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Clinical Oral Investigations Aug 2023To evaluate the short-term effects of hard and soft splints of different thicknesses on maximum bite force (MBF) and sleep quality (SQ) in participants with sleep... (Randomized Controlled Trial)
Randomized Controlled Trial
Short-term effect of material type and thickness of occlusal splints on maximum bite force and sleep quality in patients with sleep bruxism: a randomized controlled clinical trial.
OBJECTIVE
To evaluate the short-term effects of hard and soft splints of different thicknesses on maximum bite force (MBF) and sleep quality (SQ) in participants with sleep bruxism (SB).
METHODS
One-hundred-fifteen patients were randomly allocated to five groups: Groups H2(Hard splint-2 mm), H3(Hard splint-3 mm), S2(Soft splint-2 mm), S3(Soft splint-3 mm), and C (control). Outcomes were MBF (assessed with a digital gnathodynamometer) and SQ (assessed with the Pittsburgh Sleep Quality Index). Measurements were performed at T0 (before the splints), T1 (1-month follow-up), and T2 (2-months follow-up). Data were analyzed using one-way analysis of variance(ANOVA), Tukey's HSD, and chi-square tests (alpha = 0.05).
RESULTS
At T1, the highest MBF values were observed in group H3 (658.01 ± 22.6 N), while the lowest in group S2 (585.45 ± 8.68 N). For T2, the highest values were obtained in H3 group (676.85 ± 21.9 N), and the lowest in group S2 (565.65 ± 10.9 N) (p < 0.05).For SQ, groups S2 and S3 revealed the lowest PSQI values at T1 (9.1; 9.6) and T2 (9; 9.5) (p < 0.001).
CONCLUSIONS
The short-term use of both 2 and 3-mm thick soft splints resulted in a decrease in MBF. Improvement in SQ in patients using soft splints was observed in the 1st month and was maintained in the 2nd month.
CLINICAL RELEVANCE
This study provides insights on short-term clinical effects as regards to increased sleep quality and regulated maximum bite force as a function of splint material type and the thickness of the splint.
Topics: Humans; Sleep Bruxism; Occlusal Splints; Bite Force; Sleep Quality; Splints; Bruxism
PubMed: 37127807
DOI: 10.1007/s00784-023-05049-4 -
Healthcare (Basel, Switzerland) Apr 2022There is still a gap in the scientific knowledge on the linkage between craniofacial structure and spinal postural control in temporomandibular disorder (TMD) patients.... (Review)
Review
There is still a gap in the scientific knowledge on the linkage between craniofacial structure and spinal postural control in temporomandibular disorder (TMD) patients. This systematic review aimed to assess the role of occlusal splints on spinal posture of TMD patients. PubMed, Web of Science, and Scopus were systematically searched from inception until 5 January 2022 to identify observational studies with a longitudinal study design presenting: patients with diagnosis of TMD according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD); occlusal splint therapy as intervention; postural assessment as outcome. Out of 133 records identified, 104 were suitable for data screening, and only 7 articles were included satisfying the eligibility criteria. We found that occlusal splints might have a positive effect on posture in TMD patients, albeit there is little evidence of appropriate investigation for postural assessment. This systematic review suggested that the occlusal splint might be considered a non-invasive therapeutic approach for patients with TMD. However, the low number of studies with high-quality methodology in these patients showed an urgent need for further research using combined force platform stabilometry and kinematic evaluation of the spine to investigate the impact of occlusal splints on posture.
PubMed: 35455916
DOI: 10.3390/healthcare10040739 -
Life (Basel, Switzerland) Dec 2022Occlusal splints are used as a non-invasive treatment for patients diagnosed with temporomandibular disorders (TMD). Another non-invasive treatment option for TMD...
Occlusal splints are used as a non-invasive treatment for patients diagnosed with temporomandibular disorders (TMD). Another non-invasive treatment option for TMD patients is kinesiotherapy, which may be used alone or in conjunction with occlusal splint therapy. The aim of this study was to evaluate the changes in the intra-articular spaces of the temporomandibular joint (TMJ) after occlusal splint therapy combined with cranio-temporomandibular kinesiotherapy in TMD patients. Twenty-four patients ( = 24) diagnosed with TMD according to Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) were included. Cone beam computed tomography (CBCT) images were taken before and after treatment. The anterior, superior, posterior, and medial joint spaces were measured on the CBCT images, and the condylar ratio was calculated using Pullinger and Hollender's formula. Additionally, the thickness of the glenoid fossa (GFT), condylar medio-lateral widths (MLW), and condylar height (HCo) were measured. The condylar ratio was significantly higher after treatment ( = 0.049). The changes in dimensions of the anterior, superior, posterior and medial joint spaces were not statistically significant after treatment. No statistically significant differences were found in the dimensions of the GFT, MLW, and HCo post treatment. The condylar position did not shift anteriorly in a statistically significant way after occlusal splint therapy combined with cranio-temporomandibular kinesiotherapy in TMD patients.
PubMed: 36556507
DOI: 10.3390/life12122143 -
Photobiomodulation, Photomedicine, and... Jul 2020Temporomandibular disorder (TMD) refers to a group of disorders affecting the temporomandibular joint (TMJ) and its related muscles. The two commonly used treatment... (Review)
Review
Temporomandibular disorder (TMD) refers to a group of disorders affecting the temporomandibular joint (TMJ) and its related muscles. The two commonly used treatment modalities for TMD are occlusal splint therapy and relaxation therapy. Neither comprises definitive treatment. The objective of this review was to report updated information on photobiomodulation and stem cells, as an alternative treatment for the degenerative TMJ disc as a part of TMJ disorders. With only a few research studies reported till date, this review also proposes the mechanism of laser irradiation on inflammatory mediators to treat TMD. Photobiomodulation of stem cells with and without scaffolds could be used indirectly or directly as modulation of degenerative changes of the TMJ disc. The need for a distinct shift of the research margin in this field of dentistry is evident, specifically regarding the application of photobiomodulation and stem cells for tissue engineering of the TMJ disc.
Topics: Humans; Low-Level Light Therapy; Stem Cell Transplantation; Temporomandibular Joint Disorders
PubMed: 32486898
DOI: 10.1089/photob.2019.4790 -
BMC Oral Health Nov 2022To evaluate the effect of hard stabilization splints (HSS), counselling and exercise therapies, respectively, for the painful temporomandibular disorder (TMD) in...
Effects of occlusal splint and exercise therapy, respectively, for the painful temporomandibular disorder in patients seeking for orthodontic treatment: a retrospective study.
OBJECTIVE
To evaluate the effect of hard stabilization splints (HSS), counselling and exercise therapies, respectively, for the painful temporomandibular disorder (TMD) in patients seeking for orthodontic treatment through magnetic resonance imaging (MRI) and clinical examination.
MATERIALS AND METHODS
Eighty-seven TMD patients were divided into two groups according to their therapies: the HSS group (n = 43) comprising of patients treated with HSS, counselling and masticatory muscle exercises; the control group (n = 44) comprising of patients treated with counselling and masticatory muscle exercises alone. All patients had orthodontic therapies after the first treatment phase. The joint pain and clicking of all patients were recorded via clinical examination. MRIs of HSS groups were taken before (T), after the first phase (T), and after the orthodontic treatment (T). Parameters indicating the condyles and articular discs were evaluated. Clinical symptom (pain and clicking) changes among T, T and T time point were detected in the two groups respectively. The significant differences between HSS and control groups, as well as between male and female were tested at T and T. Position changes of condyles and discs in HSS group among T, T and T were detected in male and female respectively.
RESULTS
After the first treatment phase, there was no difference in the decrease of facial pain between the two group, as well as between male and female in the two groups (P > 0.05). Clicking decreasing was not statistically significant. After the whole orthodontic periods, the TMJ pain relapsed in female of the control group, and the number of female's pain joints was more than male's (P < 0.05). In the HSS group, the posterosuperior movements of discs and the anteroposterior movements of condyles were recorded in closing position (P < 0.05). After the whole orthodontic periods, female's disc-condyle angles increased, the discs to HRP distance decreased and condyles to VRP distance increased when compared with the data of T (P < 0.05).
CONCLUSIONS
For the orthodontic patients with painful TMD, HSS combined with counselling and exercise therapies before orthodontic treatment could provide pain relief. HSS is helpful to improve the position and relation of discs and condyles. In addition, male's prognosis is better than female's in terms of stability.
Topics: Humans; Male; Female; Occlusal Splints; Retrospective Studies; Temporomandibular Joint Disorders; Facial Pain; Exercise Therapy
PubMed: 36424568
DOI: 10.1186/s12903-022-02538-y -
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 -
Zhonghua Kou Qiang Yi Xue Za Zhi =... Dec 2020To established a digital workflow for stabilization occlusal splint with computer-aided design and computer-aided manufacturing (CAD/CAM) methods. Two subjects were...
To established a digital workflow for stabilization occlusal splint with computer-aided design and computer-aided manufacturing (CAD/CAM) methods. Two subjects were enrolled from April 2019 to May 2019 from Department of Prosthodontics, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine (one male, 25 years old; one female, 24 years old). The working models of the participants' dentition were made. Two stabilization occlusal splints were manufactured for each participant using digital workflow and conventional workflow. With the digital workflow, the three-dimensional (3D) scanning of the cast, recording of the digital personalized mandibular movements and condyle trajectory, and the design and the 3D printing for the fabrication of the final appliance using CAD/CAM technologies were performed. With conventional workflow, conventional technologies were adopted based on requirements and experiment of designing and manufacturing of stabilization splint. During try-in, a checklist was built to compare the clinical performance of the two workflows. The digital workflow of the stabilization occlusal splint was built successfully. The total score of clinical primary evaluation by the two subjects were 26 and 26 for digital workflow splints, and 25 and 23 for conventional workflow splints. Digital stabilization occlusal splint workflow is feasible.
Topics: Adult; China; Computer-Aided Design; Female; Humans; Male; Mandible; Occlusal Splints; Workflow; Young Adult
PubMed: 33280364
DOI: 10.3760/cma.j.cn112144-20200629-00381 -
Journal of Clinical Medicine Aug 2022: The aim of the study was to assess the position of the hyoid bone, as well as the width of the nasopharynx and oropharynx after occlusal splint therapy combined with...
Position of the Hyoid Bone and Dimension of Nasopharynx and Oropharynx after Occlusal Splint Therapy and Physiotherapy in Patients Diagnosed with Temporomandibular Disorders.
: The aim of the study was to assess the position of the hyoid bone, as well as the width of the nasopharynx and oropharynx after occlusal splint therapy combined with physiotherapy in patients diagnosed with temporomandibular disorders (TMD). : This was a clinical trial study. The study group consisted of 40 patients diagnosed with TMD, who were qualified for the treatment combining physiotherapy and occlusal splint therapy. Hyoid bone position as well as the width of the nasopharynx and oropharynx were assessed in lateral cephalograms taken before and after the end of the treatment. There were 15 generally healthy participants included into the control group, who had taken lateral cephalograms twice within the period of 1 to 2 years and did not receive any occlusal treatment in the meantime. : The position of the hyoid bone was significantly lowered and the dimension of the lower part of the oropharynx was significantly decreased after the end of the long-term occlusal splint therapy combined with physiotherapy in patients diagnosed with TMD. : Long-term occlusal splint therapy combined with physiotherapy affected the position of the hyoid bone and the dimension of the lower part of the oropharynx.
PubMed: 36078870
DOI: 10.3390/jcm11174939 -
Complementary Therapies in Clinical... Aug 2022This study evaluated the effect of auricular acupuncture (AA) on physical (PA) and emotional (EA) aspects of patients with temporomandibular disorders (TMDs) and... (Comparative Study)
Comparative Study Randomized Controlled Trial
This study evaluated the effect of auricular acupuncture (AA) on physical (PA) and emotional (EA) aspects of patients with temporomandibular disorders (TMDs) and compared the effect of AA with those of Sham and occlusal splints (OS). In accordance with the CONSORT guidelines, patients with TMDs were evaluated by axes I and II of the RDC-TMD. The patients were allocated among three groups: OS, Sham and AA; and followed for 8 weeks. Both intragroup and intergroup evaluation for quantitative variables were analyzed with ANOVA, one-way, followed by the Tukey test. Qualitative variables were analyzed with the Kruskal-Wallis, and Dunn tests (intergroup evaluation) and for intragroup analyses, the Friedman and Wilcoxon tests were applied. At the end of the experiment, the chi-squared test was applied to compare the three groups with respect to the number of variables that had shown improved scores. The adopted level of significance for all tests was α = 5%. Intragroup analysis showed that, in the Sham group, no improvement in performance was seen in either EA and significant was improvements in 5 variables for 9 for PA, while in the AA group, significant improvements were observed in 2 variables for EA and in 9 for PA. In the OS group at the end of this study, significant improvements were observed in 8 and 8 variables for EA and PA, respectively. The analysis of therapies used revealed that the number of variables exhibiting significantly improved outcomes after treatment was similar between the AA and OS groups, whereas the sham group showed statistically significant differences when compared with the other two groups. In conclusion, this study demonstrated that AA applied at a specific TMJ ear point was able to bring about improvements in patients with TMDs, with outcomes similar to those in patients treated with an OS. CLINICAL TRIAL REGISTRATION: RBR-69ynnw (Brazilian Registry of Clinical Trials).
Topics: Acupuncture, Ear; Brazil; Humans; Occlusal Splints; Temporomandibular Joint Disorders; Treatment Outcome
PubMed: 35487130
DOI: 10.1016/j.ctcp.2022.101569 -
International Journal of Oral and... Dec 2023Customization in orthognathic surgery allows better precision and a reduced surgical time. In Le Fort I osteotomy surgery, the maxillary segmentation is considered one...
Customization in orthognathic surgery allows better precision and a reduced surgical time. In Le Fort I osteotomy surgery, the maxillary segmentation is considered one of the most unstable procedures due to transverse instability. Various different types of palatal device have been proposed to address this instability. This note describes a customized bone-borne palatal guide and splint that may help surgeons shorten the surgical time and achieve better three-dimensional repositioning, with more postoperative comfort for the patient and occlusal control for the surgeon.
Topics: Humans; Splints; Orthognathic Surgical Procedures; Palatal Expansion Technique; Maxillary Osteotomy; Maxilla; Osteotomy, Le Fort
PubMed: 37544786
DOI: 10.1016/j.ijom.2023.07.005