Accuracy of Digital Mandibular Repositioning in Occlusal Reconstruction for Patients With Disc Displacement

Summary

This study evaluates a new, individualized treatment for adolescents with temporomandibular joint disorders (TMD) caused by bilateral, reducible disc displacement. Participants will undergo clinical and imaging examinations, including cone-beam CT (CBCT), MRI, and intraoral digital scanning to create three-dimensional models of the teeth and jaw. Based on these data, the study team will design and fabricate a personalized repositioning digital occlusal splint for each participant. Patients will be instructed on how to wear the splint and will return for regular follow-up visits to monitor symptoms and adjust the splint as needed. The study aims to improve pain, chewing function, and overall quality of life. All research-related imaging, digital scans, splint fabrication, and follow-up visits will be provided at no cost to participants. Possible risks include temporary discomfort or pressure when first wearing the splint, and the possibility that symptoms may not improve as expected. Participant safety, privacy, and data confidentiality will be strictly protected, and participants may withdraw from the study at any time without affecting their future medical care.

Conditions

• Temporomandibular Joint Disc Displacement

Interventions

DEVICE

Clinical Clicking Elimination Repositioning Splint

A custom-fabricated hard acrylic repositioning splint based on manual intraoral mandibular positioning. The splint is created by: 1. Clinically identifying the optimal jaw position through clicking elimination technique 2. Taking alginate impressions of maxillary and mandibular arches 3. Pouring stone models and manually adjusting mandibular model to the determined position 4. Fabricating a hard acrylic splint with 1-2 mm occlusal clearance 5. Finishing and polishing the splint Patients wear the splint 24 hours daily (except during meals) for 3 months, with adjustments at 2 weeks, 1 month, 2 months, and 3 months.

DEVICE

Adjustable Articulator Repositioning Splint

A custom-fabricated hard acrylic repositioning splint using adjustable articulator (Artex CR) methodology: 1. Performing mechanical facebow transfer 2. Recording condylar guidance parameters in protrusive and lateral excursions 3. Analyzing CBCT joint space measurements and MRI disc displacement data 4. Mounting study models on Artex CR articulator with precise condylar settings 5. Manually adjusting splint to achieve optimal mandibular position 6. Fabricating hard acrylic splint with 1-2 mm occlusal clearance Patients wear the splint 24 hours daily (except during meals) for 3 months, with adjustments at 2 weeks, 1 month, 2 months, and 3 months.

DEVICE

CAD-Designed Anatomical Repositioning Splint

A digitally designed and 3D-printed repositioning splint using advanced digital workflow: 1. Performing intraoral digital scanning (iTero Element) 2. Acquiring CBCT scan (I-CAT FLX) 3. Importing MRI disc displacement data 4. Using CAD software (Exocad) to: * Overlay intraoral scan with CBCT 3D model * Reference MRI disc reduction phase * Calculate optimal joint space ratios 5. Digitally designing splint with precise mandibular positioning 6. Fabricating hard acrylic splint with 1-2 mm occlusal clearance Patients wear the splint 24 hours daily (except during meals) for 3 months, with adjustments at 2 weeks, 1 month, 2 months, and 3 months.

DEVICE

Electronic Jaw Tracking Repositioning Splint

A digitally designed repositioning splint using electronic jaw motion tracking: 1. Performing 3D jaw motion tracking (Zebris JMA system) 2. Capturing mandibular movement trajectories 3. Identifying "figure-8" pattern crossover points indicating disc displacement 4. Integrating dynamic MRI data 5. Analyzing optimal joint space parameters 6. Using CAD software to design precise mandibular positioning splint 7. Fabricating hard acrylic splint with 1-2 mm occlusal clearance Patients wear the splint 24 hours daily (except during meals) for 3 months, with adjustments at 2 weeks, 1 month, 2 months, and 3 months.

Sponsors & Collaborators

• Fujian Medical University

  lead OTHER

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Model

PARALLEL

Eligibility

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2025-06-20

Primary Completion

2025-12-20

Completion

2025-12-20

Countries

• China

Study Locations