Anterior repositioning splint in the treatment of temporomandibular joints with reciprocal clicking: comparison with a flat occlusal splint and an untreated control group.

The anterior repositioning splint is widely used to treat temporomandibular joints with reciprocal clicking. This treatment was compared to a flat occlusal splint and to an untreated control group. The anterior repositioning splint decreased joint pain at rest, during chewing, and during protrusion. Reciprocal clicking was eliminated and palpatory tenderness of the joint and muscles was reduced. This favorable effect was of short duration. The majority of the patients reported pain and clicking and demonstrated tenderness following removal of the splint after 6 weeks' treatment. The flat occlusal splint decreased joint tenderness but did not affect clicking or muscle tenderness. In the control group the clicking remained and the frequency of muscle tenderness increased. The results indicate that temporomandibular joints with reciprocal clicking can be successfully treated by positioning the mandible anteriorly. Since the symptoms returned when the splint was removed a more permanent change of mandibular position seems necessary.