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Received Sep 4, 2017; Accepted Jan 29, 2018
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1. Introduction
Intra-articular temporomandibular disorders present as various pathological conditions, often concerning derangements of the condyle-disc complex [1, 2]. They occur because the physiological relationship between the articular disc and the condyle head changes. According to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), we can distinguish four basic types of articular disc displacements: disc displacement with reduction, disc displacement with reduction with intermittent locking, disc displacement without reduction with limited opening, and disc displacement without reduction without limited opening [3].
Many studies confirm that disc displacement with reduction (DDwR) is the most prevalent derangement of the condyle-disc complex [4–6]. The DC/TMD defines DDwR as an intracapsular biomechanical disorder when, in closed mouth position, the disc is in an anterior position relative to the condylar head, and the disc reduces upon opening of the mouth (medial and lateral displacement of the disc may also be present; clicking, popping, or snapping noises may occur with disc reduction) [3]. DDwR could be the result of masticatory muscle contracture. Acoustic symptoms such as clicking, popping, and snapping are evidence of disc displacement with reduction. Clicking occurs when the condylar head of the mandible skips the rear edge of the displaced articular disc during mouth opening and/or closing. Afterwards, the disc does not return to the correct position in relation to the condyle when the mandible is again, upon closure, in the central position. Clicking may occur in the initial, middle, and final phase of the mandible opening movement. Different studies have reported that pain is a comorbid symptom of temporomandibular joint (TMJ) disc displacement [7, 8]. When the disc is anteriorly displaced, the ligaments of the rear disc are elongated, stretched, and damaged, and the bilaminar zone is compressed; and thus, pain can be generated. Sometimes acoustic symptoms are accompanied by pain located in the area of the temporomandibular joints and surrounding tissues, intensifying when the patient opens their mouth and chews food. Over the years, many studies have confirmed the efficacy of anterior repositioning splints (ARS) for the management of...