| Summary: | 碩士 === 臺北醫學大學 === 牙醫學系 === 93 === Abstract
The pivot splint was developed by Goodwillie for the treatment of temporomandibular disorders (TMDs) more than 100 years ago. According to our clinical experience, such a treatment is more efficient and effective in reducing the pain and disk derangement than traditional stabilization splint. As the patient closes, it is logical that the mandible would be positioned more downward and forward to avoid the pivot. If this occurs, the condyle would be positioned off of the retrodiscal tissues, and the interarticular pressure would be lessened. If the clenching forces are located anterior to the pivot, creating a fulcrum around the second molar and pivoting the condyle downward, away from the fossa. However, no scientific evidence was approved and the mechanism of this therapy was still controversial. Many studies suggested that such an appliance loaded the joint because the pivot was anterior to the force of the elevator muscles; it did not distract the joint only if extraoral force was applied upward on the chin.
The purpose of this study was to clarify the direction and path of condyle displacement from the retruded contact position to the clenched position with pivot splint. Participants were 24 volunteers with natural dentitions and without any TMD symptoms. Maxillary pivot splints were fabricated and the path of the condyle was depicted with wrought wire (0.4 in) attached to resin plate and cemented to mandibular anterior teeth . The direction of the wire was upward as the volunteer clenching, so the condyle was distracted away from the fossa and the biting net force was located anterior to the pivot. The distraction of the mandible would be helpful in treating the patient of joint pain and disc displacement without reduction.
Key words : pivot splint, distraction, temporomandibular disorders
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