Article: Volume 49 Number 7 Page 536 - July/August 2022

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  Dental Update 502: 536-544

TMD:  Temporomandibular Disorders. Part 4: Appliance Therapy

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Abstract: Appliances have been used in the management of temporomandibular disorders (TMD) for many years, and over this time designs have waxed and waned in popularity. The majority of appliance designs have few studies to support their use and what evidence is available, is often of low quality. This article, the fourth in a series of six, reviews the mechanisms of action, evidential support for, and provides advice on when to use commonly used appliance designs.

Clinical relevance: There are a plethora of splint designs in use, but it is essential that the evidence supporting each is understood so that the most appropriate design is used for each individual situation.

Author notes: Martin James, BDS(Hons), MJDF RCS (Eng), FHEA, MPerio RCSEd, Specialty Registrar in Restorative Dentistry, University Dental Hospital of Manchester. Funmi Oluwajana, BDS(Hons), MFDS RCSEd, Specialty Registrar in Restorative Dentistry, University Dental Hospital of Manchester. Emma Foster-Thomas, BDS (Hons), MFDS RCS (Glasg), Academic Clinical Fellow, in Restorative Dentistry, University Dental Hospital of Manchester. Charles Crawford, BDS MSc MFGDP(UK) PGCT&L, Lead Clinician TMD Clinic, University Dental Hospital of Manchester. Emma Foster-Thomas, BDS(Hons), MFDS RCPS(Glasg), Academic Clinical Fellow in Restorative Dentistry, University Dental Hospital of Manchester. Peter Clarke, BDS(Hons), MFDS RCPS(Glasg), M Perio RCSEd, Specialty Registrar in Restorative Dentistry, University Dental Hospital of Manchester. A Johanna Leven, BDS, MFDS RCSEd, FDS (Rest Dent) RCSEd, Consultant and Honorary Senior Lecturer in Restorative Dentistry, University Dental Hospital of Manchester. email: martin.james6@nhs.net

Objective: The reader should be aware of the commonly used appliance designs, how they affect TMD symptoms, in what situations they should be prescribed and how appliance therapy fits into wider TMD management strategies.