Do the Mandibular Condyles Change Their Positions within Glenoid Fossae after Occlusal Splint Therapy Combined with Physiotherapy in Patients Diagnosed with Temporomandibular Joint Disorders? A Prospective Case Control Study.

The research question was: do the mandibular condyles change their position within glenoid fossae after treatment combining occlusal splint therapy and physiotherapy in patients diagnosed with temporomandibular disorders (TMD)? Forty patients with TMD were included into the study. They underwent initial physiotherapy, and a six-month treatment of occlusal splint therapy with physiotherapy. Cone-beam computed tomography images of temporomandibular joints (TMJs) were taken before and after the treatment. The control group consisted of 15 asymptomatic patients, who did not receive any type of occlusal treatment. The changes in the dimension of anterior, superior, posterior, and medial joint spaces after the end of the treatment in patients with TMD were statistically insignificant. The average value of condylar ratio was significantly higher after the end of the treatment ( p = 0.025). The changes in the condylar sagittal position were statistically insignificant. Occlusal splint therapy with physiotherapy did not change significantly the dimension of joint spaces, nor placed the mandibular condyles into the centric relation. Treatment of patients with TMD should not aim at gnathological concept of placing the mandibular condyles into centric relation, because centric relation appears not to be mandatory to achieve successful results of treatment in patients with TMD.