Q-1:
If a placebo splint resolves symptoms of TMD, as proved by some studies, and therapeutic effect is also achieved with splints that are not in centric relation, what is the clinical significance in finding the exact position of condyles within the joint?
Q-2:
If the position of the joint changes during a splint-wearing period, it doesn’t mean that this position will stay. It is logical that during splint wearing period you have a changed position of the lower jaw and you will probably observe a changed position of the joints. However, will that change in a position be permanent if a patient stops wearing a splint? Also, the real question is – if the joint position goes back to its previous state and the patient has no symptoms, is it possible that that changed position is not really the reason that patient’s symptoms resolved?
Sir, in my openion, splint causes deprogramming of muscles, as the occlusion of pt is in MIP, which does not coincide with CR of pt, after wearing splint, deprogrammin and reprogramming of muscles occur, while when pt is not wearing splint cr co position is not maintained, so selective grinding may help in solving TMD and if after wearing splint TMD issue is resolved, means no occusal correction is needed then there may be some issue with muscles only , or it may be not TMD it can be the symptoms of MPDS.
These questions seem misdirected. TMD is a group of variable musculoskeletal conditions that have been shown more times than not to insufficiently respond to the usage of oral splints. Experts have studied, re-studied, reviewed, and re-reviewed the usage of splints for decades without any reasonably good evidence that they work well for TMD. Future research on TMD should move away from splints.
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