Outcomes of temporomandibular joint disorder therapy: observations over 13 years.

Objective: To evaluate the outcome of temporomandibular joint (TMJ) disorder therapy with different kinds of splints.

Methods: One-hundred-and-twenty-nine patients with TMJ disorders and meeting the primary selection criterion of reporting pain in the TMJ region were clinically evaluated. Magnetic resonance imaging of the TMJ was performed at baseline 1993-94. A protrusion splint was used whenever joint clicking could be eliminated by protrusion. In the other cases, a pivot or a Michigan splint was inserted. Re-evaluation of the patients after 12 months included a clinical examination. After 5 and 13 years, all patients were examined by means of a questionnaire.

Results: Pain was significantly reduced in the case of more than two-thirds of the patients 1 year after the first consultation. After 5 and 13 years, the percentages of patients with reported pain had increased only slightly. However, the therapy did not reduce joint noises or mouth opening. The prevalence of joint noises was reduced to less than a quarter after 1 year, but during the next 13 years increased to the former level. Initially, one-third of the patients had mouth-opening reduction. This proportion dropped to one-third of these cases after 1 year, but increased to 40% after 13 years.

Conclusions: Treatment using splints reduced pain in approximately two-thirds of the patients, but with no difference between the three types of splints used.