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Acta Otorhinolaryngologica Italica :... Feb 2022This retrospective study aimed to verify the outcomes of stabilising occlusal splint therapy prescribed to 22 patients with unilateral definite Ménière's disease and...
OBJECTIVE
This retrospective study aimed to verify the outcomes of stabilising occlusal splint therapy prescribed to 22 patients with unilateral definite Ménière's disease and comorbid temporomandibular joint disorder.
METHODS
The results of a battery of audiometric and vestibular tests were recorded before and after 6 months of treatment, as well as the scores of disease-specific questionnaires.
RESULTS
The average hearing threshold in the affected ear and the acoustic immittance were unchanged. No spontaneous and positional nystagmus were recorded. Caloric hypo-responsiveness and vestibular myogenic evoked responses did not vary. No changes of stabilometric body sway parameters in eyes opened condition and with optokinetic stimulation delivered to the unaffected labyrinth were observed. A significant reduction was recorded in eyes closed condition and with the optokinetic stimulation toward the affected ear. The Tinnitus Handicap Inventory, the Situational Vertigo Questionnaire and the Numeric Pain Rating Scale scores improved. The number of vertigo attacks was reduced.
CONCLUSIONS
Occlusal splint therapy is a favourable option to reduce aural symptoms of Ménière's disease and comorbid temporomandibular joint disorder, even if its pathophysiological mechanism remains elusive.
Topics: Humans; Meniere Disease; Occlusal Splints; Retrospective Studies; Temporomandibular Joint Disorders; Vestibule, Labyrinth
PubMed: 35129540
DOI: 10.14639/0392-100X-N1641 -
Journal of Oral Rehabilitation Nov 2023To review the materials and fabrications methods of occlusal splints with their advantages and shortcomings and to clarify the indications for each. (Review)
Review
OBJECTIVE
To review the materials and fabrications methods of occlusal splints with their advantages and shortcomings and to clarify the indications for each.
BACKGROUND
Temporomandibular joint disorders (TMDs) encompass a range of conditions affecting the masticatory system. Occlusal splints are currently recognised as a viable option for the management of TMDs when they are adopted in conjunction with additional approaches varying from conservative procedures (counselling, biofeedback, physical therapy, pharmacotherapy) to irreversible and less conservative ones (occlusal adjustments, orthodontics, arthroscopy and surgery). These splints can vary in design, function and material. The components used to fabricate the splints must withstand occlusal forces, be aesthetically pleasing, comfortable and minimally interfering with function and phonetics. Traditional methods for fabricating splints include sprinkle-on, thermoforming and lost wax techniques. However, with the advancement of CAD/CAM technology, additive (3D printing) and subtractive (milling) manufacturing methods expand the range of possibilities by introducing novel solutions for elaborating splints.
METHODS
An electronic search was conducted on PubMed using the following keywords: "occlusal splint", "guard and "materials", and "manufacturing." Thirteen in vitro publications were screened and they consisted of four clinical studies, nine reviews (three of them were systematic reviews), and five case reports.
CONCLUSION
The choice of material is crucial for the success of splint therapy. Factors such as biocompatibility, ease of fabrication, adjustability, cost and patient preference should be considered. Newer materials and techniques are emerging because of advancements in material science and manufacturing techniques. However, it should be noted that most of the evidence is based on in vitro studies with different methodologies, limiting their validity in daily practice.
PubMed: 37392157
DOI: 10.1111/joor.13550 -
Journal of Clinical Orthodontics : JCO Jul 2022
Topics: Humans; Occlusal Splints; Splints; Temporomandibular Joint Disorders; Treatment Outcome
PubMed: 36067126
DOI: No ID Found -
BMC Oral Health Mar 2023This systematic review aims to examine the existing original studies to determine the effectiveness of occlusal splints (OSs) in the management of orofacial myalgia and...
BACKGROUND
This systematic review aims to examine the existing original studies to determine the effectiveness of occlusal splints (OSs) in the management of orofacial myalgia and myofascial pain (MP) in comparison with no treatment or other interventions.
MATERIALS AND METHODS
Based on the inclusion and exclusion criteria of this systematic review, randomized controlled trials were qualified, in which the effectiveness of occlusal splint therapy in the management of muscle pain was examined in comparison with no treatment or other interventions. This systematic review was conducted according to the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020. The authors searched three databases (PubMed, CINAHL (The Cumulative Index to Nursing and Allied Health Literature) and Scopus) for English publications published between January 1, 2010, and June 1, 2022. The last database search was carried out on June 4, 2022. Data were extracted from the included studies and assessed for risk of bias using the revised Cochrane risk-of-bias tool for randomized trials.
RESULTS
Thirteen studies were identified for inclusion in this review. In total, 589 patients were diagnosed with orofacial muscle pain who underwent education and various forms of therapy including different types of OSs, light emitting diode therapy, acupuncture, low-level laser therapy, device-supported sensorimotor training, Kinesio Taping, myofunctional therapy, and physical therapy. All studies included demonstrated a high risk of bias.
CONCLUSIONS
There is insufficient evidence regarding whether OS therapy in the treatment of orofacial myalgia and MP offers an advantage over other forms of interventions or no treatment. Further reliable clinical studies in this area are needed to improve the quality of research, which should be performed with larger groups of blinded respondents and controls.
CLINICAL RELEVANCE
Due to the large-scale nature of orofacial muscle pain, it is assumed that each dental clinician will meet patients with orofacial muscle pain repeatedly in daily practice; hence, the review of the effectiveness of OSs in the management of orofacial myalgia and MP is necessary.
Topics: Humans; Myalgia; Occlusal Splints; Facial Pain
PubMed: 36978070
DOI: 10.1186/s12903-023-02897-0 -
Journal of the Mechanical Behavior of... Feb 2022To investigate the volumetric and vertical loss of occlusal splints manufactured by conventional (heat-cure), subtractive (CAD/CAM) and additive (3D-printing) methods.
OBJECTIVES
To investigate the volumetric and vertical loss of occlusal splints manufactured by conventional (heat-cure), subtractive (CAD/CAM) and additive (3D-printing) methods.
METHODS
Six occlusal splint materials were investigated (n = 126), using three manufacturing methods: heat-cured, CAD/CAM and 3D-printed built-in three different printing angles (0°,45°and 90°). Block-on-ring wear testing was performed with extracted human molars as the antagonist. All samples were tested with an applied force of 49N at 1 Hz and 60RPM in artificial saliva at 37 °C for six and 12 months. Scanning electron microscopy images were analysed to evaluate the wear on the tooth enamel and in the splint material. Volumetric and vertical wear loss were statistically analysed.
RESULTS
The lowest volumetric and vertical loss was observed in CAD-CAM materials (6.44 ± 1.77 mm and 48.3 ± 7.14 μm) with no statistical significance to the heat-cured material (17.22 ± 9.23 mm and 148 ± 121.1 μm) after 12 months (p < 0.172). The mean volumetric loss of 3D printed materials ranged from 0.25 ± 0.15 mm to 0.29 ± 0.1 4mm with no statistical difference, whereas, the differences in vertical loss from 131.63 ± 44.1 μm to 493 ± 79.19 μm were statistically significant (p < 0.001). The highest vertical loss was observed in the KeySplint Soft 3D printed at 90° (385.35 ± 82.37 μm), whereas FreePrint Splint 2.0 with a build angle of 0° had the highest volumetric loss (204.59 ± 25.67 mm).
CONCLUSION
CAD-CAM material had the highest wear resistance followed by heat-cured material.KeySplint Soft and FreePrint Splint 2.0 3D printed materials would be preferred for patients that do not have severe bruxing episodes. No significant wear of human enamel after six and 12 months was observed under SEM for any tested materials.
Topics: Computer-Aided Design; Humans; Materials Testing; Occlusal Splints; Printing, Three-Dimensional; Surface Properties
PubMed: 34998068
DOI: 10.1016/j.jmbbm.2021.105053 -
Oral Surgery, Oral Medicine, Oral... Jan 2023To determine the best disocclusion guidance in occlusal splints (OSs) to manage and treat temporomandibular disorder (TMD) and sleep bruxism (SB). (Review)
Review
OBJECTIVE
To determine the best disocclusion guidance in occlusal splints (OSs) to manage and treat temporomandibular disorder (TMD) and sleep bruxism (SB).
STUDY DESIGN
The research was conducted on 7 major electronic databases and 3 gray literature sources. We included randomized trials, nonrandomized clinical trials, and before-and-after studies. The risk of bias (RoB) was assessed by Joanna Briggs Institute of Critical Appraisal Tools. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to grade the certainty of evidence.
RESULTS
Qualitative synthesis included 16 surveys reporting data from 620 participants. Canine guidance (CG) was widely searched. Bilateral balanced occlusion (BBO) and CG significantly decreased pain levels compared with the placebo splint. Comparing between OS and absence of therapy, only CG was assessed and showed significant improvements on mouth opening, pain, sleep quality, and muscle activity. When compared different guide types among themselves, no significant improvement was founded in any evaluated outcome. Three studies presented high RoB, 7 presented moderate RoB, and 6 presented low RoB.
CONCLUSIONS
It is suggested there is not enough evidence to support that there are any specific kind of guidance responsible for improving evaluated outcomes on TMD and SB.
Topics: Humans; Occlusal Splints; Sleep Bruxism; Temporomandibular Joint Disorders; Splints; Pain
PubMed: 36241594
DOI: 10.1016/j.oooo.2022.07.009 -
BMC Oral Health Sep 2023Temporomandibular joint (TMJ) disc repositioning through open suturing (OSu) is a new disc repositioning method. Its result for adolescents with condylar resorption and... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Temporomandibular joint (TMJ) disc repositioning through open suturing (OSu) is a new disc repositioning method. Its result for adolescents with condylar resorption and dentofacial deformities combined with and without postoperative occlusal splints (POS) has not been well studied.
OBJECTIVE
This study was to evaluate and compare the effects of OSu with and without POS in the treatment of TMJ anterior disc displacement without reduction (ADDwoR) in adolescent skeletal Class II malocclusion.
METHODS
A total of 60 adolescents with bilateral ADDwoR were enrolled in this study. They were randomly allocated into two groups: OSu with and without POS. Magnetic resonance imaging (MRI) and lateral cephalometric radiographs were used to measure changes in condylar height and the degree of skeletal Class II malocclusion from before operation and at 12 months postoperatively. Changes in these indicators were compared within and between the two groups.
RESULTS
After OSu, both groups exhibited significant improvements in condylar height and occlusion at the end of 12 months follow-up (P < 0.05). The group of OSu with POS had significantly more new bone formation (2.83 ± 0.75 mm vs. 1.42 ± 0.81 mm, P < 0.001) and improvement in dentofacial deformity than the group of OSu only (P < 0.05). The new bone height was significantly correlated with POS (P < 0.001), the changes of SNB (P = 0.018), overjet (P = 0.012), and Wits appraisal (P < 0.001).
CONCLUSION
These findings indicated that OSu can effectively stimulate condylar regeneration and improve skeletal Class II malocclusion in adolescents with bilateral ADDwoR. The results are better when combined with POS.
TRIAL REGISTRATION
This trial was prospectively registered on the chictr.org.cn registry with ID: ChiCTR1900021821 on 11/03/2019.
Topics: Adolescent; Humans; Dental Occlusion; Joint Dislocations; Magnetic Resonance Imaging; Malocclusion, Angle Class II; Occlusal Splints; Temporomandibular Joint; Temporomandibular Joint Disc; Temporomandibular Joint Disorders
PubMed: 37759222
DOI: 10.1186/s12903-023-03402-3 -
Journal of Oral and Maxillofacial... May 2019Orthodontic treatment has been transformed by the introduction and overwhelming adoption of clear aligner therapy (CAT). Many patients are demanding esthetic and...
Orthodontic treatment has been transformed by the introduction and overwhelming adoption of clear aligner therapy (CAT). Many patients are demanding esthetic and metal-free treatment alternatives, including those requiring orthognathic surgery (OGS), to correct their dentofacial deformities. The adoption of performing OGS for CAT has been cautious and challenging for many reasons. Intermaxillary fixation, postoperative occlusal control, preoperative decompensation management, and long-term stability need to be tested and assessed. This report presents an accurate 3-dimensional (3D) printed hard acrylic splint specifically for patients without any orthodontic attachment to be used in the positioning and fixation of osteotomized jaws. It is simple to manufacture and its use intraoperatively is efficient, straightforward, and accurate. This report introduces the Clear Aligner Orthognathic Splint for surgery and the steps required for 3D planning with recommendations for perioperative orthodontic support.
Topics: Esthetics, Dental; Humans; Occlusal Splints; Orthodontic Appliances, Removable; Orthognathic Surgical Procedures; Splints
PubMed: 30664865
DOI: 10.1016/j.joms.2018.12.012 -
International Journal of Environmental... Sep 2021The role of the dento-mandibular apparatus and, in particular, occlusion and jaw position, received increased attention during last years. In the present study, we aimed... (Review)
Review
The role of the dento-mandibular apparatus and, in particular, occlusion and jaw position, received increased attention during last years. In the present study, we aimed to systematically review, on the light of the new potential insights, the published literature covering the occlusal splint (OS) applications, and its impact on exercise performance. A structured search was carried out including MEDLINE/PubMed and Scopus databases with additional integration from external sources, between March and June 2021. To meet the inclusion criteria, studies published in the English language, involving humans in vivo, published from 2000 to 2021 and that investigated the role of occlusal splints on athletes' performance were selected. Starting from the 587 identified records, 17 items were finally included for the review. Four main aspects were considered and analyzed: (1) occlusal splint characteristics and occlusion experimental conditions, (2) jump performance, (3) maximal and explosive strength, and (4) exercise technique and biomechanics. The results of the systematic literature analysis depicted a wide heterogenicity in the experimental conditions and suggested the application of the OS as a way to improve athletes' or individuals' oral health, and as a potential tool to optimize marginal aspects of exercise performance.
Topics: Athletes; Exercise; Humans; Mandible; Occlusal Splints
PubMed: 34639640
DOI: 10.3390/ijerph181910338 -
The Journal of Sports Medicine and... Feb 2021The aim of the study was to evaluate how muscular performances, balance and posture were influenced applying Occlusal Splints and Taopatch 8 (Tao Technologies Srls,... (Clinical Trial)
Clinical Trial
BACKGROUND
The aim of the study was to evaluate how muscular performances, balance and posture were influenced applying Occlusal Splints and Taopatch 8 (Tao Technologies Srls, Cittadella, Padua, Italy) devices in athletes.
METHODS
Eighteen athletes, 7 females and 11 males, with an average age of 23.8 years, were included. Two devices were used: 1) a customized soft occlusal splint to be applied to the lower ach; 2) nanotechnological devices based on carbon nanotubules and quantum dots (Taopatch) positioned on C7 and xiphoid process. Four functional tests were performed: surface electromyography (sEMG), kinesiography, the squat jump and counter movement jump and handgrip test. The tests were performed in the following order: at the baseline (no treatments), and after having applied the bite alone, the occlusal splint and Taopatch devices together and the Taopatch devices alone.
RESULTS
The sEMG showed an increased maximum clenching voltage in respect of the baseline for all treatments that included the occlusal splint. The kinesiography showed an improvement of the movements of the occlusal muscles. The squat jump increased the height of 10-14 mm, the best results registered with the bite. The handgrip showed an increased strength, that was higher with the bite and the Taopatch devices used alone (~5 lbs.).
CONCLUSIONS
The use of an occlusal splint and Taopatch devices use alone or in conjunction immediately influenced strength and balance of the occlusal postural muscles.
Topics: Adult; Cross-Over Studies; Electromyography; Female; Hand Strength; Humans; Italy; Male; Movement; Occlusal Splints; Posture; Young Adult
PubMed: 32744040
DOI: 10.23736/S0022-4707.20.11053-3