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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 -
Journal of Indian Prosthodontic Society 2021Contradicting evidence regarding the effects of occlusal splint therapy in the management of Temporomandibular disorder (TMD) and promising results shown by muscle... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Contradicting evidence regarding the effects of occlusal splint therapy in the management of Temporomandibular disorder (TMD) and promising results shown by muscle energy technique.
AIM
To determine and compare the effects of occlusal splint therapy, muscle energy technique, and combined treatment with education for self-management and counseling in the management of TMD.
STUDY DESIGN AND SETTINGS
Randomized clinical trial.
METHODOLOGY
A total of 160 participants diagnosed with TMD according to Diagnostic Criteria/TMD axis I were randomly allocated into four treatment groups with equal allocation ratio using random numbers table. The main inclusion criteria were the presence of pain in the preauricular area, TMJ and/or muscles of mastication and maximum mouth opening <40 mm. Group A participants received muscle energy technique, Group B participants received occlusal splint therapy, Group C participants received combined treatment, and Group D participants received education for self-management and counseling (control). Control group treatment was provided to all the trial participants.
STATISTICAL ANALYSIS
Intragroup comparison was made using Friedman test and Wilcoxon test while intergroup comparison was done using Kruskal-Wallis test and Mann-Whitney U test.
RESULTS
Intensity of pain on a visual analog scale and maximum mouth opening were measured at baseline, at 1 week, at 2 weeks, at 1 month, and after 3 months.
CONCLUSION
Muscle energy technique, occlusal splint therapy and combined treatment significantly reduce pain compared to controls and muscle energy and combined treatment are superior to other groups for mouth opening improvements in patients with TMD.
Topics: Humans; Muscles; Occlusal Splints; Pain Measurement; Temporomandibular Joint Disorders; Treatment Outcome
PubMed: 34810363
DOI: 10.4103/jips.jips_332_21 -
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 -
Minerva Stomatologica Apr 2020In recent years, interest has been given to the relationship between dental occlusion and athletes' performance. A correct occlusion allows for a correct position of the...
INTRODUCTION
In recent years, interest has been given to the relationship between dental occlusion and athletes' performance. A correct occlusion allows for a correct position of the mandible in space and could be reached by wearing a splint made by a dentist. Achieving this condition appears to be an advantage for all athletes, and especially for those who have TMJ dysfunction. The purpose of the study was to investigate the hypothesis and common belief that correcting the occlusion or the use of a splint could improve an athlete's performance.
EVIDENCE ACQUISITION
A search on electronic database has been performed and obtained 141 results; then, following the application of the inclusion criteria, only 11 articles were selected.
EVIDENCE SYNTHESIS
A good occlusion seems to be an advantage for the athletes.
CONCLUSIONS
The use of an occlusal splint should be evaluated in different sports, because the occlusion and TMJ conditions of the athletes are different and the efforts in which they are subjected could not be generalized because the sports have various rules and characteristics that involves the stomatognathic system differently.
Topics: Dental Occlusion; Mandible
PubMed: 32181617
DOI: 10.23736/S0026-4970.20.04350-2 -
Ulusal Travma Ve Acil Cerrahi Dergisi =... Jan 2022Mandibular condyle fractures can be treated conservatively by intermaxillary fixation (IMF) or by open reposition and internal fixation. Although many studies have...
BACKGROUND
Mandibular condyle fractures can be treated conservatively by intermaxillary fixation (IMF) or by open reposition and internal fixation. Although many studies have discussed for the optimal treatment method, the issue remains controversial. In this study, we aimed to compare conservative techniques in the mandibular condyle fractures.
METHODS
Twenty four unilateral condyle fracture patients aged between 18 and 48 years were treated according to one of three different modalities. Bracketing, arch bar or mini screw was applied to all non-surgery patients to obtain IMF. Eight patients were treated with only IMF meanwhile eleven patients were treated with one or double-sided amplifier occlusal splint according to the status of fractured segments, in addition to IMF. Remaining five patients have undergone open reduction and fractured segments immobilized with mini plates. Pre- and post-operative images were recorded with a computerized tomography device. Clinical and radiological examinations were performed by orthodontists and surgeons at baseline and at 6 months of treatment.
RESULTS
The condyle lengths of the patients with unilateral fracture after recovery were compared with the unaffected side. The length between the most protruding point of the condyle and the mandible was measured and the length difference was only 5.94 mm in patients who were treated by IMF. The length difference of patients who used brackets and splints was 3.36 mm (p<0.05). The length difference of patients who were repaired by plate screws was 1.80 mm (p>0.05). However, there was no statistically significant difference (p>0.05) between the groups in the IMF, occlusal splint and IMF and mini plate groups, between the trauma side and the opposite side. None of the patients developed ankylosis, open mouth, limitation of mouth opening, facial asymmetry, laterognathia, and retrognathia. The occlusion of the patients who were not known to have pre-trauma occlusions were directed, repositioned and provided an appropriate occlusion.
CONCLUSION
The use of IMF with an occlusal splint is a more conservative and acceptable treatment modality than open reduction in selected cases.
Topics: Adolescent; Adult; Bone Screws; Follow-Up Studies; Fracture Fixation, Internal; Humans; Jaw Fixation Techniques; Mandibular Condyle; Mandibular Fractures; Middle Aged; Treatment Outcome; Young Adult
PubMed: 34967439
DOI: 10.14744/tjtes.2020.94992 -
The Saudi Dental Journal Nov 2022Occlusal function stimulates different areas of the cerebral cortex. The purpose of this narrative review was to identify the relationship between occlusion and brain... (Review)
Review
OBJECTIVES
Occlusal function stimulates different areas of the cerebral cortex. The purpose of this narrative review was to identify the relationship between occlusion and brain activity so as to provide theoretical support to enable future studies on the subject.
STUDY SELECTION DATA AND SOURCES
Relevant case-control studies, clinical trials, and systematic reviews available in English were retrieved from the following databases: MEDLINE, PubMed, ScienceDirect, Wiley Online Library, and Biblioteca Virtual en Salud (BVS). Of the 53 articles obtained, 12 were included.
CONCLUSION
The sensorimotor cortex is affected by changes in occlusion. It is speculated that occlusion could play an important role in the development of diseases, from anxiety and stress to Alzheimer's disease and senile dementia. Further investigations into the interactions between occlusion and brain function are needed to elucidate the parts of the brain that are affected when occlusion is disturbed and to determine whether brain function is altered.
CLINICAL SIGNIFICANCE
Dentists must consider that alterations in the occlusal pattern during mastication can lead to changes in the activation of different brain regions related to memory, learning, anticipatory pain, and anxiety. This suggests that mastication maintains the integrity of certain brain areas and that it may be a key factor in the onset of neurodegenerative diseases.
PubMed: 36267531
DOI: 10.1016/j.sdentj.2022.09.001 -
Polymers Jun 2024The aim of this study is to investigate the influence of printing material, build angle, and artificial aging on the accuracy of SLA- and DLP-printed occlusal devices in...
The aim of this study is to investigate the influence of printing material, build angle, and artificial aging on the accuracy of SLA- and DLP-printed occlusal devices in comparison to each other and to subtractively manufactured devices. A total of 192 occlusal devices were manufactured by one SLA-printing and two DLP-printing methods in 5 different build angles as well as milling. The specimens were scanned and superimposed to their initial CAD data and each other to obtain trueness and precision data values. A second series of scans were performed after the specimens underwent an artificial aging simulation by thermocycling. Again, trueness and precision were investigated, and pre- and post-aging values were compared. A statistically significant influence was found for all main effects: manufacturing method, build angle, and thermocycling, confirmed by two-way ANOVA. Regarding trueness, overall tendency indicated that subtractively manufactured splints were more accurate than the 3D-printed, with mean deviation values around ±0.15 mm, followed by the DLP1 group, with ±0.25 mm at 0 degree build angle. Within the additive manufacturing methods, DLP splints had significantly higher trueness for all build angles compared to SLA, which had the highest mean deviation values, with ±0.32 mm being the truest to the original CAD file. Regarding precision, subtractive manufacturing showed better accuracy than additive manufacturing. The artificial aging demonstrated a significant influence on the dimensional accuracy of only SLA-printed splints.
PubMed: 38932064
DOI: 10.3390/polym16121714 -
Journal of Dental Sciences Mar 2021This study aimed to compare the effect of four approaches in the treatment of TMJ disc displacement without reduction (DDwoR).
BACKGROUND/PURPOSE
This study aimed to compare the effect of four approaches in the treatment of TMJ disc displacement without reduction (DDwoR).
MATERIALS AND METHODS
Thirty-two patients (40 joints) with mean age 28.025 ± 7.18 (23 female patients and nine male patients) were assigned randomly into four groups (10 joints in each group). Group I, patients were treated by centric splint. Group II, patients were treated by distraction splint. Group III, patients were treated by arthrocentesis and centric splint, while group IV patients were treated by arthrocentesis and distraction splint. The groups were compared in terms of joint function (mouth opening), joint pain through joint palpation, and use of visual analog scale (VAS). These records were taken preoperatively, two weeks, one month, three, and six months postoperatively. Also, the presence of disc recapture was evaluated in all patients on MRI at the end of the treatment period.
RESULTS
Significant improvements in all parameters were recorded in all groups. At two weeks postoperatively, there was a significant improvement in all parameters in group III and group IV than group I and group II, while there was no statistical difference between group III and group IV. Regarding mouth opening and joint palpation, there was a significant improvement in group III than group I and group II. Also, there was a significant improvement in group IV than group II at the subsequent follow-up periods. Regarding VAS, at one and three months postoperatively, there was a significant improvement in group III than other groups.
CONCLUSION
However, both types of splints provide better results without a statistical difference; the simultaneous application of arthrocentesis and occlusal splint decreases pain and improving the function effectively and more rapidly.
PubMed: 33854726
DOI: 10.1016/j.jds.2020.08.008 -
Cranio : the Journal of... Jul 2020The aim of this study was to evaluate the effect of an occlusal splint on body posture of intra-articular temporomandibular joint (TMJ) disorders patients. (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
The aim of this study was to evaluate the effect of an occlusal splint on body posture of intra-articular temporomandibular joint (TMJ) disorders patients.
METHODS
The study was performed on 45 women affected by TMJ disorders divided into an occlusal splint group and a control group. Rasterstereographic recordings were performed at baseline and after 1, 3, and 6 months, in order to analyze the following postural parameters: trunk inclination, cervical and lumbar arrows, kyphotic and lordotic angles, trunk imbalance, pelvic tilt and torsion.
RESULTS
Regarding the postural parameters in the intragroup analysis, no significant differences were detected. The analysis between the two groups revealed significant differences concerning the cervical arrow, the kyphotic and lordotic angles.
DISCUSSION
Even if some differences were found between the control and the occlusal splint group, the low range of statistical significance made these results not significant from a clinical point of view.
Topics: Female; Humans; Lordosis; Occlusal Splints; Posture; Temporomandibular Joint Disorders
PubMed: 30215301
DOI: 10.1080/08869634.2018.1511265 -
Journal of the Mechanical Behavior of... Dec 2021The aim of this in vitro study was to assess the mechanical properties of five commercially available subtractive computer-aided design and computer-aided manufacturing...
AIM
The aim of this in vitro study was to assess the mechanical properties of five commercially available subtractive computer-aided design and computer-aided manufacturing (CAD-CAM) milled splint materials, as well as to compare them with conventional heat-polymerized and autopolymerizing resins used in the construction of conventional splints.
MATERIAL AND METHODS
Five CAD-CAM milled (ProArt CAD Splint, Therapon Transpa, Temp Premium Flexible Transpa, Cast, and Aqua), one autopolymerizing (Palapress), and one heat-polymerized (Paladon 65) resin materials were evaluated. Flexural strength, E-modulus, Vickers hardness, fracture toughness, fracture work, water sorption, and water solubility were measured. Samples were evaluated after dry and water storage for 30 days at 37 °C. Data were collected and statistically analyzed.
RESULTS
Under both storage circumstances, the flexural strength values of Paladon 65, Therapon Transpa, Temp Premium Flexible Transpa, and Aqua were statistically non-significant (P=0.055). The polycarbonate-based CAD-CAM material Temp Premium Flexible Transpa had the highest statistically significant values of the fracture toughness and fracture work (P<0.001). Moreover, it exhibited the lowest percentages of water sorption and water solubility among the investigated materials (P<0.001). All of the CAD-CAM materials exhibited dry elastic moduli greater than Palapress and lower than Paladon 65. One of the CAD-CAM materials, Cast, had the highest dry Vickers hardness value, which was non-significant when compared to Therapon Transpa (P=0.762).
CONCLUSION
CAD-CAM polycarbonate-based splint materials exhibit higher fracture toughness and fracture work as well as lower water sorption and solubility than polymethyl methacrylate-based ones. The mechanical characteristics of the assessed CAD-CAM milled splint materials were not typically superior to those of the conventional heat-polymerized resin. However, some of them outperformed the autopolymerizing acrylic resin in terms of flexural strength, surface microhardness, water sorption, and water solubility.
Topics: Computer-Aided Design; Dental Materials; Flexural Strength; Materials Testing; Occlusal Splints; Polymethyl Methacrylate; Surface Properties
PubMed: 34530298
DOI: 10.1016/j.jmbbm.2021.104813