Analysis of the efficacy and influencing factors of anterior repositioning splint in the treatment of temporomandibular joint anterior disc displacement with reduction

doi:10.19438/j.cjoms.2026.01.003

Abstract

Abstract: PURPOSE: To explore the efficacy of anterior repositioning splint(ARS) in the treatment of anterior disc displacement with reduction(ADDWR) and its influencing factors, so as to provide reference for clinical treatment selection. METHODS: A total of 58 ADDWR patients who received ARS treatment in Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from January 2009 to June 2018 were included. According to the effect of articular disc reduction 6 months after the end of treatment, they were divided into the success group(n=40) and the failure group(n=18). The initial clinical characteristics and cephalometric indexes of the two groups were compared, and the independent influencing factors of treatment effect were screened by multivariate logistic regression. RESULTS: In the initial stage of treatment, the degree of chin deviation in the failure group was significantly greater than that in the success group (P<0.001), while the Sn-G Vert distance (P<0.05) and S Vert-Co distance (P<0.001) were significantly smaller than those in the success group. Multivariate logistic regression showed that chin deviation(OR=0.12, 95%CI=0.03-0.58), S Vert-Co distance(OR=2.53, 95%CI=1.128-5.67) and Sn-G Vert distance(OR=4.67, 95%CI=1.14-19.09) were independent influencing factors for the efficacy of ARS(P<0.05). CONCLUSIONS: The degree of chin deviation, S Vert-Co distance and Sn-G Vert distance in the initial stage of treatment are key indicators for the efficacy of ARS in the treatment of ADDWR. In clinical practice, these indicators can be combined to evaluate the prognosis and optimize the treatment plan.

Key words: Anterior disc displacement with reduction, Anterior repositioning splint, Reduction effect, Chin deviation, Influencing factors

CLC Number:

R782.6

Li Minhan, Zhang Chuhan, Zhu Yan, He Jiaying, Yang Chi, Ma Zhigui. Analysis of the efficacy and influencing factors of anterior repositioning splint in the treatment of temporomandibular joint anterior disc displacement with reduction[J]. China Journal of Oral and Maxillofacial Surgery, 2026, 24(1): 17-22.

References

[1] Valesan LF, Da-Cas CD, Réus JC, et al.Prevalence of temporomandibular joint disorders: a systematic review and meta-analysis[J]. Clin Oral Investig, 2021, 25(2):441-453.
[2] Talaat WM, Adel OI, Al Bayatti S.Prevalence of temporomandibular disorders discovered incidentally during routine dental examination using the Research Diagnostic Criteria for Temporomandibular Disorders[J]. Oral Surg Oral Med Oral Pathol Oral Radiol, 2018, 125(3): 250-259.
[3] Silva MAG, Pantoja LLQ, Dutra-Horstmann KL, et al.Prevalence of degenerative disease in temporomandibular disorder patients with disc displacement: a systematic review and meta-analysis[J]. J Craniomaxillofac Surg, 2020, 48(10): 942-955.
[4] Schellhas KP, Pollei SR, Wilkes CH.Pediatric internal derangements of the temporomandibular joint: effect on facial development[J]. Am J Orthod Dentofacial Orthop, 1993, 104(1): 51-59.
[5] Huang IY, Wu JH, Kao YH, et al.Splint therapy for disc displacement with reduction of the temporomandibular joint. part I: modified mandibular splint therapy[J]. Kaohsiung J Med Sci, 2011, 27(8):323-329.
[6] Chen HM, Liu MQ, Yap AU, et al.Physiological effects of anterior repositioning splint on temporomandibular joint disc displacement: a quantitative analysis[J]. J Oral Rehabil, 2017, 44(9): 664-672.
[7] Ma Z, Xie Q, Yang C, et al.Can anterior repositioning splint effectively treat temporomandibular joint disc displacement?[J]. Sci Rep, 2019, 9(1): 534-541.
[8] Andrews LF.The 6-elements orthodontic philosophy: treatment goals, classification, and rules for treating[J]. Am J Orthod Dentofacial Orthop, 2015, 148(6): 883-887.
[9] Ikeda K, Kawamura A, Ikeda R.Prevalence of disc displacement of various severities among young preorthodontic population: a magnetic resonance imaging study[J]. J Prosthodont, 2014, 23(5): 397-401.
[10] Qu G, Bu L, Li X, et al.Malocclusion associated with temporomandibular joint anterior disc displacement and condylar resorption in adolescents: a cross-sectional study[J]. J Oral Rehabil, 2025, 52(6): 760-768.
[11] Lai YC, Yap AU, TüRP JC. Prevalence of temporomandibular disorders in patients seeking orthodontic treatment: a systematic review[J]. J Oral Rehabil, 2020, 47(2): 270-280.
[12] Szyszka-Sommerfeld L, Sycińska-Dziarnowska M, Gerreth K, et al.The impact of malocclusion on the prevalence of pain-related temporomandibular disorders in children and adolescents: a systematic review[J]. Front Neurol, 2025, 16:1550110.
[13] Ye C, Fan P, Zhang J, et al.Craniofacial morphology of temporomandibular disorder patients with different disc positions: stratifying features based on sex and sagittal skeletal pattern[J]. J Clin Med, 2023, 12(2): 652.
[14] Shokri A, Zarch HH, Hafezmaleki F, et al.Comparative assessment of condylar position in patients with temporomandibular disorder (TMD) and asymptomatic patients using cone-beam computed tomography[J]. Dent Med Probl, 2019, 56(1): 81-87.
[15] Mohamed HN, Ashmawy MS, Ekladious MEY, et al.Analysis of the relationship between condylar changes and anterior disc displacement with reduction: a preliminary study[J]. Oral Radiol, 2023, 39(1): 154-163.
[16] Tun Oo L, Miyamoto JJ, Takada JI, et al.Three-dimensional characteristics of temporomandibular joint morphology and condylar movement in patients with mandibular asymmetry[J]. Prog Orthod, 2022, 23(1): 50-62.
[17] Toh AQJ, Chan JLH, Leung YY.Mandibular asymmetry as a possible etiopathologic factor in temporomandibular disorder: a prospective cohort of 134 patients[J]. Clin Oral Investig, 2021, 25(7): 4445-4450.
[18] Usümez S, Oz F, Güray E.Comparison of clinical and magnetic resonance imaging diagnoses in patients with TMD history[J]. J Oral Rehabil, 2004, 31(1): 52-56.