Application of the Visualization of Treatment Objective (VTO) Analyses in Fabricating Anterior Repositioning Splints

Study Overview
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Brief Summary
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This study conducted a randomized controlled clinical trial to evaluate the effect of the the therapeutic position of the anterior repositioning splint determined by VTO analyse compared with traditional method for the treatment of the Anterior Disk Displacement with Reduction of the Temporomandibular Joint.

Detailed Description
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A randomised clinical trial was conducted with 20 patients diagnosed with ADDWR through RDC/TMD and they were randomly allocated into the group 1(traditional group):the therapeutic position of the ARS were determinded by the minimum protrusive position,which was the traditional method to fabricate the anterior repositioning splints;group2(digitial group): the therapeutic position of the ARS were determinded by the VTO analyse,first,the participants were constructed to take CBCT and MRI scans,the ideal therapeutic position of the ARS were located in which the temporomandibular joint space distribute well and the condylar recapture the disc,the dentist could determine the amount of condylar movement and performed VTO analyse by assessing the CBCT and MRI scans ,then it could easily realize the final condylar movements with the application of the dental articulator. They were followed-up in the baseline,1 month,2 and 3 months after the inserted of the splints using the Craniomandibular Index (CMI) for temporomandibular joint function and PHQ-9,GAD-7 for psychological assessments,the tmj space and disc-condylar angle were measured through the CBCT and MRI scans,before and after ARS therapy.

Official Title
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Application of the Visualization of Treatment Objective (VTO) Analyses in the Treatment of the Temporomandibular Joint Disc Displacement

Conditions
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Temporomandibular Joint Disorders

Intervention / Treatment
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* Procedure: therapeutic position of the anterior repositioning splints


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: anterior disc displacement with reduction (ADDWR) confirmed by magnetic resonance imaging (MRI) Classified as ASA 1 or 2 Willing to participate and sign a written informed consent form. Exclusion Criteria: pregnant women heart pace disorders and epilepsy

Ages Eligible for Study
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Minimum Age: 10 Years
Maximum Age: 30 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: A randomised clinical trial was conducted with 20 patients diagnosed with ADDWR through RDC/TMD and they were randomly allocated into the group 1(traditional group):the therapeutic position of the ARS were determinded by the minimum protrusive position;group2(digitial group): the therapeutic position of the ARS were determinded by the VTO analyse.
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: the therapeutic position of the ARS were determinded by the minimum protrusive position<br>the therapeutic position of the ARS were determinded by the minimum protrusive position,which was the traditional method to fabricate the anterior repositioning splints,the patients were instructed to protrusive the mandible in a therapeutic position in which the click is eliminated. | Procedure: therapeutic position of the anterior repositioning splints<br>* the ADDWR paricipants will be allocated into 2 grounps and treated with anterior repositioning splints determined by traditional and digitial method respectively.<br>|
| Experimental: the therapeutic position of the ARS were determinded by the VTO analyse<br>the therapeutic position of the ARS were determinded by the VTO analyse,first,the participants were constructed to take CBCT and MRI scans,the ideal therapeutic position of the ARS were located in which the temporomandibular joint space distribute well and the condylar recapture the disc,the dentist could determine the amount of condylar movement and performed VTO analyse by assessing the CBCT and MRI scans ,then it could easily realize the final condylar movements with the application of the dental articulator. | Procedure: therapeutic position of the anterior repositioning splints<br>* the ADDWR paricipants will be allocated into 2 grounps and treated with anterior repositioning splints determined by traditional and digitial method respectively.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| temporomandibular joint function | the Craniomandibular Index (CMI) was used to assess the temporomandibular joint function after the inserted of the splints. | up to three months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| psychological assessment the PHQ-9 | the PHQ-9 were used to assess the psychological factors in the baseline,1 month,2 and 3 months after the inserted of the splints. | three months | 
| psychological assessment GAD-7 | GAD-7 were used to assess the psychological factors in the baseline,1 month,2 and 3 months after the inserted of the splints. | three months | 
| disc-condyle angle | the disc-condyle angle were measured through MRI scan | three months | 
| temporomandibular joint space | the temporomandibular joint space were calculated through CBCT scan | three months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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temporomandibular Joint Anterior Disc Displacement, the visualization of treatment objective (VTO), anterior repositioning Splint