-
Acta Odontologica Scandinavica May 2024Temporomandibular joint (TMJ) pathologies are prevalent, affecting approximately 40% of the worldwide population, with nearly 80% involving intracapsular disorders....
OBJECTIVE
Temporomandibular joint (TMJ) pathologies are prevalent, affecting approximately 40% of the worldwide population, with nearly 80% involving intracapsular disorders. Despite this, standardized treatment protocols are lacking. This study aimed to compare the efficacy of conservative and surgical approaches in managing intracapsular TMJ disorders.
METHODS
Eighty-six patients diagnosed with intracapsular TMJ disorders were included in the study, with 40 males and 46 females, averaging 52.4 ± 4.7 years. Patients were recruited from polyclinics in Beijing, China (n = 36), and Kyiv, Ukraine (n = 50). A comprehensive examination protocol was conducted, including assessment of patient complaints, medical history, jaw mobility measurements, TMJ palpation, and magnetic resonance imaging (MRI) screening.
RESULTS
The main outcomes of our study revealed significant improvements in patients undergoing surgical intervention for intracapsular TMJ disorders, particularly in cases of disc displacement. Conservative mouth guard/occlusal splint treatment showed limited effectiveness, primarily improving joint effusion and disc displacement. Surgical intervention led to notable enhancements in various TMJ parameters, with significant improvements observed in joint function and pain reduction. Based on these findings, orthodontic rehabilitation was recommended to ensure long-term efficacy, focusing on optimizing occlusion and restoring TMJ function. These results highlight the importance of tailored treatment approaches for managing intracapsular TMJ disorders, emphasizing the role of surgical intervention coupled with comprehensive rehabilitation strategies.
CONCLUSIONS
Future research should consider demographic factors and explore innovative examination methods, such as optical systems, to enhance understanding and management of intracapsular TMJ disorders.
Topics: Humans; Temporomandibular Joint Disorders; Male; Female; Middle Aged; Adult; China; Ukraine; Magnetic Resonance Imaging; Treatment Outcome
PubMed: 38712696
DOI: 10.2340/aos.v83.40633 -
Journal of the Korean Association of... Aug 2019Patients with masticatory muscle tendon-aponeurosis hyperplasia (MMTAH) experience limited mouth opening due to restricted muscle extension. Hyperplastic aponeurosis and... (Review)
Review
Patients with masticatory muscle tendon-aponeurosis hyperplasia (MMTAH) experience limited mouth opening due to restricted muscle extension. Hyperplastic aponeurosis and tendons lead to the restriction of muscle extension. The criteria for the diagnosis of MMTAH are limited mouth opening that progresses very slowly from adolescence, intraoral palpation reveals a hard cord-like structure along the overhang of the anterior border of the masseter muscle on maximum mouth opening, and a square mandible. Conservative treatment, including pharmacotherapy, occlusal splint and physical therapy are ineffective. The standard therapy is surgical treatment, such as anterior partial aponeurectomy of the masseter muscle and coronoidectomy. The long-term results are very satisfying.
PubMed: 31508348
DOI: 10.5125/jkaoms.2019.45.4.174 -
The Journal of Craniofacial SurgeryAn augmented reality tool allows visual tracking of real anatomical structures and superimposing virtual images, so it can be used for navigation of important structures...
BACKGROUND
An augmented reality tool allows visual tracking of real anatomical structures and superimposing virtual images, so it can be used for navigation of important structures during surgery.
OBJECTIVES
The authors have developed a new occlusal splint-based optical navigation system for craniomaxillofacial surgery. In this study, the authors aim to measure the accuracy of the system and further analyze the main factors influencing precision.
METHODS
Ten beagle dogs were selected and a three-dimensional model was established through computed tomography scanning, dental model making, and laser scanning, and then registration was performed according to the tooth marking points. The bilateral mandibular osteotomy was performed on Beagle dogs under navigation system based on the occlusal splint. The left side was taken to compare the deviation between the preoperative plan and the surgical results, and the accuracy of distance and angle and the stability of the system were analyzed.
RESULTS
The average position deviation between the preoperative design and intraoperative navigation was: 0.01 ± 0.73 mm on the lateral height of the mandibular ramus, 0.26 ± 0.57 mm on the inner height of the mandibular ramus, and 0.20 ± 0.51 mm on the osteotomy length. The average angle deviation is 0.94° ± 1.38° on the angle between the mandibular osteotomy plane and ramus plane and 0.66° ± 0.97° on the angle of the retained mandibular angle. And most of the data showed good consistency.
CONCLUSIONS
In summary, the accuracy of the system can meet clinical requirements and can be used as a useful tool to improve the accuracy of craniomaxillofacial surgery.
Topics: Animals; Augmented Reality; Dogs; Imaging, Three-Dimensional; Mandible; Mandibular Osteotomy; Occlusal Splints; Osteotomy; Surgery, Computer-Assisted
PubMed: 34260445
DOI: 10.1097/SCS.0000000000007833 -
Medicina (Kaunas, Lithuania) Sep 2020Temporomandibular disorders are complex dysfunctions of masticatory muscles and temporomandibular joints. Their symptoms affect more than 40% of the population and their... (Review)
Review
Temporomandibular disorders are complex dysfunctions of masticatory muscles and temporomandibular joints. Their symptoms affect more than 40% of the population and their prevalence is rising. It is important to establish a unified protocol for this specialistic examination. This review describes the authors' own longstanding experiences and the discrepancies in the current literature regarding this topic as well as a detailed procedure of diagnosing temporomandibular disorders including the leading but often underrated role of a medical interview. We presented optimal physical examination methods as well as specific situations in which additional diagnostic and imaging tools may be useful. The emphasis was put on the importance of differential diagnosis between temporomandibular disorders and other diseases presenting with similar symptoms.
Topics: Facial Pain; Humans; Masticatory Muscles; Temporomandibular Joint Disc; Temporomandibular Joint Disorders
PubMed: 32942581
DOI: 10.3390/medicina56090472 -
European Journal of Dentistry May 2022The purpose of this pilot study was to demonstrate the capabilities of the T-Scan Novus system in bruxism treatment by splints. Bruxism patients underwent treatment with...
The purpose of this pilot study was to demonstrate the capabilities of the T-Scan Novus system in bruxism treatment by splints. Bruxism patients underwent treatment with a splint made by additive manufacturing. Intraoral scanning was performed using Trios Color (3Shape), and digital design was performed using 3Shape Dental system design - splint studio. The biocompatible material Dental LT Clear Resin was printed using a Formlabs Form 2 printer. The T-Scan Novus system with a software attached to it, version 9.1, was used for digital examination of the occlusion. A splint with an occlusal thickness of 2.5 mm was developed and software adapted with relief to antagonists. The digitally set occlusion with even contacts turned out to be clinically unbalanced. After adjusting with T-Scan Novus, a balanced occlusion was achieved in the right and left halves. The treatment of bruxism with splint therapy continues to be the main method. Its combination with digital technologies allows more precise constructions and more accurate balancing of occlusal relationships.
PubMed: 34863081
DOI: 10.1055/s-0041-1736315 -
Bioengineering (Basel, Switzerland) Apr 2023Abnormal bite force is an important risk factor for oral and maxillofacial disorders, which is a critical dilemma that dentists face every day without effective...
Abnormal bite force is an important risk factor for oral and maxillofacial disorders, which is a critical dilemma that dentists face every day without effective solutions. Therefore, it is of great clinical significance to develop a wireless bite force measurement device and explore quantitative measurement methods to help find effective strategies for improving occlusal diseases. This study designed the open window carrier of a bite force detection device through 3D printing technology, and then the stress sensors were integrated and embedded into a hollow structure. The sensor system mainly consisted of a pressure signal acquisition module, a main control module, and a server terminal. A machine learning algorithm will be leveraged for bite force data processing and parameter configuration in the future. This study implemented a sensor prototype system from scratch to fully evaluate each component of the intelligent device. The experimental results showed reasonable parameter metrics for the device carrier and demonstrated the feasibility of the proposed scheme for bite force measurement. An intelligent and wireless bite force device with a stress sensor system is a promising approach to occlusal disease diagnosis and treatment.
PubMed: 37237577
DOI: 10.3390/bioengineering10050507 -
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 Journal of Prosthetic Dentistry Jun 2023Occlusal devices can be either conventionally processed, milled, or printed. However, little is known about the biocompatibility of 3D printing resin materials.
STATEMENT OF PROBLEM
Occlusal devices can be either conventionally processed, milled, or printed. However, little is known about the biocompatibility of 3D printing resin materials.
PURPOSE
The purpose of this in vitro study was to compare the viability and morphology of human gingival fibroblast cells (HFG-1) after cultivation on conventionally processed, milled, and printed occlusal device materials with different surface treatments.
MATERIAL AND METHODS
Disks of a conventionally processed (PalaXpress Clear [pP]), milled (Yamahachi PMMA Clear [sY]), and 2 different printed materials (Dental LT Clear Resin [aD]; Freeprint splint [aF]) were prepared. The surfaces of the specimens were finished by using 2 different treatments (unpolished and polished with P1200-grit silicon carbide paper). HGF-1 cells were cultivated on the specimens for 24 hours, and a viability assay was performed by using polystyrene disks as a control (n=9 disks per group). Cell morphology and the topography of the specimens were examined with scanning electron microscopy (n=3 disks per group). Two-way analysis of variance was applied to determine the effect of material and surface treatment followed by the post hoc Fisher least significant difference test (α=.05).
RESULTS
Overall, material (P<.001) and surface treatment (P<.001) significantly influenced the viability of HGF-1 cells. The viability of cells on all specimens displayed mean values between 0.85 and 1.01 compared with the control except for unpolished aD (0.00 ±0.07) and aF (0.02 ±0.05) that had only a few cells with a round shape.
CONCLUSIONS
The behavior of HGF-1 cells on conventionally processed and milled specimens was similar and not dependent on the surface treatment. Unpolished printed specimens had a cytotoxic effect. However, after polishing, cell behavior was similar to that of the conventionally processed and milled specimens.
Topics: Humans; Dental Materials; Materials Testing; Printing, Three-Dimensional; Fibroblasts; Surface Properties
PubMed: 34598769
DOI: 10.1016/j.prosdent.2021.08.015 -
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