Farklı Kalınlıktaki Okluzal Splintlerin Temporomandibbular Eklem Üzerine Oluşturduğu Stres Dağılımının Araştırılması

Abstract

TMJ disorders (TMD) are a common group of patients with chronic pain and reduced quality of life. TMDs can be caused by abnormal stresses from insertion and one of the main methods used in the treatment is occlusal splints. In the published studies, varying thickness splints were used. The aim of this study is to compare the stresses of 3 and 6 mm thick splints on TME with finite element analysis (FEA) and to determine the ideal occlusal splint thickness. TME model was obtained by using computed tomography (CT) data from a patient with skeletal and dental class 1 occlusion. A disc displacement model has been formed by taking the TME disc into the anterior position. Using this model, 3 different models were obtained with occlusal splints with 3 and 6 mm vertical thickness and a model with no occlusal splint. The loading conditions were determined by assigning anatomical muscle strength and vectors on these models in computer environment. In all models, the intensity of stress on the TMJ disc is concentrated on the lateral side between the anterior and middle bands of the disc. In models with occlusal splint, the stress intensity on the disc is spread towards the middle band and the amount is decreased. In all models, the stress density in the condyle head and fossa is concentrated on the surfaces corresponding to the anterior and middle band of the TMJ disc. In the occlusal splint models, the density and amount of stress decreased in the condyle and fossa. Compared to the stress of all components of TMJ, a 6 mm occlusal splint was used, which resulted in less stress intensity than a 3 mm occlusal splint. The use of occlusal splints in the treatment of TMDs reduces stress in TMJ. The use of occlusal splints in increasing vertical thickness may be more useful in reducing stresses occurring in TMJ. Clinical studies to determine the appropriate vertical thickness of occlusal splints to be used in TMD patients based on evidence; should be supported by biomechanics and FEA studies.

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