Comparative Efficacy of Different Types of Occlusal Splints in the Correction of Temporomandibular Joint Muscle and Joint Dysfunction According to Comprehensive Digital Diagnosis

Objective. To conduct a comparative analysis of the clinical efficacy of stabilizing and repositioning occlusal splints in the comprehensive treatment of patients with temporomandibular joint (TMJ) dysfunction. Particular attention was paid to an objective assessment of the results using an extensive range of modern digital and instrumental diagnostic techniques, allowing for a multiparametric picture of the changes. Materials and methods. This prospective, randomized study included 75 patients divided into three equal groups of 25 each. The first group received therapy using a stabilizing occlusal splint in combination with TENS therapy, the second group received a repositioning splint and TENS, and the third (control) group received TENS therapy alone. Dynamic observation and outcome assessment were conducted at 1, 3, and 6 months using a comprehensive diagnostic tool, including electromyography (EMG) of the masticatory muscles, computed kinesiography for mandibular movement analysis, T-Scan analysis of occlusal contacts, and magnetic resonance imaging (MRI) of the TMJ. Results. The most pronounced and statistically significant improvements were observed in the group of patients using the repositioning splint. By the third month of treatment, normalization of muscle tone according to EMG data was achieved in 96.0 % of patients in this group (versus 80.0% in the stabilization splint group, p < 0.05), and restoration of correct articular disc position according to MRI data was achieved in 88.0 % (versus 68.0 %, p < 0.05). T-Scan and kinesiography methods confirmed a more physiological distribution of masticatory load and restoration of the normal trajectory of mandibular movements in this group. Conclusion. These data indicate that the combined use of a repositioning occlusal splint in combination with TENS therapy offers a statistically significant advantage over a stabilization splint and monotherapy. This approach has proven highly effective in correcting both functional (normalization of muscle activity and biomechanics) and morphological (disc position) disorders characteristic of TMJ dysfunction.