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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 -
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 -
Journal of the Mechanical Behavior of... Jun 2023Although additive manufacturing has been widely applied for occlusal splint (OS) fabrication, it is still unclear whether 3D printing system and post-curing atmosphere...
Although additive manufacturing has been widely applied for occlusal splint (OS) fabrication, it is still unclear whether 3D printing system and post-curing atmosphere would play a role in the wear resistance of additive-manufactured OS. Therefore, the aim of this study was to evaluate the effect of 3D printing system (liquid crystal display (LCD) and digital light processing (DLP)) and post-curing atmosphere (air and nitrogen gas (N)) on the wear resistance of hard and soft OS materials for additive-manufactured OSs (KeySplint® Hard and Soft). The evaluated properties were microwear (by two-body wear test) and nano-wear resistances (by nanoindentation wear test) as well as flexural strength and flexural modulus (by three-point bending test), surface microhardness (by Vickers hardness test), and nanoscale elastic modulus (reduced elastic modulus) and nano surface hardness (by nanoindentation test). For the hard material, the surface microhardness, microwear resistance, reduced elastic modulus, nano surface hardness, and nano-wear resistance were significantly affected by the printing system (p < 0.05), while all the evaluated properties except flexural modulus were significantly affected by the post-curing atmosphere (p < 0.05). Meanwhile, both the printing system and post-curing atmosphere significantly affected all the evaluated properties (p < 0.05). The specimens additive-manufactured by DLP printer tended to show higher wear resistance in the hard material groups and lower wear resistance in the soft material groups when compared to those by LCD printer. The post-curing at N atmosphere significantly enhanced the microwear resistance of hard material groups additive-manufactured by the DLP printer (p < 0.05) and soft material groups additive-manufactured by the LCD printer (p < 0.01), while it significantly enhanced the nano-wear resistance of both hard and soft material groups regardless of the printing system (p < 0.01). It can be concluded that 3D printing system and post-curing atmosphere affect the micro- and nano-wear resistance of tested additively manufactured OS materials. In addition, it can be also concluded that the optical printing system providing higher wear resistance depends on the material type, and using nitrogen gas as a protection gas during post-curing enhances the wear resistance of tested materials.
Topics: Materials Testing; Occlusal Splints; Printing, Three-Dimensional; Flexural Strength; Nitrogen; Surface Properties
PubMed: 37028121
DOI: 10.1016/j.jmbbm.2023.105799 -
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 -
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 -
Prilozi (Makedonska Akademija Na... Dec 2019Cephalea from orofacial origin is a diffuse, mild to moderate pain that appears as a bandage around the head. There are many different etiological causes of dental...
INTRODUCTION
Cephalea from orofacial origin is a diffuse, mild to moderate pain that appears as a bandage around the head. There are many different etiological causes of dental origin that contribute to the appearance of cephalea.
PURPOSE
The purpose of our research is dental treatment of patients with traumatic occlusion, bruxism and loss of occlusal support, which have a pathological condition - cephalea from orofacial origin.
MATERIAL AND METHODS
For the purposes of this paper, 15 patients with cephalea from orofacial origin were analysed, diagnosed and treated. The control group consisted of 15 patients without etiological factors. A butterfly deprogrammer and a stabilization splint were made depending on the indication.
RESULTS AND DISCUSSION
According to our patient study results, it appears to be a link between inadequately made prosthetic devices, bruxism and loss of occlusal support with cephalea. The therapy should help the patient urgently and continue to relieve the cephalea symptoms from orofacial origin. The results show an improvement in 86.7% of the examinees.
CONCLUSION
The butterfly deprogrammer and stabilization splint are new methods that can contribute along with other therapeutic modalities in improving the quality of life in a patient with cephalea from orofacial origin.
Topics: Dental Care; Dental Occlusion; Facial Pain; Follow-Up Studies; Humans; Malocclusion; Pain Management; Quality of Life; Treatment Outcome
PubMed: 32109212
DOI: 10.2478/prilozi-2020-0010 -
Life (Basel, Switzerland) Jun 2022The gold standard for the management of sleep bruxism (SB) is the use of a rigid occlusal splint; however, there are limitations for its use in children and alternatives...
The gold standard for the management of sleep bruxism (SB) is the use of a rigid occlusal splint; however, there are limitations for its use in children and alternatives to the management of SB are needed. Photobiomodulation therapy has been used with positive results in temporomandibular disorders. This study aimed to evaluate the effects of photobiomodulation therapy with infrared LED in children with SB. Thirty children were divided into three groups: Group 1: control/absence of bruxism (n = 10); Group 2: SB treated with infrared LED (n = 10); Group 3: SB treated with occlusal splint (n = 10). Electromyographic evaluation of masseter, anterior temporalis, and upper trapezius, and salivary dopamine levels were assessed before and after treatments. Data were statistically analyzed using two-way mixed model ANOVA. An increase in the temporalis and right masseter EMG activity at rest was observed in Group 3, with large effect size (p < 0.05). Left masseter and temporalis EMG activity did not differ over time in the LED group, similar to the control group. Moreover, the EMG activity of masticatory muscles during chewing and upper trapezius muscle did not differ over time in all groups. The results also pointed to a difference in the levels of dopamine between children with and without SB, with Group 3 showing higher levels in the pre-treatment time compared to controls (p < 0.025). In conclusion, an increase in the masticatory muscles activity at rest was observed in children undergoing splint therapy. Moreover, a difference in the levels of salivary dopamine was found between children with and without SB.
PubMed: 35888053
DOI: 10.3390/life12070964 -
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 -
Turkish Journal of Physical Medicine... Mar 2020This study aims to evaluate the effects of additional low-level laser therapy (940 nm GaAlAs) to the routine occlusal splint therapy on maximal mouth opening (MMO),...
OBJECTIVES
This study aims to evaluate the effects of additional low-level laser therapy (940 nm GaAlAs) to the routine occlusal splint therapy on maximal mouth opening (MMO), visual analog scale (VAS) scores, and passive mouth opening (PMO).
PATIENTS AND METHODS
Between January 2016 and March 2018, a total of 40 patients (10 males, 30 females; mean age 22.35 years; range, 18 to 60 years) with disc displacement with reduction of the temporomandibular joint were included. The patients were divided into two groups. Group 1 (control group, n=20) received routine non-steroidal anti-inflammatory drug (NSAID) therapy and occlusal splint therapy for eight hours per day for a total of three months. Group 2 (laser group, n=20) received NSAID, occlusal splint therapy and 940 nm wavelength diode laser therapy for two sessions per week for a total of four weeks. The MMO, PMO, and VAS scores were recorded before and at one, two, three, four, and 12 weeks after treatment. The joint and muscle examinations were performed.
RESULTS
A constant decrease was found in the VAS scores in both groups. At four (p=0.008) and 12 weeks (p=0.003), a statistically significant difference in the VAS scores was observed. At all time points, PMO and MMO scores increased in both groups. The MMO scores were statistically higher in the laser group at all time points (p<0.005).
CONCLUSION
Our study results suggest that short-term low-level laser therapy additional to conventional treatment may yield satisfactory outcomes.
PubMed: 32318671
DOI: 10.5606/tftrd.2020.3355 -
International Journal of Environmental... Jan 2022Whiplash is a consequence of traumatic injuries, mostly related to road accidents, with variable clinical manifestations, also known as Whiplash Associated Disorders,...
BACKGROUND
Whiplash is a consequence of traumatic injuries, mostly related to road accidents, with variable clinical manifestations, also known as Whiplash Associated Disorders, such as neck, head and temporo-cranio-mandibular pain.
METHODS
The current study aims to evaluate the onset and evolution of temporomandibular joint pain in people with whiplash in a study group treated with the use of Zimmer Collars (adjustable rigid cervical collars for neck immobilization), as compared to a control group. This prospective study included 31 patients followed by the Dental Prosthesis Department of the University of Bari "Aldo Moro": 20 patients with whiplash (age range: 20-39 years) treated with Zimmer collars and 11 patients with whiplash (age range: 20-33 years) who were not. Immediately after the whiplash occurred, a visual analogue scale (VAS) was used to describe the intensity of pain and to complete the chart of the European Academy of Craniomandibular Disorders. Five out of twenty patients, already treated with a Zimmer collar, wore an occlusal splint as well because of persistent pain reported at the 28-day and 60-day follow-up and were supported by pharmacological therapy with analgesics (paracetamol) and muscle relaxants (thiocolchicoside).
RESULTS
During the last follow-up (at six months), three out of five patients displayed a residual VAS score of 3, 4, and 5, respectively, while the remaining two displayed a VAS of 0. In the control group, four out of eleven patients needed to wear an occlusal splint but without muscle relaxants and analgesics pharmacological therapy; these four corresponded to the patients showing a residual painful symptomatology, with VAS reaching value of 2, and also were the oldest patients of the group. Data regarding VAS values and Zimmer collar use, both at the first visit and six months later, were statistically analyzed.
CONCLUSION
Our prospective study highlights how whiplash-associated acute disorders are often self-limiting over a period of few months, thus reducing the possibility of symptom chronicity; the latter seems to be strictly related to lesion severity, pre-existence of a craniomandibular dysfunction and patient age, but appears to be independent from Zimmer collar use, as statistically confirmed.
Topics: Adult; Humans; Neck; Pain; Pain Measurement; Prospective Studies; Whiplash Injuries; Young Adult
PubMed: 35055722
DOI: 10.3390/ijerph19020901