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Journal of Dentistry Jul 2024To evaluate the effect of polishing and layering thickness on the wear resistance of 3D-printed occlusal splint materials.
OBJECTIVE
To evaluate the effect of polishing and layering thickness on the wear resistance of 3D-printed occlusal splint materials.
METHODS
Specimens with 3 different layer thicknesses (50, 75, 100 µm) were produced in the form of a disc 3 mm thick using V-Print splint resin on a 3D-printer with digital light processing technology. (n = 16 for each thickness) All specimens were washed and cured according to the manufacturer's instructions. Half of the specimens of each layer thickness were polished with silicon carbide papers. All specimens were subjected to 120.000 cycles of a chewing simulator for 2-body wear tests. Before and after the wear test, the specimens were scanned with a laser scanner, and the images were overlaid using a 3D analysis program and the volume loss was calculated. The wear patterns of the specimens were examined under a scanning electron microscope. Statistical evaluation was performed using a Shapiro-Wilk test, 2-way ANOVA, 1-way ANOVA, and Tukey post hoc test (α = 0.05).
RESULTS
While polishing had a significant effect (p = 0.003) on the wear volume of the occlusal splints, layer thickness (p = 0.105) and their interaction between polishing and layer thickness (p = 0.620) did not significantly affect the wear volume. Regardless of the polishing, the lowest mean wear was observed for D50 (0.064 mm), followed by D75 (0.078 mm), and D100 (0.096 mm). However, a significant difference was observed only between polished D50 and unpolished D100.
CONCLUSION
The polished 3D-printed occlusal splint resin showed higher wear resistance than the unpolished one, regardless of the layer thickness.
CLINICAL SIGNIFICANCE
Since different layer thicknesses of 50 µm and greater had no effect on the wear resistance of the material, a layer thickness of 100 µm may be preferred for faster printing. However, polishing occlusal splints may reduce the amount of wear and improve clinical performance.
Topics: Materials Testing; Surface Properties; Occlusal Splints; Dental Polishing; Humans; Printing, Three-Dimensional; Microscopy, Electron, Scanning; Carbon Compounds, Inorganic; Silicon Compounds; Dental Restoration Wear; Lasers; Dental Materials; Computer-Aided Design; Mastication
PubMed: 38801940
DOI: 10.1016/j.jdent.2024.105101 -
The International Journal of... Feb 2024Artificial intelligence (AI) has been expanding into areas that were thought to be reserved for human experts and has a tremendous potential to improve patient care and...
Artificial intelligence (AI) has been expanding into areas that were thought to be reserved for human experts and has a tremendous potential to improve patient care and revolutionize the healthcare field. Recently launched AI-powered dental design solutions enable automated occlusal device design. This article describes a dental method for the complete digital workflow for occlusal device fabrication using two different AIpowered design software programs (Medit Splints and 3Shape Automate) and additive manufacturing. Additionally, the benefits and drawbacks of this workflow were reviewed and compared to conventional workflows.
Topics: Artificial Intelligence; Workflow; Humans; Software; Computer-Aided Design; Dental Prosthesis Design; Occlusal Splints
PubMed: 38787592
DOI: 10.11607/ijp.8941 -
European Journal of Oral Sciences May 2024This study aimed to investigate the bisphenol A (BPA) release from four CAD/CAM splint materials: three polycarbonate-based (DD BioSplint C, Splint Plus Biostar, Temp...
This study aimed to investigate the bisphenol A (BPA) release from four CAD/CAM splint materials: three polycarbonate-based (DD BioSplint C, Splint Plus Biostar, Temp Premium Flexible) and one polymethylmethacrylate-based (Temp Basic) material. From each material, ten cylindrical samples (n = 40) were immersed in high-performance liquid chromatography (HPLC) grade water following ISO 10993-12 and incubated for 24 h in an incubation shaker at 37°C and 112 rpm. Following BPA derivatization, analysis was performed by high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS). After 24 h of incubation, all investigated materials released significant amounts of BPA compared to water blanks. The material-dependent elution increased in the following order: DD BioSplint C < Splint Plus Biostar < Temp Basic < Temp Premium Flexible. Subtracting extraneous BPA, the concentrations ranged between 2.27 ng/mL and 12.65 ng/mL. After extrapolating the concentrations in relation to the average surface area of occlusal splints, the amount of BPA per mL exceeded the Tolerable Daily Intake (TDI) set by the European Union for a person weighing 70 kg by 1.32-6.16 times. Contrary to the release from previously investigated materials, BPA elution from CAD/CAM splint materials was highly elevated. Considering the increasing adaptation of CAD/CAM techniques, elution from them may represent a relevant BPA source in daily dental practice.
PubMed: 38778467
DOI: 10.1111/eos.12993 -
Journal of Oral Rehabilitation May 2024Myogenic temporomandibular disorders (M-TMD) commonly involve occlusal splint (OS) therapy and musculoskeletal physiotherapy (MPT).
BACKGROUND
Myogenic temporomandibular disorders (M-TMD) commonly involve occlusal splint (OS) therapy and musculoskeletal physiotherapy (MPT).
OBJECTIVES
To compare the effects of combining OS with MPT and education (EG) against OS and education (CG), in chronic M-TMD patients.
METHODS
In this double-blind randomised controlled trial, 62 participants were assigned to either EG or CG. The primary outcomes, pain levels at rest (VAS rest), maximum oral opening (VAS open) and during chewing (VAS chew), were measured by Visual Analogue Scale (VAS) in cm. The secondary outcome was the range of motion (ROM) for maximum oral opening. Both interventions lasted 3 months, with outcomes assessed at baseline (T0), post-treatment (T1) and 3 months post-treatment (T2).
RESULTS
Intention-to-treat analysis revealed significant improvements favouring EG (VAS rest = -1.50 cm [CI: -2.67, -0.32], p = .04; VAS open = -2.00 cm [CI: -3.23, -0.75], p < .01; VAS chew = -1.71 cm [CI: -2.90, -0.52], p = .01; ROM = 4.61 [CI: 0.93, 8.30], p = .04). Additionally, VAS measures were influenced by follow-up times (VAS rest = -0.73 cm [CI: -1.30, -0.17], p = 0.03; VAS open = -0.97 cm [CI: -1.57, -0.37], p < .01; VAS chew = -1.15 cm [CI: -1.73, -0.58], p < .01). At T1, EG demonstrated higher number of responders compared to CG for VAS open (χ(1) = 4.39, p = .04) and VAS chew (χ(1) = 11.58, p < .01).
CONCLUSION
Adding MPT to education and OS yields better outcomes in terms of pain reduction and ROM improvement, in chronic M-TMD.
TRIAL REGISTRATION NUMBER
NCT03726060.
PubMed: 38757854
DOI: 10.1111/joor.13729 -
Oral Surgery, Oral Medicine, Oral... Apr 2024Anterior displacement of the temporomandibular joint (TMJ) disc is a disorder in which the articular disc is dislocated from its correct position relative to the...
Is there a superiority between arthrocentesis and stabilizing occlusal splint for the treatment of anterior disc displacement with reduction and intermittent block and anterior disc displacement without reduction in TMJ? Randomized clinical trial.
INTRODUCTION
Anterior displacement of the temporomandibular joint (TMJ) disc is a disorder in which the articular disc is dislocated from its correct position relative to the mandibular condyle and mandibular fossa. Traditionally, the initial treatment of disc displacements involves various conservative measures, including the use of a stabilizing interocclusal splint. However, in cases where there is associated limited mouth opening, as in the case of anterior disc displacement with reduction and intermittent block (ADDwRIB), and anterior disc displacement without reduction (ADDw/oR), arthrocentesis has been suggested as another modality of initial treatment due to its faster effect in preventing disease progression to a more advanced stage, as well as reducing the chances of pain chronification and central sensitization.
OBJECTIVES
This study aimed to analyze whether there is a preponderance in efficacy between treatments with a stabilizing interocclusal splint or arthrocentesis in these patients.
METHODS
A randomized, prospective, longitudinal clinical trial was conducted. The sample was obtained by convenience, between June 2021 and January 2023. Twenty-four patients with diagnoses of ADDwRIB and ADDw/oR were included. The diagnosis and clinical evaluations followed the DC/TMD criteria, and TMJ MRI was performed. Patients were randomly allocated to 2 treatment groups. Group 1 (n = 13): stabilizing interocclusal splint. Group 2 (n = 11): arthrocentesis. Patients were evaluated after 1, 2, 3, and 6 months for clinical parameters of pain, functionality, and psychosocial status.
RESULTS
Both treatments were effective in reducing pain levels, with no statistically significant differences. Group 1 showed significantly greater mouth-opening levels compared to Group 2 (P = .041).
CONCLUSION
Both groups showed significant improvements in various parameters evaluated throughout the study, indicating they are equally effective in pain control and most functional and quality of life parameters. However, the stabilizing interocclusal splint treatment was superior in restoring mouth opening.
PubMed: 38749875
DOI: 10.1016/j.oooo.2024.04.001 -
Clinical Oral Investigations May 2024Material chemistry and workflow variables associated with the fabrication of dental devices may affect the biocompatibility of the dental devices. The purpose of this...
OBJECTIVES
Material chemistry and workflow variables associated with the fabrication of dental devices may affect the biocompatibility of the dental devices. The purpose of this study was to compare digital and conventional workflow procedures in the manufacturing of acrylic-based occlusal devices by assessing the cytotoxic potential of leakage products.
METHODS
Specimens were manufactured by 3D printing (stereolithography and digital light processing), milling, and autopolymerization. Print specimens were also subjected to different post-curing methods. To assess biocompatibility, a human tongue epithelial cell line was exposed to material-based extracts. Cell viability was measured by MTT assay while Western blot assessed the expression level of selected cytoprotective proteins.
RESULTS
Extracts from the Splint 2.0 material printed with DLP technology and post-cured with the Asiga Flash showed the clearest loss of cell viability. The milled and autopolymerized materials also showed a significant reduction in cell viability. However, by storing the autopolymerized material in dHO for 12 h, no significant viability loss was observed. Increased levels of cytoprotective proteins were seen in cells exposed to extracts from the print materials and the autopolymerized material. Similarly to the effect on viability loss, storing the autopolymerized material in dHO for 12 h reduced this effect.
CONCLUSIONS/CLINICAL RELEVANCE
Based on the biocompatibility assessments, clinical outcomes of acrylic-based occlusal device materials may be affected by the choice of manufacturing technique and workflow procedures.
Topics: Humans; Materials Testing; Cell Survival; Biocompatible Materials; Printing, Three-Dimensional; In Vitro Techniques; Acrylic Resins; Cell Line; Blotting, Western
PubMed: 38748326
DOI: 10.1007/s00784-024-05707-1 -
Swiss Dental Journal Feb 2024The aim of the treatment of this case was to restore the form, function and aesthetics of all teeth in a patient with amelogenesis imperfecta within the age limit of the...
The aim of the treatment of this case was to restore the form, function and aesthetics of all teeth in a patient with amelogenesis imperfecta within the age limit of the disability insurance (IV). Single-tooth zirconia crowns were selected as the treatment of choice and cemented with a conventional glass ionomer cement. For the maintenance of the oral rehabilitation and the protection of the reconstructions a michigan splint was produced and instructed to be carried over night.
Topics: Humans; Amelogenesis Imperfecta; Crowns; Glass Ionomer Cements; Zirconium; Female; Male; Esthetics, Dental; Dental Prosthesis Design; Occlusal Splints
PubMed: 38739045
DOI: 10.61872/sdj-2024-03-02 -
The International Journal of... May 2024Mandibular deviation (MD) is a common reconstruction sequela after segmental mandibulectomy. Although proper postoperative rehabilitation is critical for MD management...
Mandibular deviation (MD) is a common reconstruction sequela after segmental mandibulectomy. Although proper postoperative rehabilitation is critical for MD management and minimization, the information available is limited. This report describes postoperative rehabilitation with an occlusal splint fabricated using computer-aided design (CAD) and computer-aided manufacturing (CAM) (CAD/CAM-OS) and the results of a threedimensional occlusal analysis using an intraoral scanner after hemimandibulectomy and plate reconstruction. Despite the short follow-up, adherence to postoperative rehabilitation with CAD/CAM-OS for MD correction, even during radiotherapy, was demonstrated by the digital workflow and analysis results.
PubMed: 38727621
DOI: 10.11607/ijp.8904 -
Journal of Oral Rehabilitation May 2024Single nucleotide polymorphisms (SNPs) may influence pain susceptibility and impact treatment response in pain-related temporomandibular disorders (TMDp).
BACKGROUND
Single nucleotide polymorphisms (SNPs) may influence pain susceptibility and impact treatment response in pain-related temporomandibular disorders (TMDp).
OBJECTIVE
Explore the role of COMT (rs4646310, rs6269, rs4818, rs4680) and OPRM1 (rs1799971) genotypes in regulating treatment response.
METHODS
Sixty TMDp patients (55 females and 5 males), diagnosed with the Diagnostic Criteria for TMD (DC/TMD), underwent standardised treatment (information and education, home physical therapy, occlusal splint) for 6 months. Treatment outcomes included: pain intensity, pain-free mouth opening, jaw functional limitation, depression, and anxiety. Genotyping for COMT and OPRM1 SNPs was performed using DNA from buccal mucosa swabs and TaqMan assays. Statistical analysis was carried out to compare the changes in treatment outcomes and the influence of genotypes on treatment response.
RESULTS
Significantly less pain reduction was observed in minor allele carriers of rs4646310, and rs4680 compared to dominant homozygous (p < .025). Minor allele carriers of rs1799971 and rs4646310 demonstrated worsening in pain-free mouth opening while dominant homozygous exhibited improvement (p < .025). Significantly less anxiety reduction was observed in minor allele carriers of rs4646310 compared to dominant homozygous (p = .003). Of the all variables assessed in the regression model, carrying a minor allele of rs1799971 predicted a poorer treatment response considering pain-free mouth opening while carrying a minor allele of rs4646310 predicted less pain and less anxiety reduction.
CONCLUSION
Our findings indicate that certain SNP variants of the COMT and OPRM1 genes were associated with poorer treatment response and may therefore play a significant role in the classification of TMDp patients. Also, assessment of patient genotype could potentially aid in predicting treatment response.
PubMed: 38725226
DOI: 10.1111/joor.13730 -
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