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Quantitative and qualitative condylar changes following stabilization splint therapy in patients with temporomandibular joint disorders

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Abstract

Objective

This study aimed to explore the quantitative and qualitative condylar changes following stabilization splint (S.S) therapy, including condylar position, morphology, and bone mineral density (BMD) in subjects with temporomandibular disorders (TMD).

Materials and methods

In this retrospective clinical study, we enrolled 40 TMD subjects (80 joints) aged 18 to 35 years, for whom a S.S was used to treat TMD. The 80 TMD consists of 32 masticatory muscle disorders (myalgia) and 48 TMJ disorders (arthralgia). Cone beam computed tomography (CBCT) was used to scan the TMJs of subjects pre- and post-treatment for three-dimensional analysis (3D). Using Mimics software v.21.0, quantitative (3D condylar and joint spaces dimensions parameters were measured using linear measurements in millimeters, according to the Kamelchuk method and Ikeda method, while the assessment of anteroposterior condyle position within the glenoid fossa was based on the method of Pullinger and Hollender), and qualitative (a round bone tissue with an area of 2 mm2 in three representative areas according to the Kamelchuk method to measure condylar BMD) pre- and post-treatment. Intra- and inter-group statistical comparisons were performed using the Wilcoxon signed ranks and the Kruskal–Wallis test, respectively.

Results

The course of treatment was 6–12 months, with an average of 9.1 months. For the pre- and post-treatment quantitative comparisons, there was a statistically significant difference in the anterior joint space (AJS) and coronal medial space, as well as the condyle length in the myalgia group and condylar width in the arthralgia group. For qualitative measurements, a significant difference was observed in the posterior slope of the myalgia group and the arthralgia group’s anterior, superior, and posterior slopes. The inter-group comparisons revealed significant differences in AJS, condylar length, and anterior slope density.

Conclusion

In short-term follow-up, the S.S influenced patients with TMD from different origins; it changes anterior and coronal medial joint space, condyle length in myalgia, and width in arthralgia. Furthermore, it improved the condyle bone density more evidently in arthralgia.

Clinical relevance

This study highlights the influence of S.S on symptomatic populations with TMD of different origins from a qualitative and quantitative perspective.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

Abbreviations

TMD:

Temporomandibular joint disorders

BMD:

Bone mineral density

S.S:

Stabilization splints

CBCT:

Cone beam computed tomography

3D:

Three dimensions

MCD:

Measures Condyle Displacement device

MIC:

Maximum intercuspation

MRI:

Magnetic resonance imaging

HU:

Hounsfield unit

AS:

Anterior slope

SS:

Superior slope

PS:

Posterior slope

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Acknowledgements

We wish to thank the New Medical Treatment and New Technology of the First Affiliated Hospital of Xi’an Jiaotong University, Shaanxi University Joint Project, for financially supporting this study; Charles S Greene, Professor, University of Illinois College of Dentistry, USA, for his insightful comments in reviewing the manuscript; and Mohammed Elhoumed, Salma Izeldin, and Nahawand Adil, Xi’an Jiaotong University, China, for their statistical assistance.

Funding

This study was funded by the New Medical Treatment and New Technology of the First Affiliated Hospital of Xi’an Jiaotong University (XJYFY-2017ZD02), Shaanxi University Joint Project (2020GXLH-Y-014).

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Authors and Affiliations

  1. Department of Stomatology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710061, Shaanxi, People’s Republic of China

    Mazen Musa, Wenfang Wang, Madiha Mohammed Saleh Ahmed, Yunshan Zhao & Xi Chen

  2. Department of Orthodontics, Al Tagana Dental Teaching Hospital, Faculty of Dentistry, University of Science and Technology Omdurman, Omdurman, 11111, Khartoum, Sudan

    Mazen Musa

  3. Department of Stomatology, Shaan’xi Provincial People’s Hospital, Xi’an, Shaanxi, People’s Republic of China

    Qianqian Zhang

  4. Department of Pediatrics Dentistry, College of Stomatology, Xi’an Jiaotong University, Xi’an, Shaanxi, People’s Republic of China

    Riham Awad

  5. Department of Orthodontics, Faculty of Dentistry, Aden University, Aden, Yemen

    Madiha Mohammed Saleh Ahmed

  6. Department of Pre-Clinical Oral Health Sciences, College of Dental Medicine, QU Health, Qatar University, Doha, Qatar

    Abeer A. Almashraqi

  7. Orthodontics and Dentofacial Orthopedics, Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia

    Maged S. Alhammadi

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  1. Mazen Musa
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Contributions

Mazen Musa and Qianqian Zhang: conception of the study, definition of the methodology, drafting of the manuscript, and analysis and interpretation of data for the work; Riham Awad and Wenfang Wang: contributions to the conception and design of the work and interpretation of data for the work, statistical analysis, and interpretation of the data and clinical examination; Madiha Mohammed Saleh Ahmed and Yunshan Zhao: substantial contributions to the acquisition of data sample recruiting and data collection; Abeer A. Almashraqi: grammatical, typo, and intellectual editing of the manuscript and contributed to critical revision of the article; Xi Chen: supervision and funding acquisition; Maged S. Alhammadi: contributions to the conception and critical revision of the article and contributed to the scope of the discussion. All authors approved the final version of the manuscript.

Corresponding author

Correspondence to Xi Chen.

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Ethics approval

This retrospective clinical study was approved by the ethics committee of Xi’an Jiaotong University, Xi’an Jiaotong University, China (No. XJTU1AF2022LSK-027).

Informed consent

For research involving human participants, informed consent was obtained from all subjects. All methods were performed following the relevant guidelines and regulations.

Competing interests

The authors declare no competing interests.

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Mazen Musa and Qianqian Zhang contributed equally to this work, and they are considered as joint first authors.

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Musa, M., Zhang, Q., Awad, R. et al. Quantitative and qualitative condylar changes following stabilization splint therapy in patients with temporomandibular joint disorders. Clin Oral Invest 27, 2299–2310 (2023). https://doi.org/10.1007/s00784-023-04963-x

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