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Comprehensive Post Orthognathic Surgery Orthodontics: Complications, Misconceptions, and Management.Oral and Maxillofacial Surgery Clinics... Feb 2020Post orthognathic surgery patient management is critical for high-quality and predictable outcomes. Surgeons and orthodontists must have the knowledge and ability to... (Review)
Review
Post orthognathic surgery patient management is critical for high-quality and predictable outcomes. Surgeons and orthodontists must have the knowledge and ability to implement postsurgical management protocols and strategies to provide the best care and outcomes possible. This article presents basic concepts, philosophies, treatment protocols, risks, and potential complications associated with postsurgical patient management. Postsurgical orthodontic goals are to maximize the occlusal fit and provide predictable means to retain the occlusion. Aggressive orthodontic mechanics may be required to provide the best occlusal fit. Complications can occur, but early recognition of complications and implementation of corrective tactics should minimize adverse outcomes.
Topics: Cephalometry; Humans; Orthodontics; Orthodontics, Corrective; Orthognathic Surgery; Orthognathic Surgical Procedures
PubMed: 31685347
DOI: 10.1016/j.coms.2019.09.003 -
Advanced Biomedical Research 2020Temporomandibular disorder is a multifactorial disease that causes pain in the jaw and face area with nondental origin, which frequently limits talking, chewing, and... (Review)
Review
Temporomandibular disorder is a multifactorial disease that causes pain in the jaw and face area with nondental origin, which frequently limits talking, chewing, and other jaw activities. Various factors such as malocclusion, trauma, stress, parafunctional habits (clenching and bruxing), osteoarthritis, and synovitis play a role in its occurrence, although the etiology of these disorders is little understood. Several treatments are being used to treat these disorders. Ozone therapy has been recently introduced as one of these treatments. Considering that no extensive study has been found in this field so far, this study is aiming to report the studies that have been conducted to determine the efficacy of ozone injection therapy in temporomandibular joint disorders. This report addresses the studies which are conducted clinically, experimentally, and semi-experimentally over the past 10 years (2009-2019). The prepared articles are screened according to the inclusion criteria. In this study, total six related articles are addressed. One study was pre- and postintervention, and five studies were clinical trials. Studies show that although more studies are needed in contrast with occlusal splint, ozone therapy is generally more effective treatment for pain reduction compared to medication.
PubMed: 33816392
DOI: 10.4103/abr.abr_105_20 -
Journal of Orofacial Orthopedics =... May 2024This study aims to evaluate the efficacy of occlusal splint and botulinum toxin (BTX) therapies for improving the pain scores and mouth opening in patients with... (Comparative Study)
Comparative Study
PURPOSE
This study aims to evaluate the efficacy of occlusal splint and botulinum toxin (BTX) therapies for improving the pain scores and mouth opening in patients with temporomandibular disorders (TMD) with sleep bruxism (SB).
MATERIALS AND METHODS
A retrospective cohort study was conducted based on clinical record reviews of patients with TMD symptoms (e.g., temporomandibular joint [TMJ] pain, masticatory muscle pain, TMJ internal derangements, joint sounds, and limited mouth opening) and SB. The patients were divided into two groups: occlusal splint group and BTX group. Maximum unassisted mouth opening (MMO) and pain score on a visual analogue scale (VAS) before treatment and at 1‑, 3‑, and 6‑month follow-up were analyzed to evaluate the clinical outcomes.
RESULTS
A total of 60 patients (49 women and 11 men, mean age 34.63 ± 11.85 years) were enrolled. Each group had 30 patients. The comparisons of the groups at 1 and 3 months after treatment indicated that the BTX group had higher MMO values (P = 0.013 and 0.034, respectively) and lower VAS scores than the occlusal splint group (P = 0.000 and 0.001, respectively). No difference between the two groups was observed 6 months after treatment (P > 0.05).
CONCLUSIONS
Both occlusal splint and BTX treatment methods were successful in treating TMD with SB. BTX provided patients with rapid relief in the early period; therefore, BTX can be recommended as a primary treatment option in patients with greater pain.
Topics: Humans; Occlusal Splints; Female; Male; Temporomandibular Joint Disorders; Adult; Treatment Outcome; Sleep Bruxism; Retrospective Studies; Botulinum Toxins; Pain Measurement; Botulinum Toxins, Type A; Middle Aged; Neuromuscular Agents; Cohort Studies
PubMed: 37843582
DOI: 10.1007/s00056-023-00498-8 -
European Journal of Dentistry Oct 2022Health promotion and disease prevention link intricately with lifestyle habits such as a healthy diet, physical activity, and good sleep quality. Temporomandibular joint...
Health promotion and disease prevention link intricately with lifestyle habits such as a healthy diet, physical activity, and good sleep quality. Temporomandibular joint (TMJ) dysfunction and associated disorders can take away sleep and well-being depending on the form and intensity that affect the individual. A multidisciplinary effort has contributed to significant health advances, improving clinical outcomes concerning TMJ dysfunction. This report presents the case of a 37-year-old Caucasian female physical educator with a good healthy diet with complaints of tooth tightening, constant TMJ and neck pain, and tinnitus. The patient was treated with inferior occlusal splint placement and selective occlusal adjustments based on neuro-occlusal rehabilitation. The patient reported relief of pain symptoms with occlusal and body balance, discontinued analgesic medication, and maintained the occlusal splint to practice sports and sleep due to the perception of improved physical performance and sleep, and quality of life. Based on this report, it is necessary to analyze the causes and define the effects of different disorders to establish their diagnosis and treatment and changing patterns to reestablish functional balance.
PubMed: 35820439
DOI: 10.1055/s-0042-1749365 -
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 -
Clinical Oral Investigations Sep 2022To investigate the two-body wear of occlusal splint materials fabricated from subtractive computer-aided manufacturing (CAM) compared to three-dimensional printing (3DP).
OBJECTIVES
To investigate the two-body wear of occlusal splint materials fabricated from subtractive computer-aided manufacturing (CAM) compared to three-dimensional printing (3DP).
MATERIAL AND METHODS
Forty-eight substrates (n = 12/material) in the design of a mandibular first molar were fabricated using CAM (CAM-TD, Thermeo, pro3dure medical GmbH, Iserlohn, Germany; CAM-CL, CLEARsplint, Astron Dental Corporation, Lake Zurich, USA) and 3DP (3DP-GI, GR22 flex, pro3dure medical GmbH; 3DP-KY, KeySplint soft, Keystone Industries, Gibbstown, USA). The substrates were subjected to mastication simulation (120,000 cycles, 37 °C, 50 N, 1.3 Hz) opposed to enamel antagonists. The two-body wear was measured through matching of the scanned substrates before and after aging using Gaussian best-fit method. The damage patterns were categorized and evaluated based on microscopic examinations. Data was analyzed using Kolmogorov-Smirnov test followed by 1-way analysis of variance (ANOVA). Pearson correlation was calculated between vertical and volumetric material loss. The failure types were analyzed with Chi-test and Ciba Geigy table.
RESULTS
No difference in two-body wear results between all materials was found (p = 0.102). Fatigue substrates showed a perforation for CAM and a fracture for 3DP. No abrasion losses on the antagonists were detected.
CONCLUSIONS
3DP substrates showed no differences in two-body wear compared to CAM ones but are more likely to show a fracture. None of the tested materials caused an abrasion on human teeth structure.
CLINICAL RELEVANCE
While therapies with occlusal splint materials are rising, 3DP offers a promising alternative to CAM in terms of production accuracy and therapeutic success at reduced costs.
Topics: Ceramics; Computer-Aided Design; Dental Enamel; Dental Porcelain; Humans; Materials Testing; Molar; Occlusal Splints; Printing, Three-Dimensional
PubMed: 35612645
DOI: 10.1007/s00784-022-04543-5 -
Australian Dental Journal Dec 2019Obstructive sleep apnoea is a serious medical condition of increasing prevalence that has a multitude of treatment modalities. The aim of this study was to review the... (Review)
Review
BACKGROUND
Obstructive sleep apnoea is a serious medical condition of increasing prevalence that has a multitude of treatment modalities. The aim of this study was to review the results of patients treated with mandibular advancement splints in the Oral and Maxillofacial Surgery Unit of South Australia to inform ongoing practice in this area.
METHODS
The casenotes of patients who received a splint for obstructive sleep apnoea between January 2008 and June 2014 were audited. Data collection included referral and demographic details, sleep study results, splint type and follow-up details.
RESULTS
Three hundred and four patients were identified as having been provided a mandibular advancement splint for obstructive sleep apnoea, of which 82 had diagnostic and splint-in-situ sleep studies available for comparison. It was observed that 27 had clinically significant objective improvement, 40 had no clinically significant change and 15 had clinically worse OSA following MAS therapy. Mean reductions in Apnoea-Hypopnoea Index and Respiratory Disturbance Index were eight events (27%) and 13 events (33%) per hour respectively with treatment.
CONCLUSIONS
Based on this study, mandibular advancement splint therapy is a viable treatment for a subset of patients with obstructive sleep apnoea. Protocol driven, multi-disciplinary care with auditing of results is recommended.
Topics: Humans; Mandibular Advancement; Occlusal Splints; Sleep Apnea, Obstructive; Snoring; South Australia; Splints; Treatment Outcome
PubMed: 31372998
DOI: 10.1111/adj.12712 -
Journal of Oral Rehabilitation Nov 2019The low-cost and reversible treatments concerning disorders of the masticatory muscles represent a vast array of regimens. Common treatments include information,... (Review)
Review
BACKGROUND
The low-cost and reversible treatments concerning disorders of the masticatory muscles represent a vast array of regimens. Common treatments include information, stretching exercises, manual therapy, acrylic splints and cognitive behavioural therapy.
OBJECTIVE
The aim of this study was to evaluate the evidence behind the use of self-exercising programmes and occlusal splints in the treatment of myofascial pain.
METHODS
We conducted a thorough search of five databases, using four cardinal search terms in combination with twelve supporting terms. We also assessed the evidence quality, using GRADEpro software.
RESULTS
The search resulted in 4967 individual studies. 18 studies met the inclusion criteria and were re-evaluated.
CONCLUSION
The selected studies were in favour of a self-care or an occlusal splint treatment of myalgia. However, a GRADE assessment showed that 14 of the 18 selected studies had low or very low evidence quality. Studies also showed weaknesses with regard to nomenclature and reproducibility. Hence, it is our professional opinion that the evidence level for prescribing self-exercises and occlusal splints in the treatment of myalgia is low.
Topics: Evidence-Based Medicine; Exercise Therapy; Facial Pain; Humans; Myalgia; Occlusal Splints; Reproducibility of Results; Treatment Outcome
PubMed: 31286551
DOI: 10.1111/joor.12856 -
Folia Medica Cracoviensia Apr 2023Temporomandibular disorder (TMD) is a disease of multifactorial etiology and a complex of symptoms, related to disorders of the masticatory muscles, temporomandibular... (Review)
Review
Temporomandibular disorder (TMD) is a disease of multifactorial etiology and a complex of symptoms, related to disorders of the masticatory muscles, temporomandibular joints and the surrounding orofacial structures. One of the main problems in the course of TMD disorders is the systematic increase in the tension of the masticatory muscles (masseter muscles, temporalis and medial and lateral pterygoid muscles), what is the cause of many damages and the development of pathological conditions in the stomatognathic system. The article discusses the differences in the structure of the masticatory and skeletal muscles, as well as the different nature and isoforms of myosin, which determines the much faster generation of contraction in the masticatory muscles and consequently easier generation of excessive, harmful tensions in the masticatory muscles. The article describes the causes of increased tension in the masticatory muscles and methods of their relaxation used in the basic and supportive treatment of temporomandibular disorders. The use of occlusal splints, physiotherapeutic procedures and TMD treatment with botulinum toxin type A were characterized. A role of psychological support and the methods used for patients with TMD were emphasized.
Topics: Humans; Temporomandibular Joint Disorders; Masticatory Muscles; Masseter Muscle; Temporomandibular Joint; Occlusal Splints
PubMed: 37406276
DOI: 10.24425/fmc.2023.145429 -
Biomedical Journal Jun 2021Previous computer-generated splints were designed and produced without modification than the traditional occlusal splints, which did not facilitate surgeon's...
BACKGROUND
Previous computer-generated splints were designed and produced without modification than the traditional occlusal splints, which did not facilitate surgeon's intraoperative judgment in the single-splint two-jaw orthognathic surgery. Modifications of the digital occlusal splint can be achieved using computer-aided design and computer-aided manufacturing (CAD/CAM) software. This study reported the design, clinical application and validation of a novel CAD/CAM occlusal splint.
METHODS
The maxillary and mandibular segments were fixed into the final occlusal splint and moved to the planned position according to the 3-dimensional simulation. The composite occlusal splint has 4 orthogonal bars to facilitate intraoperative assessment of the dental and skeletal midline, facial soft tissue midline, occlusal plane, upper tooth show, facial symmetry and facial bone position. To validate the surgical outcome, 5 parameters including pitch, roll and yaw rotations, midline deviation and chin position were measured on the virtual plan and the postoperative cone-beam computed tomography images to quantify the difference.
RESULTS
The results showed no significant differences in the 5 parameters between the simulation and postoperative images. The root-mean-square difference between the conventional splints and CAD/CAM surgical splint ranged from 0.18 to 0.31 mm by superimposition of the two image models. All patients were satisfied with the treatment outcomes. Overall, this novel occlusal splint is ideal for verification of the maxillomandibular position during surgery.
CONCLUSION
The novel composite occlusal splint provided useful and informative check to verify the maxillomandibular complex (MMC) position and facial appearance in single-splint two-jaw orthognathic surgery.
Topics: Computer-Aided Design; Humans; Mandible; Occlusal Splints; Orthognathic Surgery; Orthognathic Surgical Procedures; Splints
PubMed: 34144940
DOI: 10.1016/j.bj.2020.03.004