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Zhonghua Kou Qiang Yi Xue Za Zhi =... Aug 2019Occlusal splint is a removable device for the treatment of oral and maxillary diseases with reversible occlusal treatment property. When patients wear the occlusal...
Occlusal splint is a removable device for the treatment of oral and maxillary diseases with reversible occlusal treatment property. When patients wear the occlusal splint, the occlusal contact state can be changed and the position of the lower jaw may be adjusted, with the improvement of functions of temporomandibular joints and masticatory muscles. There are various types of occlusal splints, among which stabilization splint, soft occlusal splint and repositioning splint are widely used in the treatment of temporomandibular disorders and night bruxism. For the patients requiring occlusal reconstruction, occlusal splint can be used as an important means to adjust and verify the therapeutic jaw position. As a major trend of research in future, the digital design and production of occlusal splint are still in the initial stage and need to be further improved.
Topics: Humans; Jaw Relation Record; Masticatory Muscles; Occlusal Splints; Sleep Bruxism; Temporomandibular Joint Disorders
PubMed: 31378028
DOI: 10.3760/cma.j.issn.1002-0098.2019.08.003 -
Journal of Prosthodontics : Official... Dec 2021This review aimed to identify the reported intraoral scanning applications in fabricating different types of removable prostheses in the field of prosthodontics. (Review)
Review
PURPOSE
This review aimed to identify the reported intraoral scanning applications in fabricating different types of removable prostheses in the field of prosthodontics.
METHODS
A comprehensive electronic search was performed using the PubMed and MEDLINE databases. This review included in vitro studies and clinical reports published between January 2013 and March 2021. The main keywords were as follows: intraoral scanning, digital impression, computerized digital impression, removable prosthesis, chairside computer-aided design/computer-assisted manufacturing, digital complete denture, digital immediate complete denture, digital interim complete denture, digital removable partial denture, digital removable overdenture, digital obturator, digital occlusal splints, and digital maxillofacial prostheses.
RESULTS
In total, 33 papers (22 clinical reports, 8 papers focused on dental techniques, and 3 clinical studies) were included in the final analysis.
CONCLUSIONS
The efficiency of using intraoral scanning in the field of removable prosthodontics was documented. However, there is a need for more clinical studies to identify intraoral scanning-usage protocols and to yield reliable and valid data.
Topics: Computer-Aided Design; Dental Impression Technique; Denture, Overlay; Denture, Partial, Removable; Prosthodontics
PubMed: 34043266
DOI: 10.1111/jopr.13395 -
Zhonghua Kou Qiang Yi Xue Za Zhi =... Jul 2022Masticatory muscle disorders (MMD) is the biggest subtype of temporomandibular disorders (TMD). Among them, local fibromyalgia and myofascial pain are localized lesions,...
Masticatory muscle disorders (MMD) is the biggest subtype of temporomandibular disorders (TMD). Among them, local fibromyalgia and myofascial pain are localized lesions, manifested as masticatory muscle pain, which can be aggravated with jaw function. MMD is caused by a combination of multiple factors. Occlusal disharmony such as occlusal trauma, occlusal interference, and decreased vertical dimension of occlusion have the potential risk of inducing or aggravating the MMD. During prosthodontic treatment, iatrogenic occlusal interference should be avoided. Most patients with MMD can be relieved by comprehensive treatment, and occlusal therapy or prosthodontic treatment is used as an auxiliary means of diagnosis and treatment. By means of occlusal splint, occlusal adjustment and denture restoration, the goal of relieving masticatory muscle tension, stabilizing occlusal support, eliminating occlusal interference and adjusting jaw position can be achieved, so as to eliminate some risk factors of MMD and relief the pain faster.
PubMed: 35790506
DOI: 10.3760/cma.j.cn112144-20220408-00163 -
Annali Italiani Di Chirurgia 2022To investigate the changes of audiological tests and the cone beam computed tomography (CBCT) measurements of temporomandibular joint (TMJ) and middle-inner ear...
INTRODUCTION
To investigate the changes of audiological tests and the cone beam computed tomography (CBCT) measurements of temporomandibular joint (TMJ) and middle-inner ear structure after occlusal splint therapy in temporomandibular disorders (TMD) patients with otological symptoms, and explore the etiological mechanism between TMD and otological symptoms.
METHODS
The 25 subjects aged 18 to 40 years who diagnosed with TMD combined the otological symptoms enrolled in the study.They all had received orthodontic treatment in the outpatient clinic of the orthodontic department in Beijing Stomatological Hospital. All the subjects underwent the audiological tests of pure tone audiometry (PTA) and CBCT before and after the occlusal splint therapy.
RESULTS
After the stabilization occlusal splint therapy, subjects with improvement or complete remission in TMD and otological symptoms accounted for 84% and 80% in all subjects respectively. There were statistically differences in the distances between condylar center (CoC) and sella (S) in sagittal and vertical directions before and after treatment, and statistically difference between ATM and S in sagittal direction. The threshold of PTA at 8000Hz were negatively correlated with the sagittal displacement of condyle and positively correlated with the coronal displacement of condyle. The thickness of top 1/3 of anterior wall of tympanum in sagittal were positively correlated with the threshold of PTA at 4000Hz.
CONCLUSION
The changes in the TMJ position through occlusal splint therapy might cause the changes in structure of middle-inner ear, which might be one of the reasons for the improvement in otological symptoms.
KEY WORDS
Audiology, CBCT, Otological symptoms, TMD.
Topics: Audiology; Cone-Beam Computed Tomography; Humans; Mandibular Condyle; Occlusal Splints; Temporomandibular Joint Disorders
PubMed: 34290153
DOI: No ID Found -
Journal of Esthetic and Restorative... Dec 2023To evaluate the volumetric changes on occlusal surface of computer-aided design and computer-aided manufacturing (CAD-CAM) occlusal devices fabricated following a fully...
OBJECTIVE
To evaluate the volumetric changes on occlusal surface of computer-aided design and computer-aided manufacturing (CAD-CAM) occlusal devices fabricated following a fully digital workflow after occlusal adjustment, compared to those fabricated with an analog workflow.
MATERIALS AND METHODS
Eight participants were included in this clinical pilot study, receiving two different occlusal devices fabricated with two different workflows, fully analog and fully digital. Every occlusal device was scanned before and after the occlusal adjustments to compare the volumetric changes using a reverse engineering software program. Moreover, three independent evaluators assessed a semi-quantitative and qualitative comparison using visual analog scale and dichotomous evaluation. The Shapiro-Wilk test was performed to validate normal distribution assumption, and a dependent t-Student test for paired variables was used to determine statistically significant differences (p-value < 0.05).
RESULTS
The root mean square value was extracted from the 3-Dimensional (3D) analysis of the occlusal devices. The average values of the root mean square were higher for the analogic technique (0.23 ± 0.10 mm) than the digital technique (0.14 ± 0.07 mm) but the differences were not statistically significant (paired t-Student test; p = 0.106) between the two fabrication techniques. The semiquantitative visual analog scale values between the impression for the digital (5.08 ± 2.4 cm) and analog (3.80 ± 3.3 cm) technique were significant (p < 0.001), and statistically significant differences values were assessed for evaluator 3 compared to the other evaluators (p < 0.05). However, the three evaluators agreed on the qualitative dichotomous evaluation in 62% of the cases, and at least two evaluators agreed in 100% of the evaluations.
CONCLUSIONS
Occlusal devices fabricated following a fully digital workflow resulted in fewer occlusal adjustments, as they could be a valid alternative to those fabricated following an analog workflow.
CLINICAL SIGNIFICANCE
Fabricated occlusal devices following a fully digital workflow could have some advantages over analog workflow such reduce occlusal adjustments at delivery appointment, which can result in reduced chair time and therefore increased comfort for the patient and clinician.
Topics: Humans; Occlusal Splints; Pilot Projects; Occlusal Adjustment; Computer-Aided Design; Workflow; Dental Prosthesis Design
PubMed: 37395327
DOI: 10.1111/jerd.13080 -
Journal of the Mechanical Behavior of... Feb 2021Occlusal devices to reduce symptoms of bruxism and temperomandibular disorders can nowadays be manufactured in a digital workflow but studies comparing the accuracy of...
Occlusal devices to reduce symptoms of bruxism and temperomandibular disorders can nowadays be manufactured in a digital workflow but studies comparing the accuracy of those occlusal devices are still limited. Therefore, the aim of this investigation was to investigate the accuracy of injection molding compared with four computer-aided design (CAD) and computer-aided manufacturing (CAM) techniques for the manufacturing of occlusal devices. In addition, the number of contact points and retention were evaluated to assess clinical relevance. A conventional workflow consisting of alginate impression, wax-up, and injection molding (IM) and digital workflows including intraoral scanning, digital design, and subtractive manufacturing (SM) or additive manufacturing by using stereolithography (SLA), digital light processing (DLP), and material jetting (Polyjet) were investigated. Sixteen splints were fabricated with each method. The intaglio surfaces of the splints were laser scanned and superimposed with the reference data sets to analyze the surface deviations. In addition, the number of contact points after repositioning the splints on the reference model was evaluated with occlusal foil. Finally, the retention was measured in a tensile test. One-way ANOVA with post hoc Tukey tests were used for statistical analyses (α = .05). IM and SM splints demonstrated the highest manufacturing accuracy without significant differences to each other (P > .985). Additive manufactured splints revealed greater deviations with equal results for SLA and Polyjet (P > .949) and significantly higher deviations for DLP compared to all other groups (P < .002). Comparable retention force was measured for IM, SM, and SLA (P > .923), whereas Polyjet splints showed the greatest variability. IM and SM splints presented the most contact points (P = .505). Additive manufactured splints demonstrated fewer contacts without significant difference to each other (P > .116). It can be concluded, that there is no difference in manufacturing accuracy, retention, and number of contacts between IM and SM splints. AM splints demonstrated higher, however, clinically acceptable deviations.
Topics: Bruxism; Computer-Aided Design; Dental Prosthesis Design; Humans; Occlusal Splints; Splints; Workflow
PubMed: 33189599
DOI: 10.1016/j.jmbbm.2020.104179 -
BMC Oral Health Jun 2022Precise orthognathic surgical splints are important in surgical-orthodontic treatment. This study aimed to propose a standardized protocol for three-dimensional...
BACKGROUND
Precise orthognathic surgical splints are important in surgical-orthodontic treatment. This study aimed to propose a standardized protocol for three-dimensional (3D)-printed splints and assess the precision of splints with different occlusal coverage on the dentition (occlusal coverage depth, OCD), thus optimizing the design of 3D-printed splints to minimize the seemingly unavoidable systematic errors.
METHODS
Resin models in optimal occlusion from 19 patients were selected and scanned. Intermediate splints (ISs) and final splints (FSs) with 2-mm, 3-mm, 4-mm, and 5-mm OCDs were fabricated and grouped as IS-2, IS-3, IS-4, IS-5, FS-2, FS-3, FS-4, and FS-5, respectively. The dentitions were occluded with each splint and scanned as a whole to compare with the original occlusion. Translational and rotational deviations of the lower dentition and translational deviations of the landmarks were measured.
RESULTS
For vertical translation, the lower dentitions translated inferiorly to the upper dentition in most of the splints, and the translation increased as OCD got larger. Vertical translations of the dentitions in 89.47% of IS-2, 68.42% of IS-3, 42.11% of IS-4, 10.53% of IS-5, 94.74% of FS-2, 63.16% of FS-3, 26.32% of FS-4, and 21.05% of FS-5 splints were below 1 mm, respectively. For pitch rotation, the lower dentitions rotated inferiorly and posteriorly in most groups, and the rotation increased as OCD got larger. Pitch rotations of the dentitions in 100% of IS-2, 89.47% of IS-3, 57.89% of IS-4, 52.63% of IS-5, 100.00% of FS-2, 78.95% of FS-3, 52.63% of FS-4, and 47.37% of FS-5 splints were below 2°, respectively. On the other hand, the transversal and sagittal translations, roll and yaw rotations of most groups were clinically acceptable (translation < 1 mm and rotation < 2°). The deviations of ISs and FSs showed no statistical significance at all levels of coverage (P > 0.05).
CONCLUSIONS
A protocol was proposed to generate 3D-printed ISs and FSs with normalized basal planes and standardized OCDs. Deviations of the ISs and FSs were more evident in the vertical dimension and pitch rotation and had a tendency to increase as the OCD got larger. ISs and FSs with both 2-mm and 3-mm OCD are recommendable regarding the precision relative to clinical acceptability. However, considering the fabrication, structural stability, and clinical application, ISs and FSs with 3-mm OCD are recommended for accurate fitting.
Topics: Humans; Occlusal Splints; Orthognathic Surgical Procedures; Printing, Three-Dimensional; Splints; Vertical Dimension
PubMed: 35655203
DOI: 10.1186/s12903-022-02247-6 -
Medicina (Kaunas, Lithuania) May 2022Background and Objectives: The aim of the study was to assess the craniovertebral and craniomandibular changes in patients diagnosed with temporomandibular joint...
Craniovertebral and Craniomandibular Changes in Patients with Temporomandibular Joint Disorders after Physiotherapy Combined with Occlusal Splint Therapy: A Prospective Case Control Study.
Background and Objectives: The aim of the study was to assess the craniovertebral and craniomandibular changes in patients diagnosed with temporomandibular joint disorders (TMD) after physiotherapy combined with occlusal splint therapy. Materials and Methods: There were forty patients (32 females, 80%), diagnosed with TMD, included into the study group. After the initial series of physiotherapy, patients received maxillary occlusal splints to be worn day and night. Participants continued physiotherapy simultaneously with occlusal splint therapy for 6 months. Lateral cephalograms taken in natural head position before and after the end of the therapy were used for measurements. The control group consisted of 15 healthy participants (12 females, 80%), who had taken lateral cephalograms twice, and did not receive any type of occlusal treatment nor physiotherapy in the meantime. Results: Occlusal splint therapy and physiotherapy combined together significantly affected: the vertical position of the mandible (significant increase, p < 0.0001), the sagittal position of mandible (significant decrease, p = 0.0065), as well as the width of the functional space between C1 and C2 (significant decrease, p = 0.0042). Moreover, the cervical lordosis was restored after the end of the treatment (p < 0.0001). Conclusions: Cooperation of physiotherapists with dental practitioners is necessary in the treatment of patients with TMD, including temporomandibular joint osteoarthritis.
Topics: Animals; Case-Control Studies; Dentists; Female; Humans; Occlusal Splints; Physical Therapy Modalities; Professional Role; Temporomandibular Joint Disorders
PubMed: 35630101
DOI: 10.3390/medicina58050684 -
Medicine Aug 2019Migraine and tension-type headache often occur comorbid with temporomandibular disorder; occlusal splint therapy is the most common treatment for temporomandibular... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Migraine and tension-type headache often occur comorbid with temporomandibular disorder; occlusal splint therapy is the most common treatment for temporomandibular disorder. The aim of this study was to assess the effects of occlusal splint therapy on headache symptoms in patients with migraine and/or tension-type headache comorbid with temporomandibular disorder.
METHODS
Sixty adult patients with migraine and/or tension-type headache and comorbid temporomandibular disorder were randomly assigned to individualized occlusal splint therapy applied during day- and nighttime plus usual care (n = 30) or usual care alone (n = 30). Primary outcome was the change in current pain intensity on a 100 mm visual analogue scale from week 1 to week 12. Secondary outcomes included changes in headache days and headache hours assessed by headache diaries over a 2-week period, health-related quality of life (SF-36), and adverse events from week 1 to week 12 and (in the occlusal splint plus usual care group only) to week 24.
RESULTS
No group differences in changes in pain intensity from week 1 to week 12 were found. The number needed to treat was 3.8. Physical quality of life reduced stronger in the usual care group than in the occlusal splint plus usual care group. In the occlusal splint plus usual care group, headache intensity significantly decreased and physical quality of life significantly increased from week 1 to week 12 and to week 24 (all P < .001). No adverse events were reported.
CONCLUSIONS
A day- and night-time occlusal splint therapy in addition to usual care was not superior to usual care alone in patients with chronic headache and comorbid TMD. Four patients need to be treated to induce a minimal clinically relevant improvement in one patient. The small sample size and lack of power limit these findings.
Topics: Adult; Female; Humans; Male; Middle Aged; Migraine Disorders; Occlusal Splints; Pain Measurement; Quality of Life; Temporomandibular Joint Disorders; Tension-Type Headache; Treatment Outcome
PubMed: 31415392
DOI: 10.1097/MD.0000000000016805 -
Turkish Journal of Orthodontics Mar 2022The aim of this study was to identify the strategies used for the diagnosis and treatment of patients with temporomandibular disorders (TMDs) by general dental...
OBJECTIVE
The aim of this study was to identify the strategies used for the diagnosis and treatment of patients with temporomandibular disorders (TMDs) by general dental practitioners (GDPs) in the city of Istanbul.
METHODS
A total of 154 GDPs were assessed by a single examiner in this questionnaire-based study. Descriptive statistics were calculated for all variables, and the results were analyzed at a 95% CI and statistical power of 80% with the significance level set at P < .05.
RESULTS
The most frequently employed strategies for obtaining a diagnosis were patients' medical history (33.1%), physical examination (37.7%), and a combination of diagnostic methods (29.2%). The most commonly referred specialties were prosthodontics (62.2%) and maxillofacial surgery (36.9%). All GDPs treated their TMD patients with occlusal splints, and the majority of the occlusal splints were hard occlusal splints (62.8%). Half of the GDPs considered the etiology of TMD to involve stress, whereas 49.4% believed that TMD is of a multifactorial etiology.
CONCLUSION
The GDPs clarified that TMD patients were mostly treated with occlusal splints and this datum is consistent with the suggestions of previous consensus papers.
PubMed: 35370133
DOI: 10.5152/TurkJOrthod.2022.21170