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Effect of CAD/CAM versus conventional anterior repositioning splints on the management of temporomandibular joint disc displacement with reduction: A randomized controlled clinical trial

Purpose: The aim of the current study was to investigate the effect of CAD/CAM versus conventional anterior repositioning splints (ARS) on the management of temporomandibular joint disc displacement with reduction. Materials and methods: Twenty patients (15 females and 5males) diagnosed (clinically and by magnetic resonance imaging (MRI)) with disc displacement with reduction (DDWR) were selected from the outpatient clinic of oral and maxillofacial surgery department, Faculty of Dentistry, Beni-Suef University. Patients were randomly divided into two groups; Group I patients received ARS constructed following the conventional technique. Group I patients had 8 normal (control) and 12 DDwR joints as scanned by MRI. Group II patients received ARS constructed by CADCAM technique. Group II patients had 6 normal(control) and 14 DDwR joints as scanned by MRI. Subjective symptoms were evaluated using temporomandibular disorder (TMD) questionnaire before treatment (baseline), 1-, 3- and 6-months post- insertion. Moreover, MRI measurements of the disc-condyle angle and the disc/condyle positions were performed for normal (control) and DDwR joints in group I and group II. There measurements were done before treatment, immediately at the time of splint insertion and finally after 6 months post-insertion. Results There was no statistically significant difference between the scores of TMD questionnaire items between group I and group II at baseline and different follow up visits. Likewise, there was no statistically significant difference in disc-condyle angle and disc/condyle positions (MRI measurements) between DDwR joints in group I (conventional ARS) and group II (CAD/CAM ARS) at pretreatment, immediately at the time of splint insertion and after 6 months post-insertion. Conclusion Within the limitations of this study, there was no significant difference between the effect of CAD/CAM versus conventional ARS on the management of DDwR. Hence, the CAD/CAM ARS can provide a good substitute to the conventional ARS in treatment of DDwR eliminating human errors and saving time. Moreover, the superior effect of ARS in the management of DDwR could be related mainly to the design of the splint rather than the method involved in the construction of the splint.