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At least 235 records · Page 13Linked to original sources
PubMed2003

Impact of increased occlusal contact, interleukin-1 genotype, and periodontitis severity on gingival crevicular fluid IL-1beta levels.

BACKGROUND: The study of occlusal therapy in humans with periodontitis is problematic due to potential irreversible bone loss in control subjects. The hypothesis of this pilot investigation was that increased interocclusal contact initiated by short-term occlusal splint disuse would increase tooth mobility and the bone-resorptive cytokine interleukin (IL)-1beta in gingival crevicular fluid (GCF), comparable to IL-1-positive genotype and increased periodontitis severity. METHODS: Nineteen non-smoking chronic periodontitis patients using nocturnal occlusal splints and undergoing periodontal maintenance in a private practice were evaluated at five time points: 24 hours after continuous splint use; 1, 2, and 3 days after no occlusal splint use; and 14 days after resumption of customary nighttime splint use. Subjects were evaluated to confirm that the plaque index and gingival index were < or = 1.0, and to categorize past periodontitis (moderate or severe) and IL-1 genotype (1A +4845 plus IL-1B +3954). Test sites on two anterior teeth vulnerable to occlusal trauma were sampled for mobility, GCF IL-1beta, and IL-1 receptor antagonist (ra). RESULTS: Tooth mobility remained low during the 3-day period when patients were not wearing their occlusal appliance. GCF IL-1beta decreased after not wearing the appliances (P = 0.016), especially at 48 hours. At this time, genotype-positive subjects had higher levels of GCF IL-1beta/IL-1ra than genotype-negative subjects (P = 0.045), and patients who had experienced severe periodontitis had higher IL-1beta levels than moderate periodontitis subjects (P = 0.004). CONCLUSIONS: These findings suggest that short-term discontinuation of occlusal splint therapy in non-smoking periodontitis patients undergoing periodontal maintenance does not result in potential signs of early occlusal trauma (increasing mobility or GCF IL-1beta). Longer-term studies may be needed to determine appropriate therapy applications for periodontitis-susceptible patients with definable occlusal discrepancies and/or parafunction.

Adult↗
PubMed1986

An electronic, computerized pantographic reproducibility index for diagnosing temporomandibular joint dysfunction.

One of the signs and symptoms of TMJ dysfunction is incoordinated mandibular movements. The PRI quantitates the incoordinated movements and gives a muscle dysfunction score and the relative severity of TMJ dysfunction. An electronic, computerized pantograph (Pantronic) has been developed that can be used in place of the mechanical pantograph. This study was undertaken to determine if the Pantronic can be programmed to produce PRI scores that are comparable to the M-pantograph PRI scores. Several programs were written for the computer until the Pantronic PRI was comparable to the M-pantograph PRI. The Pantronic PRI was within zero to 5 points of the M-pantograph PRI in all of the 25 patients studied. Because of this close comparison, studies used to validate the M-pantograph PRI also validate the Pantronic PRI. There was, however, a statistically significant difference (.05 level) between the two PRI scores. In spite of this difference the categories of TMJ dysfunction remained the same. The Pantronic PRI can be determined clinically in 20 to 30 minutes. It can be used to determine the presence and, more important, the absence of TMJ dysfunction; the success of occlusal splint therapy, occlusal adjustment, and restorative treatment; the changes in dysfunction over time; the success of other treatment modalities; and the level of dysfunction in TMJ dysfunction research.

Computers↗
PubMed2006

Temporomandibular joint osteochondritis dissecans: case report.

BACKGROUND: Osteochondritis dissecans is a process in which segment(s) of cartilage separate from an articular surface. It is most often reported in the larger joints of the body, including the knee, elbow, hip, wrist, and ankle. Involvement of the temporomandibular joint (TMJ) is exceedingly rare. OBJECTIVES: To describe a probable case of osteochondritis dissecans and discuss the differential diagnosis for this condition. STUDY DESIGN: In addition to clinical examination the patient was imaged using panoramic radiography, computed tomography and magnetic resonance imaging. RESULTS: Panoramic radiography showed separation of 2 rounded fragments superior to the right mandibular condyle. These were more precisely located using 3-dimensional computerized tomographic reconstructions. Magnetic resonance imaging demonstrated the right condyle as having low signal intensity area on T1-weighted images and a heterogeneous signal on T2-weighted images, with low signal dominance. No abnormality was apparent in the left TMJ. CONCLUSIONS: The patient was treated nonsurgically with a splint, occlusal adjustment, physiotherapy, and nonsteroidal antiinflammatory medications. Maximum mouth opening has increased from 24 mm to 39 mm 6 months following initiation of treatment, and pain has subsided.

Adult↗
PubMed1983

Occlusal relationship in patients with pain-dysfunction symptoms in the temporomandibular joints.

A total of 135 patients (thirty-three males, 102 females) seeking treatment for pain and dysfunction of the TMJ were divided into five subgroups using the clinical dysfunction index of Helkimo. No relation could be found between the number of occluding molars and premolars and the severity of the symptoms nor the evolution of the complaints. A weak correlation was found between the outcome of the treatment with the occlusal splint and occlusal adjustment, and the above mentioned occlusal parameters (r = 0.47).

Adolescent↗
PubMed1993

The effect of an occlusal stabilization splint and the mode of visual feedback on the activity balance between jaw-elevator muscles during isometric contraction.

The aim of the present study was to gain an insight into the influence of a vertical bite-rise (clenching in intercuspal occlusion vs. clenching on an occlusal stabilization splint), the mode of visual feedback (VF; obtained from the compound masseter signal, from the compound anterior temporalis signal, or from the compound signal of both masseter and anterior temporalis muscles) and the EMG clenching level (10% MVC and 50% MVC) on the muscle balance between the masseter and the anterior temporalis muscles. The muscle balance was quantified as the logarithmic value of the ratio between the summated mean rectified EMG activity of the masseter muscles and this activity of the anterior temporalis muscles. The muscle balance was influenced significantly by the mode of VF (p < 0.01), the muscle balance shifting toward the group of muscles from which VF was obtained. When VF was obtained from the masseter muscles, a decrease in the anterior temporalis EMG activity was observed when the vertical dimension was increased (p < 0.05-0.01). When VF was obtained from the anterior temporalis muscles, the activity of the masseter muscles was raised with respect to that of the anterior temporalis muscles during clenching with a vertical bite-rise (p < 0.05-0.01). When VF was obtained from both groups of muscles, the masseteric EMG activity increased, whereas the anterior temporalis EMG activity decreased. Hence, regardless of the mode of VF, a relatively lower activity level of the anterior temporalis muscles was achieved after insertion of an occlusal stabilization splint.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2000

Evaluation of the effect of a stabilization splint on occlusal force in patients with masticatory muscle disorders.

The purpose of this study was to evaluate the effect of stabilization splint therapy on occlusal force in patients with masticatory muscle disorders (MD). Six female patients with myalgia or myofascial pain participated in this study. The occlusal points and load on the dental arch in maximum clenching was measured using the computerized system with Dental Prescale(R) before and after the use of the splint. There were no significant changes in the number of occlusal points, mean occlusal pressure, and asymmetry in occlusal balance between before and after the use of the splint. However, there were significant differences in the extent of the area of occlusion and in the integrated occlusal loads. The integrated occlusal load converged to the normal level with the use of the splint. From the results of this study, it is suggested that the use of the stabilization splint has the effect of normalizing the occlusal force.

Adolescent↗
PubMed2004

Quantitative polygraphic controlled study on efficacy and safety of oral splint devices in tooth-grinding subjects.

The efficacy of occlusal splints in diminishing muscle activity and tooth-grinding damage remains controversial. The objective of this study was to compare the efficacy and safety of an occlusal splint (OS) vs. a palatal control device (PCD). Nine subjects with sleep bruxism (SB) participated in this randomized study. Sleep laboratory recordings were made on the second night to establish baseline data. Patients then wore each of the splints in the sleep laboratory for recording nights three and four, two weeks apart, according to a crossover design. A statistically significant reduction in the number of SB episodes per hour (decrease of 41%, p = 0.05) and SB bursts per hour (decrease of 40%, p < 0.05) was observed with the two devices. Both oral devices also showed 50% fewer episodes with grinding noise (p = 0.06). No difference was observed between the devices. Moreover, no changes in respiratory variables were observed. Both devices reduced muscle activity associated with SB.

Adult↗
PubMed1996

Trauma in patients with temporomandibular disorders: frequency and treatment outcome.

Controversy exists on the aetiological importance and the effect of jaw macrotrauma (fractures excluded) on the occurrence of temporomandibular joint disorders (TMD). The purpose of this study was to assess the incidence of jaw injury in TMD patients and to compare the severity of the symptoms, the clinical characteristics and the treatment outcome in TMD patients with or without a history of trauma to the head and neck region directly linked to the onset of symptoms. The study sample included 400 consecutive TMD clinical patients. In 24.5% of patients the onset of the pain and dysfunction could be linked directly to the trauma, mainly whiplash accidents. No significant differences could be found between the two groups in daily recurrent headache, dizziness, neck pain, joint crepitation and pain in the joints. Maximal mouth opening was less than 20 mm in 14.3% of patients with a history of trauma and in 4.1% of those without such a history. According to the Helkimo dysfunction index (DI), more trauma than non-trauma TMD patients belonged to the severe dysfunction groups (DI 4 and 5) at first examination. The outcome of a conservative treatment procedure (counselling, occlusal splint, physiotherapy, occasionally occlusal therapy and non-steroidal anti-inflammation drugs was not different between the two groups at the 1 year evaluation. The degree of maximal opening was similar: less than 20 mm in 3.7% and 2.2% in trauma and non-trauma patients respectively. Forty percent and 41% respectively were symptom free or had DI = 1. The results suggest that external trauma to the joint or to the jaw in general is an important initiating factor in the aetiology of TMD but also that the prognosis is favourable.

Adolescent↗
PubMed1991

Role of depressive illness in the outcome of treatment of temporomandibular joint pain-dysfunction syndrome.

The aim of this study was to assess the role of a depressive illness in the outcome of the treatment of patients with temporomandibular joint pain-dysfunction syndrome. One group was considered psychiatrically normal and the other had a concurrent depressive illness. The latter group was subdivided equally to produce three treatment groups: one undergoing occlusal splint therapy, one receiving antidepressant medication, and the third having a combination of occlusal splint and antidepressant therapy. The results showed clearly that there was a significant difference in response in the nonpsychiatric and combined-therapy depressed groups in comparison with the two depressed groups treated either with occlusal splint or with antidepressant therapy. The combined therapy led to resolution of the painful problem and the depression, whereas the single therapies were only partly successful in relieving the pain-dysfunction syndrome. The preexisting duration of this painful problem did not influence the response to therapy.

Adolescent↗
PubMed2006

In-vitro investigation on suitability of light-cured resins for interocclusal splints : part II: surface hardness.

OBJECTIVE: The aim of the present study was to determine the surface hardness of light- and auto-cured resins for the fabrication of occlusal splints employing Vickers hardness measurements. MATERIALS AND METHOD: In this study we used three auto-polymerized resins (Palapress, Orthocryl, Steady-Resin M) and four light-polymerized resins (Acrylight, Primosplint, Triad Tran- Sheet Colorless and Triad TranSheet Pink). The Vickers hardness measurement was carried out by means of a universal Durimet indenter applying a test load of 50 g for 30 seconds. The light-cured resins were polymerized in a Tagris Power light oven for 10 and 15 minutes each. Three separate test series were carried out (the hardness of plates under optimal conditions and of occlusal splints was measured, and the curing of light-polymerizing materials in layers of varying depth was evaluated). Data underwent statistical analysis via ANOVA and the Scheffé test. RESULTS: The microhardness determined in each case amounted to values between 10.4 HV 0.5 and 39.3 HV 0.5. The Vickers hardness determined for the plates that had been produced under optimal conditions demonstrated that their surface was significantly (p < 0.05) harder than that of cylinders and splints. The hardness values of the light-cured material Triad TranSheet Pink (39.3 HV 0.5) were significantly higher (p < 0.05) than those of all other resins. In all auto-polymerized resins, the surface hardness of the samples we examined (in the form of plates and splints) was significantly lower (p < 0.05) than that of the light-cured materials Triad TranSheet Pink and Colorless. CONCLUSION: The results we have obtained so far concerning surface hardness indicate that, in the fabrication of occlusal splints, light-cured resins may represent an alternative to auto-polymerizing materials.

Absorption↗
PubMed1977

[The occlusal bite splint and its effect on the centric relation of the maximal opening and closing movement in cases of temporomandibular joint syndrome].

Nine patients presenting temporo-mandibular joint pain-dysfunction syndrome were treated with occlusal bite splints made of acrylic resin, which eliminated premature contacts and occlusal interferences. Results were obtained with an extra-oral apparatus, of personal conception, which allowed to amplify and register maximum opening and lateral deviation in the frontal plane. The study has shown that this treatment brings: - an elimination of pain and muscle spasms - an increase in maximum opening - a decrease in lateral deviation - a marked but partial decrease in articular noises.

Dental Occlusion, Centric↗
PubMed1991

A restorative-orthodontic treatment approach in the older patient.

This report presents a case requiring a combination of restorative dentistry and orthodontic treatment in a mature adult patient. Occlusal splint and periodontal therapies were used initially. Orthodontic treatment combined the use of the occlusal splint and fixed appliance in the maxillary arch. Sectional fixed appliances were used in the mandibular arch. The final restorations were fixed--movable bridges in the mandibular arch and a removable tooth and mucosally borne prosthesis in the maxilla. Retention of the orthodontic result was provided by the fixed prostheses in the lower arch and the continued wear of a full coverage maxillary occlusal splint at night served to prevent relapse of the upper teeth.

Dental Restoration, Permanent↗
PubMed1993

[Evaluation of conservative treatment for craniomandibular disorders].

The purpose of this study was to evaluate the effectiveness of conservative treatment for craniomandibular disorders. These included patient education and home care program, physical therapy, medication and flat occlusal splint therapy. Additionally the influence of sex, age, and duration of the use of the flat occlusal splint was evaluated. Forty-eight patients with craniomandibular disorders, collected from 1988-1991 in the Temporomandibular Joint Clinic of the Dental Department of Veterans General Hospital-Taipei, were studied. The results of this study indicated that (1) the treatment result of joint and muscle pain, joint sounds, limitation of mouth opening and jaw deviation after conservative treatment showed statistically significant improvement; and (2) this study was unable to demonstrate any influence of sex, age or duration of the splint use on the treatment effect. The results of this study indicate the need to further investigate the use of the occlusal splint for 24 hours, as compared with night-times only.

Adolescent↗
PubMed1983

Craniomandibular disorders and headaches.

Three hundred patients were questioned regarding frequency of headache pain. One hundred forty-one patients were seeking treatment at the University of Kentucky College of Dentistry TMJ Clinic for CMD. A comparison group of 159 was selected from persons being screened for routine dental needs. The following findings regarding incidence and frequency of headache pain were observed: 1. The incidence of headache pain was twice as high in the CMD group than in the comparison group (p less than .001). 2. Of the persons in each group reporting the occurrence of headaches, the frequency of headaches in the CMD group was significantly higher (44%) than in the comparison group (p less than .001). Thirty-three patients with headache pain were treated for a 4-week period with occlusal splint therapy. Patients were questioned regarding the number of headaches per week they had before and after occlusal splint therapy. The following results were observed: 1. Twenty-one (63.6%) patients showed a decrease in the frequency of their headaches. 2. Ten (30.3%) patients showed complete remission of headaches. 3. No patient showed an increase in the frequency of headaches. 4. As a group the average number of headaches per week before treatment was 5.06; after occlusal splint therapy the average number of headaches per week was 2.15 (p less than .001).

Adolescent↗
PubMed1999

[Many persons with snoring problems and apnea are untreated. A review of therapeutic methods].

As sleep apnoea and snoring are very disabling conditions both for patients and their families, and hazardous for drivers and others in traffic, there is good reason to treat snoring problems. Treatment should be individualised, always beginning conservatively--i.e., positional training, weight reduction if necessary, more sleep if sleep deficiency is present, and a review of any muscle-relaxant or mucolytic medication. Sleep registration will demonstrate the extent of any sleep apnoea syndrome, which is of decisive importance for further choice of treatment. Mild apnoics and social snorers may initially be offered an occlusal splint if their dental status allows. Otherwise, in such cases surgery is a form of treatment yielding immediate results, though the patient must be forewarned of the discomfort which can occur in isolated cases. For patients with sleep apnoea syndrome of marked or intermediate severity, continuous positive airway pressure (CPAP) treatment should be available. If the patient can not tolerate CPAP treatment, the occlusal splint alternative can be tried. For patients who can not have CPAP or occlusal splint treatment, tracheostomy is a possibility. This treatment may be lifelong, but if weight reduction is achieved postoperatively, it may be possible to remove the tracheostomy.

Humans↗
PubMedDate not supplied

Pre- and posttreatment analysis of clinical symptoms of patients with temporomandibular disorders.

OBJECTIVE: This study treated patients with temporomandibular disc displacement with reduction (with pain, limited mandibular movement, and clicking sound symptoms) using a combination of analgesics, injection, mandibular exercise, and occlusal splints. METHOD AND MATERIALS: Twenty-five patients with temporomandibular joint (TMJ) disorders were evaluated for pretreatment complaints and clinical findings, such as TMJ sounds, mandibular deviation, limited mouth opening, and bilateral magnetic resonance imaging results. Diagnostic treatment was then planned; all patients received occlusal splints, and 10 patients received injections. RESULTS: Evaluations were conducted 1 year after the initial diagnosis and treatment. Complaints (especially of pain) by the patients who received injections had reduced significantly. After 6 months of occlusal splinting, clinical findings of patients with TMJ disc displacement had greatly improved. To manage parafunctional habits of the patients, night plate usage was continued. Therefore, clinical symptom reduction was maintained. CONCLUSION: The use of mandibular manipulation technique can decrease the anterior disc displacement of the TMJ.

Adolescent↗