{"title":"Evaluation of digitally fabricated occlusal devices in the treatment of temporomandibular disorders: A pilot study.","authors":"Yunpeng Wei, Ruitong Guo, Jiali Meng, Guofeng Wu, Peihua Shi, Zhifeng He, Yingjie Yi, Sufeng Zhao","doi":"10.1016/j.prosdent.2025.02.038","DOIUrl":null,"url":null,"abstract":"<p><strong>Statement of problem: </strong>Digitally fabricated occlusal devices represent a novel approach to treating temporomandibular disorders (TMDs), yet they have not been adequately evaluated.</p><p><strong>Purpose: </strong>The purpose of this pilot clinical study was to develop a manufacturing process for a digitally fabricated occlusal device, assess its therapeutic effectiveness for various types of TMDs, and examine factors influencing treatment outcomes.</p><p><strong>Material and methods: </strong>The records of patients with TMDs treated with a digitally fabricated occlusal device from May 2023 to October 2024 were retrospectively analyzed. They were divided into 3 groups based on the diagnosis: anterior disc displacement with reduction (ADDwR), anterior disc displacement without reduction (ADDwoR), or unilateral anterior disc displacement with reduction and unilateral anterior disc displacement without reduction (ADDwR +ADDwoR). Visual analog scale (VAS) scores for pain, diet, mandibular function (MF), and quality of life (QoL) and maximum interincisal opening (MIO) were compared before and at least 8 weeks after treatment. A nonparametric test was used to analyze changes in VAS scores and MIO before and after treatment (α=.05). Effects of sex, age, horizontal or vertical overlap, wearing time, and thickness of the device on the treatment were analyzed using binary logistic regression.</p><p><strong>Results: </strong>Forty-one patients with a mean ±standard deviation age of 27.95 ±11.04 years and a mean ±standard deviation follow-up of 12.51 ±14.10 weeks were evaluated. Pain, diet, MF, and QoL were significantly improved after treatment with a digitally fabricated occlusal device (P<.05), with effective rates of 80.6%, 73.5%, 74.4%, and 66.7%, respectively. Wearing time and thickness of the device affected the treatment (P<.05), whereas sex, age, and horizontal or vertical overlap did not affect the treatment (P>.05).</p><p><strong>Conclusions: </strong>Digitally fabricated occlusal devices were found to be effective treatment options for TMDs. Wearing a digitally fabricated occlusal device for 24 hours a day led to improved therapeutic outcomes. A 1- to 2-mm-thick device was found to be more effective than 2- to 3- or ≥3-mm options.</p>","PeriodicalId":16866,"journal":{"name":"Journal of Prosthetic Dentistry","volume":" ","pages":""},"PeriodicalIF":4.3000,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Prosthetic Dentistry","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.prosdent.2025.02.038","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
引用次数: 0
Abstract
Statement of problem: Digitally fabricated occlusal devices represent a novel approach to treating temporomandibular disorders (TMDs), yet they have not been adequately evaluated.
Purpose: The purpose of this pilot clinical study was to develop a manufacturing process for a digitally fabricated occlusal device, assess its therapeutic effectiveness for various types of TMDs, and examine factors influencing treatment outcomes.
Material and methods: The records of patients with TMDs treated with a digitally fabricated occlusal device from May 2023 to October 2024 were retrospectively analyzed. They were divided into 3 groups based on the diagnosis: anterior disc displacement with reduction (ADDwR), anterior disc displacement without reduction (ADDwoR), or unilateral anterior disc displacement with reduction and unilateral anterior disc displacement without reduction (ADDwR +ADDwoR). Visual analog scale (VAS) scores for pain, diet, mandibular function (MF), and quality of life (QoL) and maximum interincisal opening (MIO) were compared before and at least 8 weeks after treatment. A nonparametric test was used to analyze changes in VAS scores and MIO before and after treatment (α=.05). Effects of sex, age, horizontal or vertical overlap, wearing time, and thickness of the device on the treatment were analyzed using binary logistic regression.
Results: Forty-one patients with a mean ±standard deviation age of 27.95 ±11.04 years and a mean ±standard deviation follow-up of 12.51 ±14.10 weeks were evaluated. Pain, diet, MF, and QoL were significantly improved after treatment with a digitally fabricated occlusal device (P<.05), with effective rates of 80.6%, 73.5%, 74.4%, and 66.7%, respectively. Wearing time and thickness of the device affected the treatment (P<.05), whereas sex, age, and horizontal or vertical overlap did not affect the treatment (P>.05).
Conclusions: Digitally fabricated occlusal devices were found to be effective treatment options for TMDs. Wearing a digitally fabricated occlusal device for 24 hours a day led to improved therapeutic outcomes. A 1- to 2-mm-thick device was found to be more effective than 2- to 3- or ≥3-mm options.
期刊介绍：
The Journal of Prosthetic Dentistry is the leading professional journal devoted exclusively to prosthetic and restorative dentistry. The Journal is the official publication for 24 leading U.S. international prosthodontic organizations. The monthly publication features timely, original peer-reviewed articles on the newest techniques, dental materials, and research findings. The Journal serves prosthodontists and dentists in advanced practice, and features color photos that illustrate many step-by-step procedures. The Journal of Prosthetic Dentistry is included in Index Medicus and CINAHL.
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