PubMed · 6960005
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D C Keller. 1982. A multi-functional appliance.. https://pubmed.ncbi.nlm.nih.gov/6960005/
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BACKGROUND: Condylar fractures in childhood are generally treated in a conservative-functional manner. As a rule, very good healing results are achieved by functional orthodontic treatment alone or, after immobilization, by splinting. HISTORY AND TREATMENT: Here we report on a patient who suffered a deep condylar dislocation fracture as a result of trauma at the age of 5. After initial immobilization with Schuchardt splints she underwent functional jaw orthopedics with activators. Subsequent orthodontic treatment with removable and fixed appliances enabled her to be followed up form functional and radiographic aspects over a period of 13 years. The remodeling process of the condylar head and neck could be clearly seen in the panoramic control radiographs. RESULT: Although the traumatized right TMJ was completely pain-free and fully functional after only a short time, the remodeling of the head and neck of the originally traumatized TMJ took 13 years to correspond fully to the healthy TMJ on the opposing side.
The aims of this retrospective study were to assess the effect of a Karwetzky mandibular protrusion appliance for treating patients with mild, moderate, and severe obstructive sleep apnea. Eighty-one of 116 patients (69.8%) suffering from obstructive sleep apnea were treated with an activator model according to Karwetzky. After 4 months (SD 4.0 months) treatment outcome was controlled by polysomnography. Therapeutic outcome depended on the severity of obstructive sleep apnea. The median apnea-hypopnea index decreased from 10.6 events/h (range 2.0-14.9) to 5.8 events/h (range 0.2-17.3, P<0.01) in the mild group, from 21.7 events/h (range 17.3-28.4) to 7.7 events/h (range 1.0-30.1, P<0.001) in the moderate group, and from 42.1 events/h (range 33.2-64.9) to 18.1 events/h (range 2.4-48.8, P<0.001) in the severe group. Sleep variables did not show consistent improvement except for a trend towards more REM sleep and slow-wave sleep. The numbers of retentive teeth did not statistically influence treatment efficacy. Comparing the pre- and post-treatment polysomnographic variables, it was found that the respiratory events rather than sleep stages were significantly reduced by the Karwetzky appliance investigated.
The purpose of this study was to examine the effect of a bionator on masseter and suprahyoid muscle activities during sleep. Ten healthy Japanese males (mean age: 26.3 years) participated in this study. Electromyographic (EMG) activities of the right masseter and bilateral suprahyoid muscles were recorded during sleep with and without a bionator. Although no significant changes were observed in the maximal EMG activities of these muscles, the maximal EMG activity of suprahyoid muscles tended to decrease while wearing the bionator. The number of events over 40% maximal voluntary contraction (MVC) tended to decrease in these muscles with a bionator, but these changes were not statistically significant. These findings indicate that there are no significant changes or there is only a tendency to decrease the activities of the masseter and suprahyoid muscles while wearing a bionator during sleep.