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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 -
Current Medical Science Jun 2021Anterior repositioning splint (ARS) therapy is considered one of the most effective therapies for treating disc displacement-related temporomandibular disorders (TMDs),... (Review)
Review
Anterior repositioning splint (ARS) therapy is considered one of the most effective therapies for treating disc displacement-related temporomandibular disorders (TMDs), which account for a large proportion of TMD cases. Owing to the wide application of this therapy, the exact mechanism of remission has increasingly drawn attention. Given that practitioners have different views on ARS therapy, its indications are broadened, and operating methods diverged. This review attempts to provide an overview of ARS therapy and helps practitioners establish indications and suitable operating methods. Representative views in the past 10 years were summarised, and conclusions were drawn as follows: The mechanism of ARS therapy is mainly attributed to internal derangement correction, improvement of stress distribution and recently reported joint remodeling. It has an evident effect in the short term, and the most prevalent operating methods are protruding the mandible to the edge-to-edge position and wearing the ARS for 24 hours daily for 3-6 months. However, long-term stability is not optimal, and thus indications should be selected carefully. Notably, most of the clinical studies in this field are case analyses with low-quality evidence. Well-designed RCTs are required to further validate relevant theories.
Topics: Humans; Intervertebral Disc Displacement; Mandible; Occlusal Splints; Temporomandibular Joint Disorders
PubMed: 34169428
DOI: 10.1007/s11596-021-2381-7 -
BMC Oral Health Jun 2020This study aimed to demonstrate that the material of the occlusal splint can be chosen according to the needs of individual patients and contribute to the knowledge of...
BACKGROUND
This study aimed to demonstrate that the material of the occlusal splint can be chosen according to the needs of individual patients and contribute to the knowledge of the wear rate of these materials.
METHODS
In this study, four occlusal splint materials (Sr Ivocap Heat Cured, Valplast, SR Ivocap Elastomer and Eclipse) and three antagonists (natural tooth enamel, inCoris TZI and IPS e.max Press ceramic materials) were used. Each wear test was performed using a chewing simulator (n = 16; test load: 50 N; number of cycles: 10,000, 20,000 and 30,000; continuous rinsing with water at 30 °C for the wet condition). The Shapiro Wilk test was used for normal distribution suitability. Antagonist on average wear quantities both main effects and interactions of material, cycle and condition factors were investigated by Univariate variance analysis. Multiple comparisons were examined using the Games-Howell test.
RESULTS
There was a statistically significant effect of the difference in materials on the amount of wear (p < 0.001). Furthermore, there was a statistically significant difference among the mean values of all materials (p > 0.001). The highest mean value was obtained with Eclipse (0,318 μm), and the lowest mean value was obtained with Valplast (0,134 μm).
CONCLUSION
Our study found differences in the in vitro wear rate among various occlusal splint materials.
Topics: Ceramics; Dental Enamel; Humans; Materials Testing; Occlusal Splints; Surface Properties
PubMed: 32571384
DOI: 10.1186/s12903-020-01165-9 -
Journal of Oral Rehabilitation Feb 2024To evaluate the impact of occlusal splint plus laser therapy (OS + LT) compared with OS alone on the patient-reported outcomes and clinical parameters of patients... (Randomized Controlled Trial)
Randomized Controlled Trial
Occlusal splint and combined multiwave locked system laser therapy demonstrated differential patient-reported outcomes and clinical parameters: A randomized controlled trial in patients with temporomandibular disorder.
PURPOSE
To evaluate the impact of occlusal splint plus laser therapy (OS + LT) compared with OS alone on the patient-reported outcomes and clinical parameters of patients with temporomandibular disorders (TMDs).
METHODS
Twenty-three patients with TMDs were randomly assigned to two treatment approaches: OS and OS + LT (multiwave locked system). The two outcomes were clinical parameters (mouth-opening distances, number of muscles and TMJs with pain) and patient-reported outcomes (pain score and oral health-related quality of life [OHRQoL] determined using the 14-item oral health impact profile [OHIP-14]). The outcomes were measured at four time points: baseline, 2 weeks, 1 and 3 months after treatment. According to DC/TMD Axis I classification, the participants were diagnosed as having pain only and pain with intraarticular joint disorder. Adjusting for age and sex, the outcome changes were analysed using generalized estimating models at a 5% significance level.
RESULTS
The pain-free mouth-opening distance of the patients who received OS + LT continuously increased from 2 weeks to 3 months. However, the value was significantly increased at 3 months in patients who received OS alone. The unassisted mouth-opening distance significantly increased after 3 months in both groups. In both treatment approaches, the number of muscles and TMJs with pain, as well as the pain and OHIP-14 scores gradually decreased from baseline to 3 months.
CONCLUSIONS
The patients who received OS and OS + LT demonstrated better OHRQoL and clinical parameters during 3 months after treatment. An improvement in the pain-free mouth-opening distance at 2 weeks was found only in OS plus LT group; however, this difference may not be clinically significant.
Topics: Humans; Occlusal Splints; Quality of Life; Treatment Outcome; Temporomandibular Joint Disorders; Pain; Laser Therapy
PubMed: 37727026
DOI: 10.1111/joor.13593 -
Journal of Clinical Medicine Nov 2022Background. Acute anterior disc displacement without reduction (ADDWoR) is characterized by permanent TMJ disc displacement, pain and functional limitations. Occlusal...
Background. Acute anterior disc displacement without reduction (ADDWoR) is characterized by permanent TMJ disc displacement, pain and functional limitations. Occlusal appliances (OA) are among the therapies of choice. Methods. A single-blind randomized study was carried out to compare the therapeutic success of two different types of splints in patients with ADDWoR. A total of 30 subjects were eligible for the study out of the 330 screened. Group I (n = 15) received RA.DI.CA splint therapy and Group II (n = 15) received stabilization splint therapy. Temporomandibular pain, headache, neck pain and functional excursions were evaluated at baseline (T0), after 4 weeks (T1) and after 6 months (T2). Descriptive and inferential statistics were performed. Results. There was a significant increase in maximum jaw opening and a reduction in pain in both groups (p < 0.05), except for neck pain in Group II. Significant differences in between- and within-subject factors emerged in all of the parameters evaluated, especially between T1 and T2 scores, with a greater trend of improvement in Group I than Group II. Conclusion. RA.DI.CA splints were found to be more effective for the considered sample, especially in the treatment of comorbidities and functional movements, probably due to the greater orthopedic action and joint mobilization.
PubMed: 36498611
DOI: 10.3390/jcm11237037 -
Polymers Sep 2022Although three-dimensional (3D) printing is clinically convenient to fabricate occlusal splints, it is still unclear how the post-curing method and the printer type can...
Although three-dimensional (3D) printing is clinically convenient to fabricate occlusal splints, it is still unclear how the post-curing method and the printer type can affect 3D-printed splints. This study aimed to evaluate the effect of stroboscopic post-curing at a nitrogen gas (N) atmosphere versus post-curing in an air atmosphere, as well as the printer type (liquid crystal display (LCD) and digital light processing (DLP)) on the mechanical properties of a 3D-printed hard-type occlusal splint material. Flexural strength, flexural modulus, Vickers hardness number (VHN), fracture toughness, degree of double bond conversion (DC), 3D microlayer structure, water sorption, and water solubility were evaluated. The post-curing method significantly affected all evaluated properties except fracture toughness and 3D microlayer structure, while the printer type significantly affected all evaluated properties except flexural strength and flexural modulus. VHN and DC were significantly higher, and the smoother surface was noticeably obtained when printed by LCD printer and post-cured at an N atmosphere. The current results suggested that the post-curing method and the printer type would play a role in the mechanical properties of the evaluated material and that the combination of post-curing at an N atmosphere and LCD printer could enhance its mechanical properties and surface smoothness.
PubMed: 36235919
DOI: 10.3390/polym14193971 -
Journal of Cranio-maxillo-facial... Aug 2020To evaluate the feasibility of safely managing subcondylar fractures using an original surgical procedure combining an intraoral approach, the use of a custom-made...
INTRODUCTION
To evaluate the feasibility of safely managing subcondylar fractures using an original surgical procedure combining an intraoral approach, the use of a custom-made occlusal overlay splint, and intraoperative imaging.
MATERIALS AND METHODS
Condylar fragment was freed from surrounding soft tissues, was laterally exposed to the ramus, and a miniplate was fixed in place for osteosynthesis. An overlay splint maintaining the dental occlusion was used to facilitate reduction and stabilization during fixation. Intraoperative monitoring by cone-beam computed tomography (CBCT) was performed before completing the fixation.
RESULTS
Between November 2018 and June 2019, 10 patients were treated using this procedure. The median length of the proximal condylar fragment was 29 mm (range 24-39 min). Five patients had an associated mandibular fracture. The median duration of the condylar fracture surgery was 54.5 min (range 38-79 min). All patients had satisfactory reduction and osteosynthesis with no complications.
CONCLUSION
It is feasible to safely manage subcondylar fractures with this surgical procedure that could facilitate open reduction using intraoral approaches. Occlusal splints maintain downward pressure on the rami bilaterally and symmetrically, helping to anatomically reposition condylar process fractures. Intraoperative imaging is used to monitor this step.
Topics: Fracture Fixation, Internal; Humans; Mandibular Condyle; Mandibular Fractures; Occlusal Splints; Open Fracture Reduction
PubMed: 32680670
DOI: 10.1016/j.jcms.2020.05.005 -
Polymers Oct 2022Despite the fact that three-dimensional (3D) printing is frequently used in the manufacturing of occlusal splints, the effects of the 3D printer type and post-curing...
Despite the fact that three-dimensional (3D) printing is frequently used in the manufacturing of occlusal splints, the effects of the 3D printer type and post-curing methods are still unclear. The aim of this study was to investigate the effect of the printer type (digital light processing: DLP; and liquid crystal display: LCD) as well as the post-curing method with two different atmospheric conditions (air and nitrogen gas (N)) on the mechanical and surface properties of 3D-printed soft-type occlusal splint material. The evaluated properties were flexural strength, flexural modulus, Vickers hardness (VHN), fracture toughness, degree of double bond conversion (DC%), water sorption, water solubility, and 3D microlayer structure. The printer type significantly affected all the evaluated properties. Flexural strength, flexural modulus, and fracture toughness were significantly higher when specimens were printed by a DLP printer, while VHN and DC% were significantly higher, and a smoother surface was noticeably obtained when printed by an LCD printer. The post-curing at an N atmosphere significantly enhanced all of the evaluated properties except water sorption, 3D microlayer structure, and fracture toughness. The current results suggested that the printer type and the post-curing methods would have an impact on the mechanical and surface properties of the evaluated material.
PubMed: 36365611
DOI: 10.3390/polym14214618 -
Dental Traumatology : Official... Apr 2021Traumatic dental injuries are highly prevalent and are considered an important health problem. The aim of this study was to evaluate the in vitro stress distribution...
BACKGROUND/AIMS
Traumatic dental injuries are highly prevalent and are considered an important health problem. The aim of this study was to evaluate the in vitro stress distribution around simulated traumatized teeth subjected to different types of splints by photoelastic analysis.
MATERIALS AND METHODS
For each group, five models of maxillary and mandibular arches were made in photoelastic resin using prefabricated teeth models, which were fixed and adjusted in a semi-adjustable articulator. All splints were bonded with composite resin on the labial surfaces of the maxillary central incisors, the lateral incisors and the canine teeth, simulating trauma to the 11. The groups were divided according to the type of splint: control-without splint; rigid-brackets and 0.021 × 0.025 inch stainless steel wire; semi-rigid-brackets and 0.016 × 0.016 inch cobalt-chromium wire; fiber-fiberglass ribbon; and flexible-nylon thread. The groups were submitted to an occlusal force in a special device attached to a universal test machine in balanced, protrusive, and lateral occlusions. Then, the incisal edge of the 11 was ground to simulate infra-occlusion, and the tests were performed again. Five points were analyzed around tooth 11 with a polariscope, and the data were submitted to ANOVA and Tukey tests at a 5% level of significance.
RESULTS
When centric occlusion was analyzed by comparing normal occlusion to infra-occlusion, all groups showed high stress values in infra-occlusion with statistical differences-except for the control group. When lateral occlusion was analyzed, the nylon splint showed lower statistical differences compared with the control, fiberglass, and rigid splint groups, which did not differ between each other. The semi-rigid splint did not differ from any group.
CONCLUSIONS
Fiberglass and semi-rigid splints showed better stress distribution around the traumatized tooth under occlusal loads. The nylon splint showed characteristics of non-stress distribution.
Topics: Composite Resins; Humans; Orthodontic Wires; Periodontal Splints; Splints; Tooth Mobility
PubMed: 33180992
DOI: 10.1111/edt.12618