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Three-dimensional evaluation of upper pharyngeal airway, hyoid bone, and craniocervical changes following stabilization splint therapy in adult patients with temporomandibular joint disorders and mandibular deviation: A retrospective study - 18/11/23

Doi : 10.1016/j.jormas.2023.101646 
Madiha Mohammed Saleh Ahmed a, b, Yunshan Zhao a, Saba Ahmed Al-hadad a, c, Chunshen Li a, Lu Wang a, Wangqing Hu a, Moutaz Mohammed Saleh Ahmed e, Mazen Musa a, d, Xi Chen a, , Maged S. Alhammadi f
a Department of Stomatology, The First Affiliated Hospital of Xi'an Jiaotong University, College of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, People's Republic of China 
b Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Aden University, Aden, Republic of Yemen 
c Department of Orthodontics and Dentofacial Orthopedics, Faculty of Dentistry, Ibb University, Ibb, Republic of Yemen 
d Department of Orthodontics, Al Tegana Dental Teaching Hospital, University of Science and Technology, Omdurman, Khartoum 11111, Sudan 
e Chengdu University of Traditional Chinese Medicine, International Education College, Chengdu, Sichuan, People's Republic of China 
f Orthodontics and Dentofacial Orthopedics, Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Saudi Arabia 

Corresponding author.

Abstract

Objective

This study aimed primarily to analyze the three-dimensional (3D) changes in the pharyngeal airway (PA), and secondarily, the hyoid bone (HB) and the craniocervical (CC) following stabilization splint (SS) therapy in adult patients with temporomandibular joint disorders (TMD) and mandibular deviation (MD).

Methods

Thirty-five adult patients with TMD and MD, who were treated using SS with a mean age of 25.14 ± 6.11 years, were enrolled in this retrospective clinical study. Pre- and post-therapeutic cone-beam computed tomography (CBCT) scans were analyzed. PA dimension,nasopharyngeal, oropharyngeal, hypopharyngeal, sub-hypopharyngeal, and total pharyngeal airway spaces were measured in surface area, volume, minimum constricted area (MCA) and width, HB position, and CC posture were analyzed three-dimensionally using InVivo 6.0.3 and Dolphin 11.95 software. Wilcoxon rank-sum or Paired t-test was conducted, and P < 0.05 was considered significant.

Results

SS therapy was administered for a period of 9.49 ± 4.02 months. The oropharyngeal airway space showed a significant decrease in sagittal width. The hypopharyngeal surface area, volume, MCA, and sagittal width decreased significantly. In terms of HB, hyoid–mandibular plane (H-MP), retrognathia–third vertebra's most inferior–anterior (RGN-C3ia), and retrognathia–Sella (RGN-S) distances significantly decreased. The Nasion–Sella line and the line that passes through C2ip to the odontoid process posterior tangent (NSL-OPT) angle in CC posture also decreased significantly.

Conclusion

SS therapy in TMD patients with MD mainly results in narrowing of the hypopharyngeal region, no change in HB position and improvement in head posture. These results undoubtedly assist in diagnosis and treatment of clinical conditions.

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Keywords : Temporomandibular joint disorders, Mandibular deviation, Stabilization splints, Pharyngeal airway, Hyoid bone, Craniocervical


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Vol 124 - N° 6S2

Articolo 101646- dicembre 2023 Ritorno al numero
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