Effect of mandibular advancement device on symptoms of disc displacement with reduction

Abstract

Purpose: The purpose of this study was to confirm the effect of Mandibular Advancement Device for improvement on snoring patient who has symptoms of Disc Displacement with Reduction. Subjects and methods: Among the patients who received Mandibular Advancement Device treatment to improve snoring, sampling 34 patients who reported joint sound or intermittent locking in the first visit and made subsequent visit, were included. Diagnosis of patients was performed based on Diagnostic criteria for temporomandibular disorders (DC/TMD), and subjective symptoms and clinical signs were evaluated. Results: 29.4% (10/34) of patients stated that the joint sound was completely lost and 61.8% (21/34) of patients reported that the joint sound decreased, so total of 91.2% (31/34) had a positive response. Intermittent locking, which was repeated after waking up or during daytime, completely disappeared in 90% (27/30) and 6.7% (2/30) reported that it occurred occasionally during daytime, but did not repeat after waking up. A total of 96.7% (29/30) showed improvement. For joint pain (Arthralgia), 85% (17/20) of patients who reported pain before wearing the device said that the pain disappeared. In the case of snoring, total 70.6% (24/34) of patients shown positive responses. 55.9% (19/34) reported a decrease in snoring, and 14.7% (5/34) reported that it was completely stopped. Conclusion: Through this study, it was confirmed that using the Mandibular Advancement Device was effective in symptoms of Disc Displacement with Reduction. Additionally in certain cases, it was confirmed that usage of the Mandibular Advancement Device is more effective than using the Anterior Repositioning Splint. It is considered that a further study accompanied by Magnetic Resonance Image and long-term study is needed.

목적: 코골이 개선을 위해 하악전진장치를 착용한 환자 중 정복성 관절원판변위 증상이 개선된 환자들에 대해 그 효과를 확인하고자 하였다. 대상 및 방법: 코골이 개선을 위해 하악 전진장치 치료를 받은 환자 중 처음 내원 기록에 관절음 또는 간헐적 과두걸림을 보고했고 장치 착용 후 1회 이상 다시 내원한 34명이 최종적으로 본 연구의 대상이 되었다. 이들에 대한 진단은 Diagnostic criteria for temporomandibular disorders (DC/TMD)를 기준으로 시행했으며 주관적 증상이나 임상검사의 징후를 평가하였다. 결과: 소리가 줄어들었다고 보고한 환자가 61.8%(21/34), 완전히 소실됐다고 말한 경우가 29.4%(10/34)로 91.2%(31/34)에서 긍정적인 반응을 보였다. 아침에 일어났을 때나 일상생활에서 반복되던 간헐적 과두걸림은 90%(27/30)에서 완전 소실을 보였으며 기상 시에는 해소되었으나 일상생활에서 가끔 걸렸다고 보고한 환자가 6.7%(2/30)로 96.7%(29/30)에서 개선을 보였다. 통증의 경우 장치 착용 전 통증을 보고한 20여 명 중 85%(17/20)의 환자가 통증이 없어졌다고 했다. 코골이는 줄어들었다고 보고한 환자가 55.9%(19/34), 완전히 소실됐다고 말한 경우가 14.7%(5/34)로 전체 환자 중 70.6%(24/34)에서 긍정적인 반응을 보였다. 결론: 본 연구를 통해 하악전진장치를 이용한 측두하악장애 치료가 효과가 있음을 확인하였고 경우에 따라서는 전방재위치교합장치보다 더 안정적인 효과를 낼 수 있음을 확인하였다. 자기공명영상검사를 동반한 연구와 보다 장기적인 연구가 필요할 것으로 사료된다.