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Sensors (Basel, Switzerland) Dec 2019Bruxism is a masticatory muscle activity characterized by high prevalence, widespread complications, and serious consequences but without specific guidelines for its...
Bruxism is a masticatory muscle activity characterized by high prevalence, widespread complications, and serious consequences but without specific guidelines for its diagnosis and treatment. Although occlusal force-based biofeedback therapy is proven to be safe, effective, and with few side effects in improving bruxism, its mechanism and key technologies remain unclear. The purpose of this study was to research a real-time, quantitative, intelligent, and precise force-based biofeedback detection device based on artificial intelligence (AI) algorithms for the diagnosis and treatment of bruxism. Stress sensors were integrated and embedded into a resin-based occlusion stabilization splint by using a layering technique (sandwich method). The sensor system mainly consisted of a pressure signal acquisition module, a main control module, and a server terminal. A machine learning algorithm was leveraged for occlusal force data processing and parameter configuration. This study implemented a sensor prototype system from scratch to fully evaluate each component of the intelligent splint. Experiment results showed reasonable parameter metrics for the sensors system and demonstrated the feasibility of the proposed scheme for bruxism treatment. The intelligent occlusion stabilization splint with a stress sensor system is a promising approach to bruxism diagnosis and treatment.
Topics: Artificial Intelligence; Biofeedback, Psychology; Bite Force; Bruxism; Humans; Neural Networks, Computer; Occlusal Splints; Wireless Technology
PubMed: 31877845
DOI: 10.3390/s20010089 -
Clinical and Experimental Dental... Jun 2021Sleep bruxism is mostly assessed by reporting of tooth-grinding or clenching during sleep and by clinical signs (tooth wear, cracks, or fractures). Parafunctional tooth... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
Sleep bruxism is mostly assessed by reporting of tooth-grinding or clenching during sleep and by clinical signs (tooth wear, cracks, or fractures). Parafunctional tooth damage is usually prevented by employing occlusal appliances mainly of the full arch covering type (Michigan splint) and of the partial type covering only central incisors (NTI-tss). To date, the effects of occlusal appliances on sleep bruxism or jaw muscle activity during sleep are still controversial. The present study is a randomized controlled clinical trial that evaluated the effects of two different splint designs on jaw muscle activity in sleep bruxers otherwise healthy.
MATERIAL AND METHODS
Ten patients from a private dental practice were treated by a single operator. A Michigan splint and an NTI-tss device were manufactured individually and used at random order. Electromyographic jaw muscle activity was recorded for four consecutive nights in the first, fourth, and seventh week with and without splint. Participants reported on splint comfort and side effects.
RESULTS
Muscle activity decreased only while wearing the NTI-tss device. Most patients preferred though the Michigan splint due to its greater wearing comfort.
CONCLUSIONS
NTI-tss devices proved more effective for the reduction of jaw muscle activity during sleep. The main advantage of the prefabricated NTI-tss is its prompt availability in an acute phase of temporomandibular disorders associated with sleep bruxism. In long-term therapies, patients should be informed of the possible risk of irreversible occlusal changes. Subjective preferences, wearing comfort, and costs should also be considered.
Topics: Humans; Michigan; Muscles; Pilot Projects; Sleep Bruxism; Splints
PubMed: 33369223
DOI: 10.1002/cre2.371 -
The Saudi Dental Journal Nov 2021Occlusal appliances can distribute aggressive loads which are generated by bruxism and can reduce their frequency. The facebow record, when used in the construction of...
BACKGROUND
Occlusal appliances can distribute aggressive loads which are generated by bruxism and can reduce their frequency. The facebow record, when used in the construction of occlusal appliances, helps in minimizing occlusal discrepancies. This study aimed to compare the effect of CAD/CAM stabilization occlusal splint made with and without facebow for management of bruxer patients.
METHOD
24 Patients who were diagnosed as bruxers were randomly assigned into two equal groups and obtained maxillary CAD/CAM occlusal stabilizing splint recorded with centric relation either with or without using a facebow. The patient satisfaction using the visual analog scale (VAS) was recorded at baseline, one month and three months' follow-up periods. The adjustment time of both splints, from the start of splint delivery until becoming well-fitted and occlusally adjusted, was calculated using a stopwatch.
RESULTS
The CAD/CAM occlusal splints with or without the use of facebow improved the patient's satisfaction with no statistically significant difference between both groups at baseline, one month and three months with p values of 0.73, 0.24 and 0.45 respectively. The comparison between the two modalities regarding the adjustment time showed no statistically significant difference between both groups (P = 0.06).
CONCLUSION
According to the results of this study; no difference was detected in patient satisfaction and the time required for adjustment of CAD/CAM occlus.
PubMed: 34803311
DOI: 10.1016/j.sdentj.2020.07.002 -
Special Care in Dentistry : Official... Nov 2022Poly-(etheretherketone) (PEEK) began to be used in the field of odontology more than 10 years ago, especially in relation to the creation of removable partial dentures....
Poly-(etheretherketone) (PEEK) began to be used in the field of odontology more than 10 years ago, especially in relation to the creation of removable partial dentures. Here we report the case of a 62 years old woman diagnosed with histamine intolerance (or histaminosis), who presented a very particular set of oral symptoms. She described a certain tingling, burning, and swelling of the mucous membranes. These symptoms seem to be linked with the wearing of a resin occlusal splint which was initially prescribed to compensate for the absence of a meniscus in the left temporomandibular joint of the patient. After a multidisciplinary concertation, it was decided to create a new splint with a resin-free material. For this reason, the production of a PEEK prosthesis was considered. Following the installation of the occlusal splint in the patient, and after clinical adjustments, she described the occlusion positioning as correct and a disappearance of the symptomatology. Mechanically, PEEK seems to have higher mechanical resistance than PMMA. Despite these characteristics, the use of PEEK still presents some limitations, especially concerning the overall aesthetic. Additionally, the prescription of the occlusal splint seems to be limited to patients who need special care. The case presented here thus confirms a new perspective concerning the use of PEEK as an occlusal splint.
Topics: Female; Humans; Middle Aged; Occlusal Splints; Esthetics, Dental; Polymers; Temporomandibular Joint Disorders
PubMed: 35522194
DOI: 10.1111/scd.12725 -
Journal of Oral Rehabilitation Oct 2021Little is known about the effect of the type of splint material, heat-cured PMMA (HC) or chemical-cured PMMA (CC) on the wear of opposing tooth surfaces.
BACKGROUND
Little is known about the effect of the type of splint material, heat-cured PMMA (HC) or chemical-cured PMMA (CC) on the wear of opposing tooth surfaces.
OBJECTIVE
The aim of this in vitro study was to evaluate two-body wear of dentin, enamel, glass-ceramic or one of four resin composites when opposing splint materials, namely ProBase HC and CC.
METHODS
The two-body wear of bovine dentine, bovine enamel, glass-ceramic IPS e.max CAD (EMAX) and four composites (Filtek Z250 [Z250], Clearfil AP-X [AP-X], Clearfil Majesty Posterior [CMP], Filtek Supreme XTE [FSE]) opposing three antagonists (HC and CC and stainless steel as control) were evaluated in the ACTA wear machine. In addition, all the surfaces were evaluated with scanning electron microscopy.
RESULTS
The highest average wear was observed in the case of dentin. The lowest average wear was found EMAX. In every case-except for EMAX-the wear rate was higher with HC than with CC (all differences being statistically significant).
CONCLUSIONS
The level of wear of enamel, dentin and various resin composites was higher in contact with HC than in CC, the wear of dentin being the highest. In the case of a patient with no or little tooth wear or whose teeth are restored with composite material or glass-ceramic, the splint HC might be preferred because of its better durability. However, when the splint is in contact with opposing dentin preservation of the dentin, CC might be the best choice.
Topics: Animals; Cattle; Composite Resins; Dental Enamel; Dental Restoration Wear; Humans; Materials Testing; Occlusal Splints; Surface Properties; Tooth Wear
PubMed: 34320246
DOI: 10.1111/joor.13235 -
Journal of Indian Prosthodontic Society 2022The purpose of this study is to comparatively evaluate the Vitamin D supplementation and stabilization splint therapy in patients exhibiting temporomandibular disorders... (Randomized Controlled Trial)
Randomized Controlled Trial
Effectiveness of Vitamin D along with Splint therapy in the Vit D deficient patients with Temporomandibular disorder-A Randomized, double-blind, placebo-controlled clinical trial.
AIM
The purpose of this study is to comparatively evaluate the Vitamin D supplementation and stabilization splint therapy in patients exhibiting temporomandibular disorders (TMD).
SETTINGS AND DESIGN
The study design was double-blinded, parallel-group, randomized and placebo-controlled trial conducted in patients with low Vitamin D and TMDs, which were allocated to two groups, Study group S + D (Stabilization splint with Vitamin D supplementation) and Control Group S (Stabilization Splint with placebo drug).
SUBJECTS AND METHODS
Thirty-six participants of 18-45 years of age gap with Vitamin D deficiency and TMD were included in the study. Preoperative values of Vitamin D levels in ng/ml, comfort mouth opening (CMO) in mm, maximum mouth opening (MMO) in mm, temporomandibular joint (TMJ) tenderness (grading 0-3), Visual analog scale score (VAS Score 0-10 cm), and total energy (TE) integral values of both left and right TMJ's in Hertz (Hz) were recorded using joint vibration analysis All the values of CMO, MMO, TMJ Tenderness and VAS were recorded at each follow-up at 1 week, 1 month, 2 month, and 3 month, respectively. Postoperative Vitamin D levels and TE of both TMJs were recorded at end of 3 months.
STATISTICAL ANALYSIS USED
For intergroup comparison, Mann-Whitney U-test and Pearson Chi-square tests were done. For Intragroup comparison, Wilcoxon signed rank test was used for comparison.
RESULTS
In Intergroup comparison, a significant difference was seen in CMO, VAS score and MMO (P < 0.05) but not among mean values of TE of right and left TMJ, and Vitamin D levels (P < 0.05). In both groups, there were significant statistical variations in CMO, VAS score, MMO, and TE integral before and after treatment in the right and left TMJs (P < 0.05).
CONCLUSIONS
The study concludes centric stabilization splint helps in improving symptoms of TMD patients and Vitamin D supplementation provided faster relief in those cases.
Topics: Humans; Occlusal Splints; Vitamin D; Treatment Outcome; Temporomandibular Joint Disorders; Splints; Arthralgia
PubMed: 36510949
DOI: 10.4103/jips.jips_334_21 -
Journal of Oral Science Oct 2023Scientific evidence pertaining to the evaluation of trueness of occlusal splints fabricated using different three-dimensional (3D) printers and build orientations...
PURPOSE
Scientific evidence pertaining to the evaluation of trueness of occlusal splints fabricated using different three-dimensional (3D) printers and build orientations compared to subtractive technologies is lacking.
METHODS
Overall, one hundred and ten occlusal splints were manufactured using two different 3D printers and a dental mill. Five groups of ten were fabricated using the 3D printers at different build orientations (0, 30, 45, 60, and 90 degrees). In addition, a comparison group of ten occlusal splints was subtractively manufactured using a five-axis dental mill. All occlusal splints were scanned and exported as a standard tessellation language file. Analysis was conducted with metrology software with root mean square estimate average positive deviation and average negative deviation used as the measured outcome.
RESULTS
The 0 degree printing orientation was the most accurate for printer one with the root mean square value of 0.05 ± 0.01 mm, and 60 degree printing orientation was most accurate for printer two with the RMS value of 0.11 ± 0.01 mm. Subtractively manufactured occlusal splint had significantly higher trueness with the lowest RMS value of 0.03 ± 0.05 mm.
CONCLUSION
Build orientations influence the trueness of additively manufactured occlusal splints while occlusal splints produced by subtractive manufacturing were statistically significantly more accurate.
Topics: Occlusal Splints; Computer-Aided Design; Printing, Three-Dimensional; Software
PubMed: 37690838
DOI: 10.2334/josnusd.23-0115 -
Annals of Maxillofacial Surgery 2020Postsurgical malocclusion is a possible sequela of care following segmental mandibulectomy and osteocutaneous free flap reconstruction. Patient-specific factors may make...
Postsurgical malocclusion is a possible sequela of care following segmental mandibulectomy and osteocutaneous free flap reconstruction. Patient-specific factors may make surgical correction an impossibility. In addition, conservative occlusal adjustments may be insufficient for correction of the occlusion. An alternative approach for the management of severe postoperative malocclusion is to fabricate a maxillary occlusal splint, which establishes interocclusal articulating surfaces and facilitates mastication. The purpose of this report is to demonstrate the technique and utility of a maxillary prosthesis to correct posttreatment malocclusion in the oncologic patient.
PubMed: 33708608
DOI: 10.4103/ams.ams_253_19 -
Acta Stomatologica Croatica Sep 2020The objective of this pilot study was to examine the impact of occlusal splint treatment on mandibular border movements and the condyle position in subjects with bruxism.
OBJECTIVE
The objective of this pilot study was to examine the impact of occlusal splint treatment on mandibular border movements and the condyle position in subjects with bruxism.
MATERIALS AND METHODS
The study included 9 subjects diagnosed with bruxism (mean age 28.7) and 9 subjects in the control group (mean age 30.5). All subjects were adults, eugnathic, and with a dentoalveolar Angle Class I, without prosthetic restorations, previous or current orthodontic treatments, a systemic disease or previous surgical interventions in the temporomandibular joint. All experimental and control group subjects were provided with a standardized relaxation occlusal splint, which they wore for 8 weeks. During this time, an initial and three additional measurements of incisal opening (IO), left condyle opening (OLC), right condyle opening (ORC), left laterotrusion (LLI) and right laterotrusion (LRI) (after 2, 4 and 8 weeks) were performed using an Arcus Digamma II (Kavo) ultrasound device for mandibular movements recording. Using the same instrument, the condylar position during protrusion, left and right laterotrusion, and in the centric relation position (CR) was analyzed initially and after 8 weeks using the maximum intercuspation as reference point. Continuous variables were described using basic statistical parameters, and the statistical significance of differences between the variables was checked by the t-test and χ2 test (p <0.05).
RESULTS
The values of IO, OLC, ORC, LLI and LRI increased after 8 weeks of wearing, with the highest increase for OLC, by 13.8%. No statistically significant difference (p <0.05) was found for any changes in movements. Changes in the condyle position during all movements and those in the CR were higher in the experimental group for 10 out of 14 measured parameters compared to the control group. A statistically significant difference was established for 5 out of 14 measured parameters after the occlusal splint treatment.
CONCLUSIONS
The results of this pilot study have proven the influence of the occlusal splint treatment on mandibular border movements in subjects with bruxism by increasing the range of movements. Also the changes of the condyle position in subjects with bruxism were greater compared to those in healthy subjects.
PubMed: 33132395
DOI: 10.15644/asc54/3/10 -
Scientific Reports Jul 2020Temporomandibular disorders (TMD), when progress to a chronic state, might contribute to psychosocial or psychological distress. This study aimed to evaluate the effect... (Randomized Controlled Trial)
Randomized Controlled Trial
Temporomandibular disorders (TMD), when progress to a chronic state, might contribute to psychosocial or psychological distress. This study aimed to evaluate the effect of stabilization splint (SS) therapy on pain, pain-related disability and psychological traits of chronic TMD patients, as well as to assess selected oxidative stress (OS) biomarkers during 6-month treatment and associate them with the symptoms of anxiety and depression. Thirty-four participants were randomly assigned into two treatment groups [SS and placebo splint (PS)]. Primary outcomes were pain intensity and pain-related disability while secondary outcomes included depressive and anxiety symptoms. The influence of the treatment type was analyzed with regards to the levels of OS biomarkers in saliva. Participants treated with SS demonstrated significantly greater improvement in pain-related disability (Pain-free mouth opening: p = 0.018, η = 0.166; Number of disability days: p = 0.023, η = 0.155) and greater reduction of depressive symptoms scores (p = 0.007, η = 0.207). When compared to the PS group, participants in the SS group showed a significant reduction of oxidant/antioxidant ratio (p = 0.018, η = 0.167) at a 3-month follow-up. A stabilization splint provides advantages over PS in the treatment of depressive symptoms and pain-related disability. Furthermore, clinical success in terms of reduction of depressive symptoms, which correlates with the reduction of oxidative stress markers in the SS group, indicates that oxidative stress is related to psychological factors in chronic TMD patients.
Topics: Adult; Biomarkers; Chronic Pain; Croatia; Depression; Female; Humans; Middle Aged; Occlusal Splints; Oxidative Stress; Pain Measurement; Saliva; Stress, Psychological; Temporomandibular Joint Disorders; Treatment Outcome; Young Adult
PubMed: 32620810
DOI: 10.1038/s41598-020-67383-x