A randomized clinical trial was performed to evaluate the efficacy of three treatment options, including anterior positioning
splint therapy, physical therapy, and
physical therapy in addition to
splint therapy, in terms of treatment outcome, in patients with painful temporomandibular joint clicking. Sixty patients suffering from
acute pain and dysfunction were divided randomly into three treatment groups. Twenty patients underwent anterior positioning
splint therapy (group I), 20 patients received solely
physical therapy (group II), and 20 subjects received physical treatment in addition to splinting (group III). All patients were examined before and after the treatment using a visual analogue scale (VAS) and digital palpation of joint sounds. The data were analyzed using the Kruskal-Wallis, one-way ANOVA and Tukey tests at a significance level of P < 0.05. In comparison with the baseline, subjective
pain was decreased significantly (P < 0.05) in all three groups. A significant difference was observed between groups I and II (P <0.05), whereas no significant difference was detected between groups II and III. Six patients in group III did not continue the treatment after
physical therapy. The numbers of
pain-free patients were 12 in group I, 5 in group II and 9 in group III. We observed a reduction in the frequency of joint sounds across the entire sample (P < 0.05). Anterior positioning
splint therapy appears to be the best treatment method for reduction of
pain and joint sounds in patients with TMD, compared with the other two methods studied.