Brain Metabolism in Pre-frontal Cortex and Insula Areas in Patients With Occlusal Splint for Temporomandibular Muscle Disorders

Background : There is a relationship between anxiety/depression and the development of disorders in the temporomandibular joint (TMJ), but it is unknown whether treatment for these conditions could have any effect on emotional symptoms. The aim of the present study was to compare brain metabolism in the prefrontal cortex and insula before and after occlusal splint placement in patients with TMJ muscle disorders with anxiety and/or depression. Methods: An experimental study evaluated 23 patients with anxiety and/or depression confirmed by the Hospital Anxiety and Depression Scale (HADS) questionnaire and with TMJ muscle disorders diagnosed by means of clinical examination and the Research Diagnostic Criteria for Temporomandibular Disorders questionnaire. (RDC/TMD), an occlusal splint was then made for condylar decompression 2 mm greater than the mandibular rest space, as confirmed by panoramic radiography before and after the placement of the occlusal splint. Brain metabolism in response to a positive or negative stimulus was evaluated by functional magnetic resonance imaging (fMRI), both with and without occlusal splints. Results: In both the prefrontal cortex and insula, a statistically significant difference (p <0.001 Wilcoxon test) was found between the stimulus reading without a splint and the stimulus reading with an occlusal splint. Conclusion: There was a significant difference in brain metabolism in both the prefrontal cortex and insula area, either with positive or negative stimulation before and after occlusal splint placement, between patients with TMJ muscle disorders.