The International journal of prosthodontics, cilt.34, sa.34, ss.173-182, 2021 (SCI-Expanded)
Purpose: To compare the efficacy of low-dose laser therapy to that of conservative treatment using
two different occlusal splints (stabilization and anterior repositioning splints) in patients with internal
derangements of the temporomandibular joint (TMJ). Materials and Methods: The study population
consisted of patients with disc displacement with reduction diagnosed according to the Research Diagnostic
Criteria for Temporomandibular Disorders (RDC/TMD) Axis I and Axis II. In addition, disc displacement with
reduction was confirmed in all patients using TMJ ultrasonography. These tests were conducted for 6 months
with an interim control in the third month. The “clicking” sound from the joint on opening and closing the
mouth and the extent to which the mouth opened vertically and laterally were assessed. In all, 20 patients
received low-dose laser therapy, 20 were treated with a stabilization splint, and 20 were treated with an
anterior repositioning splint. In addition, 10 untreated patients were included as a patient control group,
and a further 10 healthy subjects were included as a healthy control group. Changes in the condition were
assessed based on the results of the RDC/TMD Axis II and with the use of an algometer. Results: The
anterior repositioning splint group showed improvement in the “clicking” sound during mouth opening.
Lateral movement improved significantly in patients who received laser therapy. In the patient control group,
the click disappeared during mouth opening, the algometrically determined pain improved, and the lateral
movement increased. There were no statistically significant differences between groups in the improvement
of vertical mouth movement or in the clicking sound during mouth closing. Conclusion: Each treatment
modality applied in this study separately produced positive results for the clicking sound, restrictions in vertical
and lateral movements, and reduction of the pressure pain threshold observed in cases of TMJ irregularity.
In conclusion, the decision regarding which treatment modality should be employed can be made based on
the patient’s symptoms. However, this study also indicates that TMJ derangements can resolve spontaneously
when left untreated.