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Acta Otorhinolaryngologica Italica :... Feb 2022This retrospective study aimed to verify the outcomes of stabilising occlusal splint therapy prescribed to 22 patients with unilateral definite Ménière's disease and...
OBJECTIVE
This retrospective study aimed to verify the outcomes of stabilising occlusal splint therapy prescribed to 22 patients with unilateral definite Ménière's disease and comorbid temporomandibular joint disorder.
METHODS
The results of a battery of audiometric and vestibular tests were recorded before and after 6 months of treatment, as well as the scores of disease-specific questionnaires.
RESULTS
The average hearing threshold in the affected ear and the acoustic immittance were unchanged. No spontaneous and positional nystagmus were recorded. Caloric hypo-responsiveness and vestibular myogenic evoked responses did not vary. No changes of stabilometric body sway parameters in eyes opened condition and with optokinetic stimulation delivered to the unaffected labyrinth were observed. A significant reduction was recorded in eyes closed condition and with the optokinetic stimulation toward the affected ear. The Tinnitus Handicap Inventory, the Situational Vertigo Questionnaire and the Numeric Pain Rating Scale scores improved. The number of vertigo attacks was reduced.
CONCLUSIONS
Occlusal splint therapy is a favourable option to reduce aural symptoms of Ménière's disease and comorbid temporomandibular joint disorder, even if its pathophysiological mechanism remains elusive.
Topics: Humans; Meniere Disease; Occlusal Splints; Retrospective Studies; Temporomandibular Joint Disorders; Vestibule, Labyrinth
PubMed: 35129540
DOI: 10.14639/0392-100X-N1641 -
BMC Oral Health Sep 2023Temporomandibular joint (TMJ) disc repositioning through open suturing (OSu) is a new disc repositioning method. Its result for adolescents with condylar resorption and... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Temporomandibular joint (TMJ) disc repositioning through open suturing (OSu) is a new disc repositioning method. Its result for adolescents with condylar resorption and dentofacial deformities combined with and without postoperative occlusal splints (POS) has not been well studied.
OBJECTIVE
This study was to evaluate and compare the effects of OSu with and without POS in the treatment of TMJ anterior disc displacement without reduction (ADDwoR) in adolescent skeletal Class II malocclusion.
METHODS
A total of 60 adolescents with bilateral ADDwoR were enrolled in this study. They were randomly allocated into two groups: OSu with and without POS. Magnetic resonance imaging (MRI) and lateral cephalometric radiographs were used to measure changes in condylar height and the degree of skeletal Class II malocclusion from before operation and at 12 months postoperatively. Changes in these indicators were compared within and between the two groups.
RESULTS
After OSu, both groups exhibited significant improvements in condylar height and occlusion at the end of 12 months follow-up (P < 0.05). The group of OSu with POS had significantly more new bone formation (2.83 ± 0.75 mm vs. 1.42 ± 0.81 mm, P < 0.001) and improvement in dentofacial deformity than the group of OSu only (P < 0.05). The new bone height was significantly correlated with POS (P < 0.001), the changes of SNB (P = 0.018), overjet (P = 0.012), and Wits appraisal (P < 0.001).
CONCLUSION
These findings indicated that OSu can effectively stimulate condylar regeneration and improve skeletal Class II malocclusion in adolescents with bilateral ADDwoR. The results are better when combined with POS.
TRIAL REGISTRATION
This trial was prospectively registered on the chictr.org.cn registry with ID: ChiCTR1900021821 on 11/03/2019.
Topics: Adolescent; Humans; Dental Occlusion; Joint Dislocations; Magnetic Resonance Imaging; Malocclusion, Angle Class II; Occlusal Splints; Temporomandibular Joint; Temporomandibular Joint Disc; Temporomandibular Joint Disorders
PubMed: 37759222
DOI: 10.1186/s12903-023-03402-3 -
Maedica Dec 2022This article presents the case of a 32-year-old woman with two distinct temporomandibular joint pathologies: right temporomandibular joint arthralgia, headache, disc...
This article presents the case of a 32-year-old woman with two distinct temporomandibular joint pathologies: right temporomandibular joint arthralgia, headache, disc displacement with reduction and intermittent locking, and limited opening, whereas the left temporomandibular joint was showing arthralgia and subluxation. A neurologist was regularly consulted and treated the patient for migraine. A detailed clinical assessment was used in the therapeutic approach. Cone beam computed tomography (CBCT) was used in the paraclinical assessment to evaluate the temporomandibular joint (TMJ); CBCT imaging revealed condylar bone changes that were not correlated with the clinical symptoms. To alleviate TMJ symptoms, the treatment plan included anti-inflammatory drugs, physiotherapy and an occlusal splint with lateral guiding ramps. After three months of anti-inflammatory medication, physiotherapy and splint wear, an improvement in the migraine symptoms and enhanced life quality was reported. The variation in pathology between the right and left joints and the extended history of temporomandibular disorder onset with no definitive diagnosis or therapy make this case unique.
PubMed: 36818250
DOI: 10.26574/maedica.2022.17.4.985 -
Trials Oct 2018Tinnitus is a highly prevalent symptom affecting 10-15% of the adult population. It often affects patient quality of life and frequently causes distress. When subjective...
BACKGROUND
Tinnitus is a highly prevalent symptom affecting 10-15% of the adult population. It often affects patient quality of life and frequently causes distress. When subjective tinnitus can be elicited by the somatosensory system of the cervical spine or temporomandibular area it is termed somatic tinnitus. The first aim of the current study is to investigate the effect of the best evidence conservative temporomandibular disorder (TMD) treatment on tinnitus in patients with co-existence of tinnitus and TMD or oral parafunctions compared to no treatment. The second aim is to identify a subgroup of patients with tinnitus that benefits from the conservative temporomandibular joint treatment.
METHODS AND DESIGN
This study is a randomised controlled trial with a delayed treatment design. Patients with a TMD (TMD pain screener ≥ 3 points) or oral parafunctions (such as clenching and bruxism), who are suffering from moderate to severe subjective tinnitus (Tinnitus Functional Index (TFI) between 25 and 90 points), will be recruited from the tertiary tinnitus clinic of the University Hospital of Antwerp, Edegem, Belgium. Patients will be excluded in case of clear otological or neurological causes of the tinnitus, progressive middle ear pathology, intracranial pathology, traumatic cervical spine or temporomandibular injury in the past 6 months, severe depression as diagnosed by a psychologist, tumours, previous surgery in the orofacial area, substance abuse that may affect the outcome measures, any contra-indication for physical therapy treatment directed to the orofacial area or when they received TMD treatment in the past 2 months. After screening for eligibility, baseline data among which scores on the TFI, tinnitus questionnaire (TQ), mean tinnitus loudness as measured with visual analogue scale (VAS), TMD pain screener, and a set of temporomandibular joint tests will be collected. Patients will be randomised in an early-start group and in a delayed-start group of therapy by 9 weeks. Patients will receive conservative TMD treatment with a maximum of 18 sessions within 9 weeks. At baseline (week 0), at the start of therapy (weeks 0 or 9), 9 weeks after therapy (weeks 9 or 18), and at follow-up (weeks 18 or 27) data from the TFI, TQ, VAS mean tinnitus loudness and the TMD pain screener will be collected.
DISCUSSION
Herein, we aim to improve the quality of care for patients with tinnitus attributed to TMD or oral parafunctions. By evaluating the effect of state-of-the-art TMD treatment on tinnitus complaints, we can investigate the usefulness of TMD treatment in patients with somatic tinnitus.
TRIAL REGISTRATION
3 July 2017, version 1 of the protocol, ClinicalTrials.gov NCT03209297 .
Topics: Auditory Perception; Belgium; Conservative Treatment; Health Knowledge, Attitudes, Practice; Hearing; Humans; Patient Education as Topic; Physical Therapy Modalities; Randomized Controlled Trials as Topic; Temporomandibular Joint; Temporomandibular Joint Disorders; Time Factors; Tinnitus; Treatment Outcome
PubMed: 30314506
DOI: 10.1186/s13063-018-2903-1 -
International Journal of Environmental... Feb 2023Temporomandibular disorders (TMD) is an umbrella term that encompasses many musculoskeletal problems that include the masticatory muscles, the temporomandibular joint,... (Review)
Review
Temporomandibular disorders (TMD) is an umbrella term that encompasses many musculoskeletal problems that include the masticatory muscles, the temporomandibular joint, and other associated structures. TMD can be divided into two large groups: those that affect the musculature and those that affect the joint. The treatment of TMD requires the combined skills of physiotherapists and dentists, as well as sometimes psychologists and other medical specialists. This study aims to examine the effectiveness of the interdisciplinary approach using physiotherapy and dental techniques on pain in patients with temporomandibular disorders (TMDs). This is a Scoping Review of studies investigating the effects of combined therapy on patients with TMD. PRISMA guidelines were followed during this review's design, search, and reporting stages. The search was carried out in the MEDLINE, CINHAL, and EMBASE databases. A total of 1031 studies were detected and analyzed by performing the proposed searches in the detailed databases. After removing duplicates and analyzing the titles and abstracts of the remaining articles, six studies were ultimately selected for this review. All the included studies showed a positive effect on pain decreasing after a combined intervention. The interdisciplinary approach characterized by the combination of manual therapy and splint or electrotherapy can positively influence the perceived symptoms; positively decrease pain; and reduce disability, occlusal impairments, and perception of change.
Topics: Humans; Temporomandibular Joint Disorders; Pain; Temporomandibular Joint; Physical Therapy Modalities; Musculoskeletal Manipulations
PubMed: 36833474
DOI: 10.3390/ijerph20042777 -
Sleep Science (Sao Paulo, Brazil) Sep 2023Sleep Bruxism (SB) is a common condition in childhood that can cause multiple consequences such as abnormal tooth wear, tensional headaches, masticatory muscle pain,... (Review)
Review
Sleep Bruxism (SB) is a common condition in childhood that can cause multiple consequences such as abnormal tooth wear, tensional headaches, masticatory muscle pain, or fatigue. The literature reports some interventions, however the treatment for SB in children is not well-established. A systematic review was performed to investigate the effectiveness of the treatments described for SB in children and adolescents: pharmacological and psychological treatments; behavioral guidelines; and dental approaches. Randomized clinical trials comparing different SB treatments with a control group were searched in the electronic databases PubMed, Scopus, Web of Science, Cochrane Library, and VHL until August 04, 2021. Two independent reviewers selected the studies, extracted the data, and assessed the risk of bias. After a two-phase selection process, 07 articles were selected. The methodology of the selected studies was analyzed using the Cochrane Risk of Bias Tool. The criteria used to qualify the studies were based on randomization, allocation, blinding of participants and evaluators, and analysis of results. The signs and symptoms of SB were reduced with pharmacotherapy (hydroxyzine/diazepam) and medicinal extracts ( ), but with occlusal splints and physiotherapy, this improvement was not statistically significant when compared to control groups. Some evidence of the efficacy of pharmacotherapy (hydroxyzine/diazepam) and medicinal extracts ( ) was found. However, this systematic review is not enough to establish a protocol for the treatment of SB. Besides, the individualized management of SB in this population should be considered, emphasizing the management of risk factors.
PubMed: 38196770
DOI: 10.1055/s-0043-1772826 -
Clinical Oral Investigations Sep 2022To investigate the two-body wear of occlusal splint materials fabricated from subtractive computer-aided manufacturing (CAM) compared to three-dimensional printing (3DP).
OBJECTIVES
To investigate the two-body wear of occlusal splint materials fabricated from subtractive computer-aided manufacturing (CAM) compared to three-dimensional printing (3DP).
MATERIAL AND METHODS
Forty-eight substrates (n = 12/material) in the design of a mandibular first molar were fabricated using CAM (CAM-TD, Thermeo, pro3dure medical GmbH, Iserlohn, Germany; CAM-CL, CLEARsplint, Astron Dental Corporation, Lake Zurich, USA) and 3DP (3DP-GI, GR22 flex, pro3dure medical GmbH; 3DP-KY, KeySplint soft, Keystone Industries, Gibbstown, USA). The substrates were subjected to mastication simulation (120,000 cycles, 37 °C, 50 N, 1.3 Hz) opposed to enamel antagonists. The two-body wear was measured through matching of the scanned substrates before and after aging using Gaussian best-fit method. The damage patterns were categorized and evaluated based on microscopic examinations. Data was analyzed using Kolmogorov-Smirnov test followed by 1-way analysis of variance (ANOVA). Pearson correlation was calculated between vertical and volumetric material loss. The failure types were analyzed with Chi-test and Ciba Geigy table.
RESULTS
No difference in two-body wear results between all materials was found (p = 0.102). Fatigue substrates showed a perforation for CAM and a fracture for 3DP. No abrasion losses on the antagonists were detected.
CONCLUSIONS
3DP substrates showed no differences in two-body wear compared to CAM ones but are more likely to show a fracture. None of the tested materials caused an abrasion on human teeth structure.
CLINICAL RELEVANCE
While therapies with occlusal splint materials are rising, 3DP offers a promising alternative to CAM in terms of production accuracy and therapeutic success at reduced costs.
Topics: Ceramics; Computer-Aided Design; Dental Enamel; Dental Porcelain; Humans; Materials Testing; Molar; Occlusal Splints; Printing, Three-Dimensional
PubMed: 35612645
DOI: 10.1007/s00784-022-04543-5 -
Singapore Dental Journal Dec 2015Occlusal diagnosis plays an important role in the planning and subsequent delivery of predictable functional and aesthetic restorations and prostheses. Once an occlusal... (Review)
Review
Occlusal diagnosis plays an important role in the planning and subsequent delivery of predictable functional and aesthetic restorations and prostheses. Once an occlusal problem is identified there are a number of techniques and materials that can be utilised to record occlusal relationships, subsequently analyse them and incorporate information obtained into the delivery of tooth restoration or replacement. This paper discusses the clinical and technical aspects of occlusal examination and analysis outlining contemporary and traditional techniques in their utilisation. Aspects of occlusal examination will be revisited; the identification and recording of centric occlusion as well as subsequent articulation will be discussed. The requirement for occlusal splint provision will also be discussed and illustrated.
PubMed: 26684489
DOI: 10.1016/j.sdj.2015.09.004 -
BMC Oral Health Mar 2023This systematic review aims to examine the existing original studies to determine the effectiveness of occlusal splints (OSs) in the management of orofacial myalgia and...
BACKGROUND
This systematic review aims to examine the existing original studies to determine the effectiveness of occlusal splints (OSs) in the management of orofacial myalgia and myofascial pain (MP) in comparison with no treatment or other interventions.
MATERIALS AND METHODS
Based on the inclusion and exclusion criteria of this systematic review, randomized controlled trials were qualified, in which the effectiveness of occlusal splint therapy in the management of muscle pain was examined in comparison with no treatment or other interventions. This systematic review was conducted according to the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020. The authors searched three databases (PubMed, CINAHL (The Cumulative Index to Nursing and Allied Health Literature) and Scopus) for English publications published between January 1, 2010, and June 1, 2022. The last database search was carried out on June 4, 2022. Data were extracted from the included studies and assessed for risk of bias using the revised Cochrane risk-of-bias tool for randomized trials.
RESULTS
Thirteen studies were identified for inclusion in this review. In total, 589 patients were diagnosed with orofacial muscle pain who underwent education and various forms of therapy including different types of OSs, light emitting diode therapy, acupuncture, low-level laser therapy, device-supported sensorimotor training, Kinesio Taping, myofunctional therapy, and physical therapy. All studies included demonstrated a high risk of bias.
CONCLUSIONS
There is insufficient evidence regarding whether OS therapy in the treatment of orofacial myalgia and MP offers an advantage over other forms of interventions or no treatment. Further reliable clinical studies in this area are needed to improve the quality of research, which should be performed with larger groups of blinded respondents and controls.
CLINICAL RELEVANCE
Due to the large-scale nature of orofacial muscle pain, it is assumed that each dental clinician will meet patients with orofacial muscle pain repeatedly in daily practice; hence, the review of the effectiveness of OSs in the management of orofacial myalgia and MP is necessary.
Topics: Humans; Myalgia; Occlusal Splints; Facial Pain
PubMed: 36978070
DOI: 10.1186/s12903-023-02897-0 -
Dentistry Journal Aug 2023Data regarding the mechanical properties of three-dimensionally (3D) printed materials for occlusal splint manufacturing are scarce. The aim of the present study was to...
Data regarding the mechanical properties of three-dimensionally (3D) printed materials for occlusal splint manufacturing are scarce. The aim of the present study was to evaluate the flexural strength and surface hardness of modern 3D-printed occlusal splint materials and compare them with two control groups, namely, milled and conventional cold-polymerized occlusal splint materials. A total of 140 rectangular specimens were manufactured for the present study. The specimens were prepared in accordance with the International Organization for Standardization standards (ISO 20795-1:2013). Five 3D-printed (NextDent Ortho Rigid, Dental LT Clear, Dentona Flexisplint, Cosmos Bite Splint, and ProArt Print Splint), one milled (ProArt CAD Splint), and one cold-polymerized (ProBase Cold) occlusal splint materials were used to determine flexural strength and surface hardness values. The three-point flexure test was used for the determination of flexural strength values, while Vickers hardness was measured to determine surface hardness. Ten specimens ( = 10) of each material were tested using these procedures. One-way ANOVA and Tukey's post-hoc test were used to analyze the obtained results (α = 0.05). The values of flexural strength ranged from 46.1 ± 8.2 MPa to 106 ± 8.3 MPa. The Vickers hardness values ranged from 4.9 ± 0.5 VHN to 20.6 ± 1.3 VHN. Significant differences were found among the tested materials ( < 0.0001). The milled and cold-polymerized materials yielded higher values for both flexural strength (only one 3D-printed resin had comparable results to cold-polymerized acrylics) and surface hardness. There are differences in the mechanical properties of the various tested occlusal splint materials. The flexural strength of most of the 3D-printed materials and their surface hardness values are still inferior when compared to the milled or cold-polymerized materials.
PubMed: 37623295
DOI: 10.3390/dj11080199