Evaluation of digitally fabricated occlusal devices in the treatment of temporomandibular disorders: A pilot study

Abstract

Statement of problem

Digitally fabricated occlusal devices represent a novel approach to treating temporomandibular disorders (TMDs), yet they have not been adequately evaluated.

Purpose

The purpose of this pilot clinical study was to develop a manufacturing process for a digitally fabricated occlusal device, assess its therapeutic effectiveness for various types of TMDs, and examine factors influencing treatment outcomes.

Material and methods

The records of patients with TMDs treated with a digitally fabricated occlusal device from May 2023 to October 2024 were retrospectively analyzed. They were divided into 3 groups based on the diagnosis: anterior disc displacement with reduction (ADDwR), anterior disc displacement without reduction (ADDwoR), or unilateral anterior disc displacement with reduction and unilateral anterior disc displacement without reduction (ADDwR +ADDwoR). Visual analog scale (VAS) scores for pain, diet, mandibular function (MF), and quality of life (QoL) and maximum interincisal opening (MIO) were compared before and at least 8 weeks after treatment. A nonparametric test was used to analyze changes in VAS scores and MIO before and after treatment (α=.05). Effects of sex, age, horizontal or vertical overlap, wearing time, and thickness of the device on the treatment were analyzed using binary logistic regression.

Results

Forty-one patients with a mean ±standard deviation age of 27.95 ±11.04 years and a mean ±standard deviation follow-up of 12.51 ±14.10 weeks were evaluated. Pain, diet, MF, and QoL were significantly improved after treatment with a digitally fabricated occlusal device (P<.05), with effective rates of 80.6%, 73.5%, 74.4%, and 66.7%, respectively. Wearing time and thickness of the device affected the treatment (P<.05), whereas sex, age, and horizontal or vertical overlap did not affect the treatment (P>.05).

Conclusions

Digitally fabricated occlusal devices were found to be effective treatment options for TMDs. Wearing a digitally fabricated occlusal device for 24 hours a day led to improved therapeutic outcomes. A 1- to 2-mm-thick device was found to be more effective than 2- to 3- or ≥3-mm options.