Effectiveness of Occlusal Splints with Low-Level Laser Therapy on Anterior Disc Displacement of The Temporomandibular Joint

Aim: This study was designed to evaluate and compare between the using of oral appliance therapy alone and using of oral appliance with laser therapy for management of anterior disc displacement of the temporomandibular joint. Subjects and methods: randomized clinical study was done on 18 patients complaining of TMJ Anterior disc displacement. They were divided into 2 equal groups. Group A:occlusal appliance group Those patients worn the hard acrylic occlusal appliance covering the maxillary teeth (anterior repositioning splint) at night for two months. Group B: laser therapy group Those patients worn the hard acrylic occlusal appliance covering the maxillary teeth (anterior repositioning splint) at night and receive laser applications on the region of temporalis muscle, masseter muscle and mandibular condyle three times a week for 4 weeks. Full clinical TMJ examination was done at 0 baseline, one week, one month and two months postoperatively. The examination was done to evaluate T.M.J pain intensity by (VAS), TMJ clicking Sounds and Maximum mouth opening .Magnetic resonance imaging(MRI) performed before and after treatment period. Results: There was high percentage of improvement in all symptoms of anterior disc displacement either with or without reduction by using of double action of splint and laser rather than the improvement by using splint only. Conclusion: The using of splint only is acceptable and successful but the using of the laser with splint is better and more successful in treatment of the patients complained from anterior disc displacement of the temporomandibular joint. INTRODUCTION Internal derangement in temporomandibular joint (TMJ) is a common dysfunction of the stomatognathic system. The most common type is disc displacement with reduction characterized by clicking in the temporomandibular joint.in about 5%of cases the disc displacement without reduction with limited mouth opening is observed. The main symptoms of anterior disc displacement with reduction are pain in affected joint and decreased range of mouth opening (≤ 35 mm), which deteriorate the function of the stomatognathic system and force the patient to look for professional help(1).