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European Journal of Oral Sciences Apr 2024This systematic review answers the question: "Does occlusal appliance use influence masticatory muscle function of dentate individuals with sleep bruxism?". The... (Meta-Analysis)
Meta-Analysis Review
This systematic review answers the question: "Does occlusal appliance use influence masticatory muscle function of dentate individuals with sleep bruxism?". The literature search included six databases, grey literature, and manual search for articles. Randomized and non-randomized clinical trials were included comparing muscle function of sleep bruxers before and after receiving occlusal appliances. Risk of bias was assessed with risk of bias assessment for randomized and non-randomized clinical trials tool. Twelve studies, three represent randomized clinical trials, were included. Risk of bias was considered low, moderate, or serious. Meta-analyses indicated that soft and hard appliances did not influence muscle activity and bite force of bruxers. Qualitative analysis showed that occlusal appliance use did not influence masticatory performance and muscle volume. However, it was effective in reducing tongue force. Certainty of evidence was considered very low for muscle activity when evaluated with hard appliances, and for bite force evaluated with both appliance materials. Low certainty of evidence was observed for muscle activity with soft appliances. Based on the findings of this meta-analysis, occlusal appliances do not affect masticatory muscle function of sleep bruxers. Regardless of appliance material, the activity of masseter and temporal, and bite force of sleep bruxers was not influenced.
Topics: Humans; Sleep Bruxism; Masticatory Muscles; Masseter Muscle; Occlusal Splints; Sleep
PubMed: 38421263
DOI: 10.1111/eos.12979 -
Cranio : the Journal of... Feb 2024The aim of this study was to assess the received TMD treatment modalities and the perceived outcome among the frequent types of EDS. A digital questionnaire was sent to...
The aim of this study was to assess the received TMD treatment modalities and the perceived outcome among the frequent types of EDS. A digital questionnaire was sent to the member of the National Swedish EDS Association during January-March 2022. The subsamples of hypermobile and classical EDS were constructed. Almost 90% reported TMD symptoms. Bite splint therapy, counselling, jaw training and occlusal adjustment were reported as the most common treatments with no statistically significant difference in terms of good effect between the two subsamples. Hypermobile and classical EDS might consider as an entity with regards to TMD.
PubMed: 38415674
DOI: 10.1080/08869634.2024.2319565 -
Frontiers in Chemistry 2024Polymethyl methacrylate is a polymer commonly used in clinical dentistry, including denture bases, occlusal splints and orthodontic retainers. To augment the...
Polymethyl methacrylate is a polymer commonly used in clinical dentistry, including denture bases, occlusal splints and orthodontic retainers. To augment the polymethyl methacrylate-based dental appliances in counteracting dental caries, we designed a polymer blend film composed of polymethyl methacrylate and polyethylene oxide by solution casting and added sodium fluoride. Polyethylene oxide facilitated the dispersion of sodium fluoride, decreased the surface average roughness, and positively influenced the hydrophilicity of the films. The blend film made of polymethyl methacrylate, polyethylene oxide and NaF with a mass ratio of 10: 1: 0.3 showed sustained release of fluoride ions and acceptable cytotoxicity. Antibacterial activity of all the films to Streptococcus mutans was negligible. This study demonstrated that the polymer blends of polyethylene oxide and polymethyl methacrylate could realize the relatively steady release of fluoride ions with high biocompatibility. This strategy has promising potential to endow dental appliances with anti-cariogenicity.
PubMed: 38406557
DOI: 10.3389/fchem.2024.1356029 -
International Journal of Oral and... Jul 2024There is currently no consensus on the best treatment for painful temporomandibular disc displacement without reduction (DDwoR), and no network meta-analysis (NMA) of... (Meta-Analysis)
Meta-Analysis Review
There is currently no consensus on the best treatment for painful temporomandibular disc displacement without reduction (DDwoR), and no network meta-analysis (NMA) of randomized clinical trials (RCTs) comparing all types of treatments for this condition has been conducted. The objective of this study was to compare and rank all treatments for DDwoR, including conservative treatments, occlusal splints, low-level laser therapy (LLLT), arthrocentesis (Arthro) alone, Arthro plus intra-articular injection (IAI) of platelet-rich plasma (PRP), Arthro plus IAI of hyaluronic acid (HA), Arthro with exercises, Arthro plus occlusal splints, and manipulative therapy. Outcome variables were pain intensity on a visual analogue scale (VAS) and maximum mouth opening (MMO, mm). The mean difference with 95% confidence interval was estimated using Stata software. The GRADE system was used to assess the certainty of the evidence. A total of 742 patients from 16 RCTs were included in the NMA. Both direct meta-analysis and NMA showed that Arthro with IAI of co-adjuvants provided better pain reduction in the short term (≤3 months) than Arthro alone. However, the quality of the evidence was very low. In the intermediate term, Arthro alone or combined with co-adjuvants provided better pain reduction than conservative treatment, but with low-quality evidence. Conservative treatment significantly increased MMO in the short term compared to other treatments. In conclusion, the results of this NMA suggest that arthrocentesis with intra-articular injection of adjuvant medications may be superior to conservative treatments in reducing pain intensity at long-term follow-up, while no significant differences were found for the MMO outcome. However, the quality of evidence was generally low to very low, and further RCTs are needed to confirm these findings.
Topics: Humans; Randomized Controlled Trials as Topic; Network Meta-Analysis; Temporomandibular Joint Disorders; Pain Measurement; Injections, Intra-Articular; Arthrocentesis; Platelet-Rich Plasma; Hyaluronic Acid; Low-Level Light Therapy; Occlusal Splints; Joint Dislocations; Temporomandibular Joint Disc; Facial Pain; Combined Modality Therapy
PubMed: 38395688
DOI: 10.1016/j.ijom.2024.02.004 -
Healthcare (Basel, Switzerland) Feb 2024This study explores orthodontists' perspectives on risks associated with orthodontic treatment, as described by Greek and Slovak orthodontists. Informed by the...
This study explores orthodontists' perspectives on risks associated with orthodontic treatment, as described by Greek and Slovak orthodontists. Informed by the foundational importance of effective communication of risk perspectives in health sciences, particularly in facilitating valid consent and shared decision-making, this research addresses gaps identified in the literature concerning the consistent communication of potential treatment risks based on demographic and cultural characteristics. This study identifies 15 potential critical risks during orthodontic treatment. These risks include root resorption; temporary undesired changes to the occlusion; sleep difficulties; not achieving an ideal result; development of black triangles between teeth; taking additional X-rays; speech difficulties; using a protective splint during sports; duration of treatment; number of visits; transmission of infectious diseases; and swallowing orthodontic appliances. A questionnaire, distributed electronically to orthodontists in Greece (N1 = 570) and Slovakia (N2 = 210) from September 2022 to December 2022, aimed to assess risk communication practices, taking into consideration socio-demographic factors, such as country, gender, age, and academic-degree-related variations. A total of 168 valid questionnaires (91 from Slovakia and 77 from Greece) were obtained, indicating significant disparities in the risks emphasized and preferred forms of consent. The Greek orthodontists focused more on the risks involved, such as relapse, root resorption, temporal occlusal changes, and failure of desired movement, while the Slovak practitioners tended to be more interested in sleeping difficulties, temporal occlusal changes, and not achieving an ideal result. They also obtained written or digital consent from patients or their parents/guardians more frequently than the Greek team. Male orthodontists discussed specific risks more frequently, including relapse and extractions, whereas females preferred written or digital consent. PhD-trained orthodontists prioritized certain risks, indicating the need for tailored approaches. This study underscores the dynamic nature of risk assessment in orthodontic practice, emphasizing its ethical and strategic dimensions. The findings advocate for tailored risk communication strategies that recognize individual, contextual, and cultural factors, and the need for an orthodontic informed consent protocol for a tailored communication approach for patients to elevate the standard of care in European orthodontics. The reliance on digital tools reflects contemporary trends in enhancing patient understanding, thereby supporting ongoing innovation in orthodontic practices.
PubMed: 38391867
DOI: 10.3390/healthcare12040492 -
Quintessence International (Berlin,... Apr 2024This clinical case outlines a comprehensive digital workflow for a minimally invasive multidisciplinary treatment. The process utilizes one open-source software for...
This clinical case outlines a comprehensive digital workflow for a minimally invasive multidisciplinary treatment. The process utilizes one open-source software for digital wax-up and one low-cost software to address esthetic concerns related to teeth misalignment. The patient's function was stabilized with a digitally made occlusal splint. The application of the described digital workflow technique, incorporating open-source, low-cost, and closed software, played a pivotal role in attaining a straightforward and predictable outcome with minimally invasive treatment. Furthermore, the continual evolution of technology contributes to the growing precision of dental procedures. The presented digital workflow helped formulate a predictable treatment plan, replicate a diagnostic digital wax-up, and achieve precise teeth alignment. This approach satisfactorily addressed the patient's esthetic concerns, providing an outstanding approximation of the definitive result.
Topics: Female; Humans; Computer-Aided Design; Esthetics, Dental; Malocclusion; Occlusal Splints; Patient Care Planning; Software; Workflow; Young Adult; Adult
PubMed: 38374723
DOI: 10.3290/j.qi.b4994315 -
Journal of Clinical Orthodontics : JCO Nov 2023
Topics: Humans; Occlusal Splints; Printing, Three-Dimensional; Computer-Aided Design; Splints
PubMed: 38346214
DOI: No ID Found -
Medicine and Pharmacy Reports Jan 2024Bruxism is associated with a variety of factors, some of which are oral (occlusion, joint, face shape) while others are of a systemic nature (respiratory, cardiac,...
BACKGROUND AND AIMS
Bruxism is associated with a variety of factors, some of which are oral (occlusion, joint, face shape) while others are of a systemic nature (respiratory, cardiac, neurotransmitters, stress). The relationship between bruxism and occlusion has received great attention, but it still has a lot of ambiguity. This study aimed at investigating the parameters that may affect bruxism: dental interferences or premature contacts, vicious habits, temporomandibular joint (TMJ) pain, TMJ noises, TMJ morning fatigue, snoring, obstructive sleep apnea, which may occur before bruxism, or because of chronic parafunction.
METHODS
We conducted an observational, analytical case-control study to determine the association between bruxism and oral cavity factors as well as general factors. Participants were chosen from a group of middle-aged Romanian population. An online questionnaire was used for data collection. A total of one hundred subjects were included in the sample. Fifty cases with bruxism were chosen as a study group, and another fifty persons of similar ages were chosen as a control group. Statistical analysis was performed using the MedCalc version 20.110 software.
RESULTS
The study comprised subjects between 18 and 42 years old. The most prevalent age range was between 20-25 years. The female-male ratio was almost similar; 62% of the participants had sleep bruxism, 10% had awake bruxism and 28% had a combined form. The arithmetic means of the daily stress levels for both research groups' scores were 3.0 for the bruxism group and 3.24 for the control group, while the work stress was 3.04 for the bruxism group and 3.41 for the control group. Dental interferences or premature contacts, vicious habits, TMJ pain, TMJ noises, TMJ morning fatigue, snoring, and obstructive sleep apnea were evaluated. The majority of subjects received an oral splint (n=26).
CONCLUSIONS
Bruxism was associated with stress, occlusal parameters (premature contacts and occlusion interferences), and joint pathologies. Bruxism was not found to be positively correlated with obstructive sleep apnea syndrome. There was a moderately significant association between bruxism and snoring. There was no evidence of an association between bruxism and vicious habits, dental aesthetics, or obstructive sleep apnea. Treatment significantly improved the quality of life, the masticatory and joint functions.
PubMed: 38344337
DOI: 10.15386/mpr-2548 -
Journal of Clinical Medicine Jan 2024(1) : This study aims to compare the effects of 3D-printed splints and conventional manufactured splints on sleep bruxism (SB) EMG activity. (2) : Twenty-six patients...
(1) : This study aims to compare the effects of 3D-printed splints and conventional manufactured splints on sleep bruxism (SB) EMG activity. (2) : Twenty-six patients (19 M, 7 F, 25.8 ± 2.6 years) were randomly allocated to a study group (3D splints) and a control group (conventional manufactured splints) and followed for a period of three months with night EMG-ECG recordings. Samples of the involved materials were analyzed for nanoindentation. The outcomes of interest considered were the overall SB index, the total amount of surface masseter muscle activity (sMMA), and general and SB-related phasic and tonic contractions. A statistical evaluation was performed with a confidence interval (CI) between 2.5% and 97.5%. (3) : Differences between groups with OAs were observed for general tonic contraction ( = 0.0009), while differences between recording times were observed for general phasic contractions ( = 0.002) and general tonic contractions ( = 0.00001). Differences between recording times were observed for the total amount of sMMA ( = 0.01), for general phasic contractions ( = 0.0001), and for general tonic contractions ( = 0.000009) during night recordings without OAs. (4) : Three-dimensional splints seem to have a higher impact on SB-related electromyographic activity but not on the overall sleep bruxism index. The more regular surfaces offered by 3D splints could be related to phasic contraction stabilization.
PubMed: 38337469
DOI: 10.3390/jcm13030776 -
Cureus Jan 2024This case report addresses the critical issue of severe tooth wear and its impact on the vertical dimension of occlusion in a 75-year-old patient. The patient presented...
This case report addresses the critical issue of severe tooth wear and its impact on the vertical dimension of occlusion in a 75-year-old patient. The patient presented with worn-down teeth, chewing difficulties, and aesthetic concerns, prompting a comprehensive treatment plan utilizing the Hobo twin-stage technique. The approach involved careful diagnosis, root canal therapy, and the creation of provisional restorations, monitored through an occlusal splint. The prosthetic phase incorporated strategically designed porcelain-fused-to-metal crowns, aiming for optimal tooth alignment and balanced movement. The successful outcome not only restored function and aesthetics but also enhanced the patient's confidence. This case underscores the effectiveness of a systematic approach in managing severe tooth wear, emphasizing the importance of regular follow-ups and good oral hygiene for long-term success.
PubMed: 38333449
DOI: 10.7759/cureus.51933