1 International Journal of Contemporary Dental and Medical Reviews (2020), Article ID 010520, 9 Pages REVIEW ARTICLE Aesthetic bite for the management of temporomandibular disorders: A case series review Giacomo Derchi 1 , Vincenzo Marchio 1 , Letizia Bolognesi 2 , Elisabetta Carli 1 , Maria Rita Giuca 1 , Mutlu Özcan 3 , Mario Bosco 4 1 Department of Surgical, Unit of Stomatology and Oral Surgery, Medical, Molecular and Critical Needs Pathologies, University of Pisa, Pisa, Tuscany, Italy, 2 Department of Clinical, Surgical, Unit of Orthodontics and Paediatric Dentistry, Section of Dentistry, Diagnostic and Paediatric Sciences, University of Pavia, Pavia, Lombardy, Italy, 3 Dental Materials Unit, Center for Dental and Oral Medicine, Clinic for Fixed and Removable Prosthodontics and Dental Materials Science, University of Zurich, Zurich, Switzerland, 4 Department of Dentistry, University of Pavia, Pavia, Lombardy, Italy Abstract Background: Oral appliances (OA) are the most widely used treatment approach for temporomandibular disorders (TMDs): They are designed to relieve or prevent degenerative forces on the joint, the articular disk, and dentition. Classical OAs, however, are cumbersome and esthetically unpleasing: A more esthetic and functional appliance might improve treatment efcacy and shorten treatment time. Aim: The aim of this case series is to introduce an esthetical device for the management of TMD. Methodology: Three adults between 43 and 60 years old with a diagnosis of intra- articular TMD were included and were instructed to apply the device throughout the day and night. The patients were recruited at the same private dental clinic and each one signed an informed consent for both treatment and inclusion in the study. We evaluated and compared four clinical parameters (mandibular excursion, mandibular opening pattern, muscular and articular pain, and TMJ noises) between time 0 (T0) and 1, 2, 3, 6, and 12 months of using the device following the protocol of diagnostic criteria for temporomandibular joint disorders (DC/TMD). A magnetic resonance imaging exam was conducted to investigate tissue changes between T0 and 3 and 12 months of therapy. Conclusions: For all four parameters, we observed considerable improvements in all patients, who noticed the positive efects of the therapy themselves. The results suggest that this esthetic device was an efective treatment to manage TMD in the described cases, also increasing patients’ quality of life. However, studies on a larger scale are required to prove the efectiveness of this device. Clinical Signifcance: This case series aims to highlight the potentiality of an esthetic device used for the management of TMDs. This is because a more esthetically pleasant and comfortable device increases the time of usage, thus improving the positive efects of the device on the TMD. Keywords: Dental esthetics, dental occlusion, dentistry, orthodontic appliances, temporomandibular joint disorders, temporomandibular joint Correspondence: Dr. Vincenzo Marchio, Unit of Stomatology and Oral Surgery, Department of Surgical, Medical, Molecular and Critical Needs Pathologies, University of Pisa, Pisa, Tuscany, Italy. Phone: +39-3338152172. E-mail: marchio.vincenzo@hotmail.it Received 03 April 2020; Accepted 08 May 2020 doi: 10.15713/ins.ijcdmr.145 How to cite the article: Derchi G, Marchio V, Bolognesi L, Carli E, Giuca MR, Özcan M, Bosco M. Aesthetic bite for the management of temporomandibular disorders: A case series review. Int J Contemp Dent Med Rev, vol.2020, Article ID: 010520, 2020. doi: 10.15713/ins.ijcdmr.145 Introduction Temporomandibular disorders (TMDs) are a heterogeneous group of diagnoses afecting the temporomandibular joint (TMJ) and the surrounding tissues. [1] TMDs are a Signifcant Public Health Issue Epidemiological studies show that approximately 33% of the population has at least one characteristic symptom and 56% have a clinical sign. [2,3] Overall 3.6–7% of the population has TMD with sufcient severity to cause them to seek treatment. [4] TMD is a prevalent disorder most commonly observed in individuals between the ages of 20 years and 40 years and the number of afected people also is increasing, perhaps due to the infuence of mental tension in today’s society. [5] The diagnosis and evaluation of TMDs must follow a standardized protocol. The latest guidelines on this topic were published in 2014: The diagnostic criteria for TMDs (DC/ TMD) [6] derive from the previous research diagnostic criteria for TMDs (RDC/TMD), [7] which allowed the standardization and reproducibility of research in the most common forms of TMD. This classifcation system is based on a biaxial model which includes an evaluation of axis 1 and axis 2. Axis 1 allows