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Sleep Science (Sao Paulo, Brazil) Sep 2023Sleep Bruxism (SB) is a common condition in childhood that can cause multiple consequences such as abnormal tooth wear, tensional headaches, masticatory muscle pain,... (Review)
Review
Sleep Bruxism (SB) is a common condition in childhood that can cause multiple consequences such as abnormal tooth wear, tensional headaches, masticatory muscle pain, or fatigue. The literature reports some interventions, however the treatment for SB in children is not well-established. A systematic review was performed to investigate the effectiveness of the treatments described for SB in children and adolescents: pharmacological and psychological treatments; behavioral guidelines; and dental approaches. Randomized clinical trials comparing different SB treatments with a control group were searched in the electronic databases PubMed, Scopus, Web of Science, Cochrane Library, and VHL until August 04, 2021. Two independent reviewers selected the studies, extracted the data, and assessed the risk of bias. After a two-phase selection process, 07 articles were selected. The methodology of the selected studies was analyzed using the Cochrane Risk of Bias Tool. The criteria used to qualify the studies were based on randomization, allocation, blinding of participants and evaluators, and analysis of results. The signs and symptoms of SB were reduced with pharmacotherapy (hydroxyzine/diazepam) and medicinal extracts ( ), but with occlusal splints and physiotherapy, this improvement was not statistically significant when compared to control groups. Some evidence of the efficacy of pharmacotherapy (hydroxyzine/diazepam) and medicinal extracts ( ) was found. However, this systematic review is not enough to establish a protocol for the treatment of SB. Besides, the individualized management of SB in this population should be considered, emphasizing the management of risk factors.
PubMed: 38196770
DOI: 10.1055/s-0043-1772826 -
Dentistry Journal Aug 2023Data regarding the mechanical properties of three-dimensionally (3D) printed materials for occlusal splint manufacturing are scarce. The aim of the present study was to...
Data regarding the mechanical properties of three-dimensionally (3D) printed materials for occlusal splint manufacturing are scarce. The aim of the present study was to evaluate the flexural strength and surface hardness of modern 3D-printed occlusal splint materials and compare them with two control groups, namely, milled and conventional cold-polymerized occlusal splint materials. A total of 140 rectangular specimens were manufactured for the present study. The specimens were prepared in accordance with the International Organization for Standardization standards (ISO 20795-1:2013). Five 3D-printed (NextDent Ortho Rigid, Dental LT Clear, Dentona Flexisplint, Cosmos Bite Splint, and ProArt Print Splint), one milled (ProArt CAD Splint), and one cold-polymerized (ProBase Cold) occlusal splint materials were used to determine flexural strength and surface hardness values. The three-point flexure test was used for the determination of flexural strength values, while Vickers hardness was measured to determine surface hardness. Ten specimens ( = 10) of each material were tested using these procedures. One-way ANOVA and Tukey's post-hoc test were used to analyze the obtained results (α = 0.05). The values of flexural strength ranged from 46.1 ± 8.2 MPa to 106 ± 8.3 MPa. The Vickers hardness values ranged from 4.9 ± 0.5 VHN to 20.6 ± 1.3 VHN. Significant differences were found among the tested materials ( < 0.0001). The milled and cold-polymerized materials yielded higher values for both flexural strength (only one 3D-printed resin had comparable results to cold-polymerized acrylics) and surface hardness. There are differences in the mechanical properties of the various tested occlusal splint materials. The flexural strength of most of the 3D-printed materials and their surface hardness values are still inferior when compared to the milled or cold-polymerized materials.
PubMed: 37623295
DOI: 10.3390/dj11080199 -
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 -
Brazilian Oral Research 2024Occlusal stabilization splints are the most common treatment for controlling the deleterious effects of sleep bruxism. This study aimed to evaluate the effectiveness of... (Randomized Controlled Trial)
Randomized Controlled Trial
Occlusal stabilization splints are the most common treatment for controlling the deleterious effects of sleep bruxism. This study aimed to evaluate the effectiveness of a low-cost, mixed occlusal splint (MOS) compared to that of a rigid splint. A randomized clinical trial was performed on 43 adults of both sexes with possible sleep bruxism and satisfactory dental conditions. They were divided into rigid occlusal splint (ROS) (n = 23) and MOS (n = 20) groups. Masticatory muscle and temporomandibular joint (TMJ) pain intensity (visual analog scale), quality of life (WHOQOL-BREF), indentations in the oral mucosa, anxiety, and depression (HADS), number of days of splint use, and splint wear were evaluated. All variables were evaluated at baseline (T0), 6 months (T6), and 12 months (T12) after splint installation (T0), and splint wear was evaluated at T6 and T12. Student's t-test, Mann-Whitney U test, non-parametric Friedman's analysis of variance for paired samples and pairwise multiple comparisons, Pearson's chi-square test, two-proportion z-test, non-parametric McNemar's and Cochran's Q, and Wilcoxon tests were used (p < 0.05). In both groups, there was a decrease in TMJ pain and pain intensity over time and improvements in the quality of life scores. At T6, there was a higher rate of splint wear in the MOS group than in the ROS group (p = 0.023). The MOS showed a higher rate of wear than the rigid splint but had similar results for the other variables. Therefore, the use of a mixed splint appears to be effective in controlling the signs and symptoms of sleep bruxism.
Topics: Adult; Female; Male; Humans; Occlusal Splints; Splints; Quality of Life; Reactive Oxygen Species; Sleep Bruxism
PubMed: 38477803
DOI: 10.1590/1807-3107bor-2024.vol38.0017 -
Dental Materials : Official Publication... Oct 2023To evaluate and compare the mechanical properties, water sorption, water solubility, and degree of double bond conversion of three different commercially available...
OBJECTIVE
To evaluate and compare the mechanical properties, water sorption, water solubility, and degree of double bond conversion of three different commercially available three-dimensional (3D) printing resins used for the fabrication of flexible occlusal splints.
METHODS
A digital printer was used to generate specimens from the evaluated splint materials (KeySplint Soft, IMPRIMO LC Splint flex, and V-Print splint comfort). The specimens were equally divided and tested either dry or after water storage at 37 °C for 30 days. A three-point bending test was used to assess flexural strength, elastic modulus, and fracture toughness. A two-body wear test was performed using a dual-axis chewing simulator. Water sorption and water solubility were measured after 30 days. The degree of double bond conversion was determined by FTIR-spectrometry. All data for the evaluated properties were collected and statistically analyzed.
RESULTS
Both material and storage conditions had a significant effect on the flexural strength (P < 0.001), elastic modulus (P < 0.001), fracture toughness (P < 0.001), and wear (P < 0.001). The highest water sorption was noticed with IMPRIMO LC Splint flex (1.9 ± 0.0 %), while V-Print splint comfort displayed the lowest water solubility (0.2 ± 0.0 %). For the degree of conversion, it was statistically non-significant among the different materials (P = 0.087).
SIGNIFICANCE
Different flexible 3D-printed splints available in the market displayed variations in the evaluated properties and clinicians should consider these differences when choosing occlusal device materials. Among the tested flexible splint materials, KeySplint Soft had the greatest flexural strength, elastic modulus, fracture toughness, wear resistance, and degree of conversion. It also showed the lowest water sorption.
Topics: Occlusal Splints; Research Design; Elastic Modulus; Printing, Three-Dimensional; Water
PubMed: 37666693
DOI: 10.1016/j.dental.2023.08.178 -
Polymers Nov 2023Three-dimensional (3D)-printed occlusal splints are becoming more prevalent in the treatment of tooth substance loss due to their fast and cost-effective production. The...
Three-dimensional (3D)-printed occlusal splints are becoming more prevalent in the treatment of tooth substance loss due to their fast and cost-effective production. The purpose of this in vitro study was to investigate whether the mechanical properties (tensile strength-TS, modulus of elasticity in tension-ME, and Vickers hardness-HV) vary between the materials (printed dimethacrylate-based resins: Keyprint KeySplint soft-KEY, Luxaprint Ortho Plus-LUX, V-Print splint-VPR, printed methacrylate-based resins Freeprint splint 2.0-FRE, and milled methacrylate-based material, CLEAR splint-CLE), and the influence of aging processes (extraoral storage conditions and nightly or daily use) was examined. The printed methacrylate-based resins (FRE, LUX, and VPR) had much higher TS (43.7-48.5 MPa compared to 12.3-13.3 MPa), higher ME (2.01-2.37 GPa compared to 0.43-0.72 GPa), and higher HV (11.8-15.0 HV compared to 3.3-3.5 HV) than both of the methacrylate-based resins (KEY and CLE) after the production process. Although the TS, ME, and HV of the printed dimethacrylate resins (FRE, LUX, and VPR) decreased significantly under humid conditions with possibly elevated temperatures (thermocycling as well as 37 °C), these mechanical properties were significantly higher than both methacrylate-based resins (KEY and CLE). Therefore, printed dimethacrylate resins should be used rather than methacrylate-based resins for high expected masticatory forces, low wall thicknesses, or very long wearing times (≥6 months).
PubMed: 38232021
DOI: 10.3390/polym15234574 -
Medicine Nov 2023Intentional replantation and dental autotransplantation are 2 similar techniques both involving atraumatic tooth extraction, visualization of the root, and replantation....
BACKGROUND
Intentional replantation and dental autotransplantation are 2 similar techniques both involving atraumatic tooth extraction, visualization of the root, and replantation. They are considered as the last resort for unsalvageable teeth. The author aims to describe 2 mandibular posterior teeth with serious periapical lesions which are resolved by intentional replantation and dental autotransplantation, respectively.
CASE SUMMARY
In case 1, a 45-year-old male patient received root canal treatment because of a cracked mandible right first molar with periapical lesions. An endodontic file was separated in the apical third of the mesiolingual root canal. After conventional canal filling of the other root canals, the molar was atraumatically extracted. The separated instrument was removed, the mesiolingual root received a retrograde filling and the molar was replanted. At the 3-month follow up, the patient was asymptomatic and the X-ray picture showed no detectable root resorption and ankylosis. In case 2, a 29-year-old woman reported discomfort during occlusal loading after a root canal treatment and a coronal restoration of the mandibular right first molar. Radiographs showed a low-density shadow in the mesial apical and in the root furcation area of the mandibular first molar so the patient was diagnosed as chronic periapical periodontitis. After the removal of the affected tooth, the extraction socket was thoroughly debrided and irrigated. The intact mandibular right third molar with similar dimensions was extracted by minimally invasive procedure and transplanted. The donor tooth was fixed by a fiber-splint for 1 month and a root canal treatment was performed 2 weeks after surgery. After 1 year, clinical and radiographical examination revealed functional and periodontal healing.
CONCLUSIONS
These 2 reports present the successful management of intentional replantation and dental autotransplantation. Both procedures are recommended after nonsurgical endodontic treatment, especially when apical microsurgery is not an option, for example because of difficult accessibility or patient preference.
Topics: Male; Female; Humans; Adult; Middle Aged; Tooth Replantation; Transplantation, Autologous; Molar; Tooth Root; Root Canal Therapy; Mandible
PubMed: 37986277
DOI: 10.1097/MD.0000000000035822 -
BMC Oral Health Jan 2024Sleep bruxism is a prevalent condition in dentistry practice, characterized by involuntary grinding or clenching of the teeth during sleep. Several therapies, including...
BACKGROUND
Sleep bruxism is a prevalent condition in dentistry practice, characterized by involuntary grinding or clenching of the teeth during sleep. Several therapies, including occlusal splints, have been used to manage sleep bruxism and temporomandibular disorders, including occlusal splints. This study aimed to compare the effectiveness of different occlusal splints in managing sleep bruxism.
METHODS
The PICO framework encompasses the characterization of the population, intervention, comparison, and pertinent outcomes. A comprehensive and systematic literature review was conducted on PubMed, Scopus, and Google Scholar to identify grey literature. The search specifically targeted scientific studies published before September 20, 2023. The Cochrane Collaboration Risk of Bias Tool assessed the accuracy of the included Randomized Control Trials (RCTs). The modified Newcastle-Ottawa Scale assessed non-randomized studies. Data were systematically extracted, synthesized, and reported thematically.
RESULTS
Out of the total of 808 articles that were evaluated, only 15 articles were found to meet the specified inclusion criteria. Adjustable splints, such as full-occlusion biofeedback splints, were more effective in reducing sleep bruxism episodes, improving patient-reported symptoms, and enhancing overall well-being. The impact of different occlusal sprints on electromyographic activity varies, and potential adverse effects should be considered individually.
CONCLUSIONS
This review provides valuable insights into the effectiveness of occlusal splints in managing sleep bruxism. The results of this study indicate that occlusal splint therapy is a viable treatment approach for sleep bruxism.
Topics: Humans; Occlusal Splints; Sleep Bruxism; Sleep
PubMed: 38182999
DOI: 10.1186/s12903-023-03782-6 -
Medicine and Pharmacy Reports Jan 2024Bruxism is associated with a variety of factors, some of which are oral (occlusion, joint, face shape) while others are of a systemic nature (respiratory, cardiac,...
BACKGROUND AND AIMS
Bruxism is associated with a variety of factors, some of which are oral (occlusion, joint, face shape) while others are of a systemic nature (respiratory, cardiac, neurotransmitters, stress). The relationship between bruxism and occlusion has received great attention, but it still has a lot of ambiguity. This study aimed at investigating the parameters that may affect bruxism: dental interferences or premature contacts, vicious habits, temporomandibular joint (TMJ) pain, TMJ noises, TMJ morning fatigue, snoring, obstructive sleep apnea, which may occur before bruxism, or because of chronic parafunction.
METHODS
We conducted an observational, analytical case-control study to determine the association between bruxism and oral cavity factors as well as general factors. Participants were chosen from a group of middle-aged Romanian population. An online questionnaire was used for data collection. A total of one hundred subjects were included in the sample. Fifty cases with bruxism were chosen as a study group, and another fifty persons of similar ages were chosen as a control group. Statistical analysis was performed using the MedCalc version 20.110 software.
RESULTS
The study comprised subjects between 18 and 42 years old. The most prevalent age range was between 20-25 years. The female-male ratio was almost similar; 62% of the participants had sleep bruxism, 10% had awake bruxism and 28% had a combined form. The arithmetic means of the daily stress levels for both research groups' scores were 3.0 for the bruxism group and 3.24 for the control group, while the work stress was 3.04 for the bruxism group and 3.41 for the control group. Dental interferences or premature contacts, vicious habits, TMJ pain, TMJ noises, TMJ morning fatigue, snoring, and obstructive sleep apnea were evaluated. The majority of subjects received an oral splint (n=26).
CONCLUSIONS
Bruxism was associated with stress, occlusal parameters (premature contacts and occlusion interferences), and joint pathologies. Bruxism was not found to be positively correlated with obstructive sleep apnea syndrome. There was a moderately significant association between bruxism and snoring. There was no evidence of an association between bruxism and vicious habits, dental aesthetics, or obstructive sleep apnea. Treatment significantly improved the quality of life, the masticatory and joint functions.
PubMed: 38344337
DOI: 10.15386/mpr-2548 -
International Dental Journal Jun 2024The aim of this superiority trial was to investigate the clinical outcomes of arthrocentesis as an early treatment supported by use of an occlusal splint vs use of an...
OBJECTIVES
The aim of this superiority trial was to investigate the clinical outcomes of arthrocentesis as an early treatment supported by use of an occlusal splint vs use of an occlusal splint only in the management of temporomandibular joint (TMJ) arthralgia.
METHODS
Ninety-five adults presenting with TMJ arthralgia were recruited into the study and randomised into 2 groups: Group 1 received arthrocentesis as an early treatment supported by use of an occlusal splint, whereas group 2 received treatment with an occlusal splint only. Seventy-four patients (group 1: n = 37; group 2: n = 37) completed the 1-year follow-up schedule and were included in the final analysis. Reduction of pain intensity measured by a numeric rating scale and increase in mouth opening distance (unassisted maximal, assisted maximal, and pain-free) was seen in both treatment groups.
RESULTS
In group 1, pain intensity significantly decreased at 6 weeks and all subsequent time points compared with group 2. In terms of mouth opening distance, a significant improvement was observed in both groups during the course of treatment, but statistical significance was not seen between the 2 treatment groups.
CONCLUSIONS
Early arthrocentesis supported by use of an occlusal splint is superior to use of an occlusal splint alone in the treatment of TMJ arthralgia. Arthrocentesis with occlusal splint support could be discussed as first-line treatment for arthralgia of the TMJ, which may co-occur with various painful and nonpainful conditions of TMJ disorders.
PubMed: 38851933
DOI: 10.1016/j.identj.2024.04.015