Treatment of Myogenic Temporomandibular Disorder by Occlusal Splint and Physical Therapy: a Case Report

Diagnostics of a patient suffering from masseter tendomyopathy as well as the 18-month follow-up of Michigan split treatment and kinesiotherapy by Schulte are described. Techniques of manual functional analysis and the diagnostically differential magnetic resonance were used for diagnostics since the patient had pathologic habitual occlusion caused by a previous inadequate splint. However, apart from the physiological disc position, there were only visible subchondral changes in terms of osteoarthritis with preserved contours of cortical bone and without additional clinical symptomatology. Diagnostics and treatment require a multidisciplinary cooperation which will enable treatment success. The goal of initial and palliative treatment is to manage, reduce and remove temporomandibular pain as well as to improve the functioning of the entire stomatognathic system. While there is an agreed gold standard in clinical diagnostics of temporomandibular disorders (clinical examination, manual examination techniques, magnetic resonance), there is no such gold standard for the choice of treatment methods. The pathophysiological and neuromuscular component of the myogenic temporomandibular disorder has not been completely explained. Recent systematic review papers confirm the value of the Michigan splint and physical therapy as successful treatment methods of temporomandibular disorders. However, there is a lack of randomized, comparable research.