is needed. Also, it should be monitored regularly for the improvement of the disorder and the occurrence of side effects.
1. Scrivani SJ, Keith DA, Kaban LB. Temporomandibular disorders. N Engl J Med 2008;359(25):2693-2705.
2. Schiffman E, Ohrbach R, Truelove E, et al. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: recommendations of the International RDC/TMD Consortium Network and Orofacial Pain Special Interest Group. J Oral Facial Pain Headache 2014; 28:6-27.
3. Costen JB. A syndrome of ear and sinus symptoms dependent upon disturbed function of the temporomandibular joint. Ann Otol Rhinol Laryngol 1934;43(1):1-15.
4. Greene CS, Obrez A. Treating temporomandibular disorders with permanent mandibular repositioning: is it medically necessary? Oral Surg Oral Med Oral Pathol Oral Radiol 2015;119:489-498.
5. Klasser GD, Greene CS. Oral appliances in the management of temporomandibular disorders. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;107(2):212-223.
6. Okeson JP. Management of temporomandibular disorders and occlusion. 7th ed. St Louis, MO: Elsevier; 2013.
7. Al-Moraissi EA, Farea R, Qasem KA, Al-Wadeai MS, Al-Sabahi ME, Al-Iryani GM. Effectiveness of occlusal splint therapy in the management of temporomandibular disorders: network metaanalysis of randomized controlled trials. Int J Oral Maxillofac Surg 2020;49(8):1042-1056.
8. Greene CS, Menchel HF. The use of oral appliances in the management of temporomandibular disorders. Oral Maxillofac Surg Clin North Am 2018;30(3):265-277.
9. Perez C, de Leeuw R, Okeson JP, et al. The incidence and prevalence of temporomandibular disorders and posterior open bite in patients receiving mandibular advancement device therapy for obstructive sleep apnea. Sleep Breath 2013;17:323-332.
10. Zhang C, Wu JY, Deng DL, He BY, Tao Y, Niu YM, Deng MH. Efficacy of splint therapy for the management of temporomandibular disorders: a meta-analysis. Oncotarget 2016;7(51):84043-84053.
11. Ekberg E, Nilner M. Treatment outcome of appliance therapy in temporomandibular disorder patients with myofascial pain after 6and 12 months. Acta Odontol Scand 2004;62:343-349.
12. Wassell RW, Adams N, Kelly PJ. The treatment of temporomandibular disorders with stabilizing splints in general dental practice:one-year follow-up. J Am Dent Assoc 2006;137:1089-1098.
13. Kuzmanovic Pficer J, Dodic S, Lazic V, Trajkovic G, Milic N, Milicic B. Occlusal stabilization splint for patients with temporomandibular disorders: Meta-analysis of short and long term effects. PLoS One. 2017;12(2):e0171296.
14. Qvintus V, Suominen AL, Huttunen J, Raustia A, Ylöstalo P, SipiläK. Efficacy of stabilisation splint treatment on facial pain – 1-year follow-up. J Oral Rehabil 2015;42(6):439-446.
15. Nagata K, Maruyama H, Mizuhashi R, Morita S, Hori S, Yokoe T, Sugawara Y. Efficacy of stabilisation splint therapy combined with nonsplint multimodal therapy for treating RDC/TMD axis I patients:a randomised controlled trial. J Oral Rehabil 2015;42(12):890-899.
16. Al-Ani MZ, Davies SJ, Gray RJ, Sloan P, Glenny AM. Stabilisation splint therapy for temporomandibular pain dysfunction syndrome. Cochrane Database Syst Rev 2004;1:CD002778.
17. Turp JC, Komine F, Hugger A. Efficacy of stabilization splints for the management of patients with masticatory muscle pain: a qualitative systematic review. Clin Oral Investig 2004;8:179-195.
