Sixty-three patients with an arthrographic diagnosis of disk displacement with reduction were randomly assigned to three treatment groups: (I)
onlays to maintain disk repositioning, (II) flat
occlusal splint, or (III) untreated controls. Guidance for construction of the disk-repositioning
onlays was established during arthrography to obtain a recaptured disk position relative to the condyle. The
onlays were cemented to the teeth and maintained the new intercuspal position anteriorly and inferiorly. The flat
occlusal splint was used at night only and was adjusted to maintain a maximal occlusal contact in
centric relation and centric occlusion. Clinical examinations were performed before and after 6 months of treatment. The disk-repositioning
onlays improved joint function and reduced joint and
muscle pain when compared with the flat
occlusal splint and with nontreatment. The signs and symptoms in the flat
occlusal splint group were no different from those in the control group. It is concluded that disk-repositioning
onlays are effective in reducing
pain and dysfunction associated with disk displacement with reduction in patients in whom the disk can be maintained in a normal relationship to the condyle with the aid of such
onlays. The symptoms, however, returned when the
onlays were removed after 6 months; this raises the question of whether a permanent change in the intercuspal position is necessary for long-term success.