Clinical aspects of the effect of aligners with a repositioning splint on the temporomandibular joint

Objective. To evaluate the effect of aligners with the effect of a repositioning splint on changes in the parameters of the articular gap and articular symptoms in patients aged 18 to 45 years. Material and methods. A clinical and radiological examination and treatment were performed on 40 patients with dental malposition and TMJ dysfunction. The patients were divided into groups: group 1 (25 patients: 1 subgroup-11 patients with dislocation of the articular disc with reposition, 2 subgroup — 6 patients with dislocation of the articular disc without reposition, 3 subgroup — 8 patients with absence of intraarticular disc position disorders.) — orthodontic treatment using aligners with the effect of repositional splint; Group 2 (15 patients) — orthodontic treatment using aligners without mandibular reposition; Aligners with the repositional splint effect had inclined planes (n=16) or “wings” (n=9) in their design. The clinical and radiological assessment of the effect of aligners with a repositioning effect was carried out according to the following parameters: clinical parameters — pain syndrome, articular noises, mouth opening volume, hypertonicity of the masticatory muscles, occlusal contacts, radiological parameters — width of the articular gap on CLC, position of the mandibular heads on CLC and MRI of the TMJ, condition of the cortical layer, position of the articular disc on MRI. Results. According to the results of the study, 92% of patients in the first group achieved centration of the mandibular heads in the articular fossa, 100% of patients experienced no joint symptoms, 88% of patients had normal mouth opening amplitude, and 70.6% of patients with articular disc dislocation had restored articular disc position. In group 2 patients, the mandibular heads were centered only in 13.3% of cases, TMJ pain was relieved in 60% of cases, mouth opening was normalized in 47.3% of cases, and the articular disc was repositioned in 6.7% of cases. Conclusion. The use of aligners with the effect of a repositioning splint not only allows you to achieve uniform occlusal contacts, but also helps to maintain the mandibular heads in a therapeutic position, having a positive effect on the temporomandibular joint.