Use of the TMJ – MBV appliance in the treatment of the initial symptoms of wilkes stage 2 internal derrange ment of the temporomandibular joint – a follow up study

Pranaya Khanal, Siddartha Dixit, Punam Basnet Dixit, R Singh


IntroductionThe Temporomandibular joint (TMJ) is considered a highly complex joint, and TMJ disorders are commonly seen in the general population. Internal derangement, where the disc is not in the normal relationship with the condyle and the fossa, is also on of the commonly seen disorders. Many treatment options are available in the literature , from conservative therapy to physiotherapy and splint therapy to surgical treatment of these disorders.

Materials and methods50 patients , both males and females were examined in the dental opd of Kathmandu Medical College for internal derangement of the TMJ and patients with wilkes stage 2 disorders were selected . all the patients were give the TMJ – MBV appliance for a period of 2 months. All the patients were recalled for follow –up at regular time intervals; day 7, 15, 30, 45 and after 60 days. Consequently, the symptoms pertaining to wilkes stage 2 disorder like pain, clicking, difficulty in mouth opening and mastication were evaluated.

Resultspain arising in the TMJ was seen to decrease from 82% to 4 % of the patients after a period of 45 days of appliance wear. Pain radiating to the adjoining areas was seen to decrease almost immediately, from 15% to 4 % after the use of the appliance. (74%) of the patients had the clicking sound which diminished after 60 days of follow – up to 20 %. All the patients had an increase in the inter – incisal distance, with the mean distance increase 27.30mm to 30.50mm after 2 months.

ConclusionThe short term use of the TMJ-MBV appliance has a beneficial role in the treatment of the initial signs and symptoms of disc derangements like the elimination of pain and clicking sounds , represented by wilkes stage 2 internal derangement of the TMJ. This appliance has been found to prevent the progression of TMD disorders to degenerative joint disorders which are amenable to treatment by surgical methods only. 


Condyle, temporomandibular joint, TMJ-MBV appliance

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