Assessment of anterior positioning splint in conjunction with lateral pterygoid BTX injection to treat TMJ disc displacement with reduction — a preliminary report
	    		
		   		
		   			
		   		
	    	
    	 
    	10.1186/s40902-021-00317-3
   		
        
        	
        	
        	
        		- Author:
	        		
		        		
		        		
			        		Maram TAEMA
			        		
			        		
			        		
			        			1
			        			
			        		
			        		
			        		
			        		
			        		;
		        		
		        		
		        		
			        		Nouran Abdel NABI
			        		
			        		;
		        		
		        		
		        		
			        		Samira IBRAHIM
			        		
			        		;
		        		
		        		
		        		
			        		Heba Ahmed KAMAL
			        		
			        		;
		        		
		        		
		        		
			        		Aala’a EMARA
			        		
			        		
		        		
		        		
		        		
		        		
		        			
			        		
			        		Author Information
			        		
		        		
		        		
			        		
			        		
			        			1. Faculty of Dentistry, Department of Prosthoontics, Cairo University, Cairo, Egypt.
			        		
		        		
	        		
        		 
        	
        	
        	
        		- Publication Type:R E S E A R C H
 
        	
        	
            
            
            	- From:Maxillofacial Plastic and Reconstructive Surgery
	            		
	            		 2021;43(1):33-
	            	
            	
 
            
            
            	- CountryRepublic of Korea
 
            
            
            	- Language:English
 
            
            
            	- 
		        	Abstract:
			       	
			       		
				        
				        	 Objective:Treatment of temporomandibular disc displacement with reduction is controversial. This study assesses the use of an anterior positioning splint with botulinum toxin in the lateral pterygoid muscle (BTX) for such cases. 
				        	
				        
				        	Methods:Twelve joints were included; groups I and II received BTX injection while group II also received an anterior positioning splint. Pain scores and clicking status were recorded at regular intervals then a postoperative MRI was done after 4 months. 
				        	
				        
				        	Results:Clinical improvement was noted in both groups. Mean pain scores dropped significantly and clicks in the twelve joints disappeared in 83% of group I and 33% of group II. MRIs showed significant disc position improvement with the higher mean change (1.33 ± 0.76) in group I. Group I showed better improvement of discal position and only one joint regained a click. Patients of group II reported discomfort from the splint which may have caused psychological distress and so worst pain scores. 
				        	
				        
				        	Conclusions:Group I showed slightly better results but the cost of BTX injections and the complications of the splint should be kept in mind and the decision of treatment selection made according to each condition.