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PubMed1982

Ureteral splints: results of a survey.

The results of a survey concerning ureteral splints are reported. Of the respondents 70 per cent preferred the term splint to stent. There was general agreement that a splint should be used in any complicated pyeloplasty as well as in any patient undergoing an operation on the ureter or ureteropelvic junction draining a solitary kidney. Additionally, use of a splint after repair of ureteral injuries by a general urologist was believed advisable. Splints are not absolutely necessary in uncomplicated pyeloplasties and in most simple ureteroneocystostomies. Most urologists use ureteral splints, and believe that they do little or no harm and rather consistently terminate in a good postoperative result.

Humans↗
PubMed2005

[Anatomy of the splint bones and their surrounding area particularly in consideration of fascial attachments].

This study concerns the vestigial metacarpal and metatarsal bones, so called splint bones. The soft tissues, which stabilize the splint bones were carefully examined. The palmar metacarpal/plantar metatarsal fascia, the metacarpal/metatarsal interosseous ligaments and the fibres, which exit distally from the splint bone, were examined in depth. Cadaveric distal limbs were collected from 5 slaughtered or euthanized horses. The legs were examined both, microscopically and macroscopically. The palmar metacarpal/plantar metatarsal fascia is a very stable structure, which connects the splint bone with its environment. The connection between splint and McIII/MtIII, established through the metacarpal/ metatarsal interosseous ligaments, showed impressive differences between specimens examined. Macroscopic examination of the soft tissue in the distal region showed a band structure, which originates from the distal end of the splint bone and extends in dorsal and distal direction towards the proximal sesamoid bone.

Animals↗
PubMed2004

Magnetic resonance imaging in stress fractures and shin splints.

The purpose of the current study was to determine whether stress fractures and shin splints could be discriminated with MRI in the early phase. Twenty-two athletes, who had pain in the middle or distal part of their leg during or after sports activity, were evaluated with radiographs and MRI scans. Stress fractures were diagnosed when consecutive radiographs showed local periosteal reaction or a fracture line, and shin splints were diagnosed in all the other cases. In all eight patients with stress fractures, an abnormally wide high signal in the localized bone marrow was the most detectable in the coronal fat-suppressed MRI scan. In 11 patients with shin splints, the coronal fat-suppressed MRI scans showed a linear abnormally high signal along the medial posterior surface of the tibia, and in seven patients with shin splints, the MRI scans showed a linear abnormally high signal along the medial bone marrow. No MRI scans of shin splints showed an abnormally wide high signal in the bone marrow as observed on MRI scans of stress fractures. This study showed that fat-suppressed MRI is useful for discrimination between stress fracture and shin splints before radiographs show a detectable periosteal reaction in the tibia.

Adolescent↗
PubMed2005

Changes in mineralization and biomechanics of tibial metaphyses in splinted rats.

The effect of 3 wk of splintage of a single hindlimb on the midarea and mineral content of both tibial metaphyses was assessed immediately after splint removal and after 1 mo of mobilization in 12-wk-old Sprague-Dawley rats. Immobilization reduced tibial metaphyseal bone mineral density (BMD) in immobilized limbs compared with "free" limbs of splinted animals and with controls. These changes persisted and were accentuated by relatively greater increases in tibial metaphyseal BMDs of unsplinted (control) animals after 7 wk. Immediately after splintage, tibial metaphyseal areas and total mineral contents of both hindlimbs of splinted animals were reduced compared with those of unsplinted animals. However, the relationship between mineralization and area differed between the free and immobilized limbs of splinted animals. The breaking strain and the breaking energy of immobilized and free femurs of splinted animals were impaired 4 wk after the removal of the splint. This impairment was correlated with an effect of splintage on femoral size with some additional local effect from immobilization. Thus osteoporotic changes consequent on immobilization include both local effects on mineralization and general effects on growth, which may separately influence the elastic properties of bone.

Adaptation, Physiological↗
PubMedDate not supplied

Some biomechanical aspects of the foot and ankle in athletes with and without shin splints.

Thirteen adult male athletes (long-distance runners and orienteerers without foot problems) and 35 male athletes with shin splints were compared with respect to: 1) the position of the lower leg and the heel while standing, 2) the passive range of mobility in the subtalar joint, and 3) the angular displacement between the calcaneus and the midline of the lower leg (Achilles tendon angle) while running with bare feet on a treadmill. In standing, the two groups differed statistically significantly in the Achilles tendon angle, which values were greater in the shin splint group. With respect to passive mobility, the athletes with shin splints had significantly greater (P less than 0.05-0.01) angular displacement values in inversion, eversion, and in their sum than the control group. While running, the Achilles tendon angle of the shin splint group was significantly greater (P less than 0.01) at the heel strike. Further, the shin splints group had a significantly greater (P less than 0.01) angular displacement between the heel strike and the maximal everted position. The results suggest structural and functional differences in the feet and ankles between healthy athletes and those with shin splints.

Achilles Tendon↗
PubMedDate not supplied

Intestinal splinting for uncomplicated early postoperative small bowel obstruction: is it worthwhile?

BACKGROUND: Established indications (obstructing extensive fibrous adhesions) and contraindications (solitary band- and short segment midgut adhesive obstruction, purulence) of intestinal tube splinting have emerged from clinical practice. The benefit of tube splinting for early postoperative small bowel obstruction (SBO), however, is still a matter of debate. METHODS: From Jan 1980 until Dec. 1989, all patients undergoing relaparotomy for uncomplicated early postoperative SBO were randomized for enterolysis, gut decompression and repair (group A, 28 patients) or the same procedure plus tube splinting (group B, 28 patients). The patients were comparable with respect to gender, age and type of preceding operations; they were followed for 5-14 years or until death. RESULTS: In the early postoperative period, 3 incidences of reobstruction and 8 of other complications were observed in group A vs. 0 and 2, respectively, in group B. No patient died. During follow-up, one patient suffered late SBO, 2 patients recurrent partial SBO and one patient died of bowel perforation in group A vs two incidences of late SBO in group B. CONCLUSIONS: Intestinal splinting performed for early postoperative SBO rendered a significant reduction of early postoperative complications; the protective efficacy against early reobstruction was clinically apparent but reached borderline significance only. In respect to late intestinal complications, splinting was not superior to simple enterolysis. Early and late complications taken together and intestinal complications considered separately were significantly more frequent in patients without splinting.

Decompression, Surgical↗
PubMed2004

Stabilisation splint therapy for temporomandibular pain dysfunction syndrome.

BACKGROUND: Pain dysfunction syndrome (PDS) is the most common temporomandibular disorder (TMD). There are many synonyms for this condition including facial arthromylagia, TMJ dysfunction syndrome, myofacial pain dysfunction syndrome, craniomandibular dysfunction and myofacial pain dysfunction. The aetiology of PDS is multifactorial and many different therapies have been advocated. OBJECTIVES: To establish the effectiveness of stabilisation splint therapy in reducing symptoms in patients with pain dysfunction syndrome. SEARCH STRATEGY: Electronic databases (including the Cochrane Oral Health Group's Trials Register; the Cochrane Central Register of Controlled Trials (CENTRAL); The Cochrane Library Issue 2, 2003; MEDLINE (1966 to June 2001); EMBASE (1966 to June 2001)) were searched. Handsearching of relevant journals was undertaken and reference lists of included studies screened. Experts in the field were contacted to identify unpublished articles. There was no language restriction. SELECTION CRITERIA: Randomised or quasi-randomised controlled trials (RCTs), in which splint therapy was compared concurrently to no treatment, other occlusal appliances, or any other active intervention. DATA COLLECTION AND ANALYSIS: Data extraction was carried out independently and in duplicate. Validity assessment of the included trials was carried out at the same time as data extraction. Discrepancies were discussed and a third reviewer consulted. The author of the primary study was contacted where necessary. The studies were grouped according to treatment type and duration of follow up. MAIN RESULTS: Twenty potentially relevant RCTs were identified. Eight trials were excluded leaving 12 RCTs for analysis. Stabilisation splint therapy was compared to: acupuncture, bite plates, biofeedback/stress management, visual feedback, relaxation, jaw exercises, non-occluding appliance and minimal/no treatment. There was no evidence of a statistically significant difference in the effectiveness of stabilisation splint therapy (SS) in reducing symptoms in patients with pain dysfunction syndrome compared with other active treatments. There is weak evidence to suggest that the use of SS for the treatment of PDS may be beneficial for reducing pain severity, at rest and on palpation, when compared to no treatment. REVIEWER'S CONCLUSIONS: There is insufficient evidence either for or against the use of stabilisation splint therapy for the treatment of temporomandibular pain dysfunction syndrome. This review suggests the need for further, well conducted RCTs that pay attention to method of allocation, outcome assessment, large sample size, and enough duration of follow up. A standardisation of the outcomes of the treatment of PDS should be established in the RCTs.

Acupuncture Therapy↗
PubMed2001

Recording compliance of dental splint use in obstructive sleep apnoea patients by force and temperature modelling.

Fibre-optic sensors are used to monitor the force and temperature of dental splints worn by patients suffering from sleep apnoea. Owing to the small size of the sensors, they can be easily embedded within the splint in a way that does not affect the effectiveness of the splint, and, at the same time, are able to indicate whether the splint has been properly worn by the patient. The overall dimensions of the sensor are approximately 0.375 mm thickness, 1 cm length and 3 mm width. The force and temperature sensors are calibrated and found to have sensitivities of better than 0.5 N and 0.1 degrees C, respectively. Trials performed on patients show that the measurement of pressure and temperature is an effective way of monitoring the proper usage of the dental splint by the patients.

Fiber Optic Technology↗
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↗
PubMed2000

The effect of splinting of teeth in combination with reconstructive periodontal surgery in humans.

The purpose of this study was to evaluate the effect of splinting teeth on the results of periodontal reconstructive surgery using a specific carbonate bone replacement graft (BRG) material. Forty-five patients were randomly treated with a periodontal surgery approach. Natural coral calcium BRG was utilised in 33 patients. This 33-patient group was divided into three equal groups. In the presplint group, teeth were splinted to at least two rigid teeth before surgery, in the postsplint group, teeth were splinted at suture removal, and in the nonsplint group, the treated teeth were not splinted at all. In 12 patients, teeth were treated with surgical debridement (DEBR) alone and not splinted. Periodontal probing depth (PPD), clinical probing attachment level (CPAL), and tooth mobility were measured using desmodontometry (DDM) and periotest (PTV) with reproducible methods before surgery and at various periods up to 1 year afterwards. A decrease in PPD (5.4 mm, SD 1.4 mm) and tooth mobility (DDM-horizontal 257 microns, SD 60 microns) and a gain of CPAL (5.1 mm, SD 1.4 mm) were seen following the use of BRG in presplint teeth. In the same group, PPD and tooth mobility were significantly reduced compared to nonsplint teeth. DEBR alone showed reductions in tooth mobility and PPD and a significantly smaller gain in CPAL than in presplint teeth treated with BRG. The less favourable improvement in periodontal function of postsplint or nonsplint teeth seemed to be due to the loss of BRG material caused by tooth mobility. These results indicate that an undisturbed wound healing process using BRG together with tooth stability is beneficial to overall clinical success.

Alveolar Bone Loss↗
PubMed1976

The influence of fixed splints on mandibular flexure.

The degree of mandibular flexure during forced opening of the jaws with various fixed splints in place was measured. Significant results indicate that: (1) all splints tested reduce the amount of mandibular flexure; (2) the reduction of measured mandibular flexure cannot be explained solely by tooth movement, rather it is indicative of a limitation of bony flexure by fixed splints; (3) extensive mandibular splints flex during forced opening; and (4) fixed prostheses involving many teeth do not completely inhibit mandibular flexure. Inhibition of mandibular flexure apparently increases as more teeth are splinted and more rigid attachments are used.

Adult↗
PubMed1980

Effect of occlusal splints on the electromyographic activities of masseter muscles during maximum clenching in patients with myofascial pain-dysfunction syndrome.

Integrated EMG activities of masseter muscles during maximum voluntary isometric contraction with and without full-arch maxillary stabilization splints were observed in patients with MPD syndrome having occlusal interferences and in healthy subjects having no occlusal interferences. The masseter muscle activity was more significantly reduced in patients with MPD syndrome during maximum clenching with splints than in those patients without splints. In healthy subjects, such a significant difference could not be observed with and without splints. This finding suggests that the elimination of the occlusal interferences by means of occlusal splints could reduce the degree of sensory information from the periodontal receptors during nocturnal clenching or grinding. This could result in a decrease in masseter muscle activity giving rise to muscular relaxation.

Action Potentials↗
PubMed1982

A parallel tube provisional splint technique.

Splinting does not replace occlusal and periodontal therapy, but it is frequently a useful adjunct to such treatment. A parallel tube splint technique that is effective for provisional splinting and simple to place has been presented. It does not require extensive tooth reduction or restorative dentistry, nor does it result in overcontouring or problems for the periodontal tissues (Figs. 16 to 19). The splint is easy to clean and maintain; it is also inexpensive when compared to other types of splints. Clinical evaluation of this technique is continuing and will be reported at a later date.

Dental Instruments↗
PubMed1983

Compound splint for comminuted mandibular fracture.

Maintenance of an adequate airway, control of bleeding, and neurologic evaluation should take precedence over treatment of facial injuries. Comminuted mandibular fractures are rare and require the use of complex splints. Severe lacerations and bone displacement accompany comminuted mandibular fractures. Extraoral facial splints constructed from donor facial moulages can be used along with intraoral splints for these patients. Preaccident photographs and radiographs are excellent aids to help realign the fractured segments. The use of an extraoral "donor" splint in conjunction with an intraoral splint to stabilize comminuted mandibular fracture helps to eliminate unnecessary gross removal of mandibular bone.

Equipment Design↗
PubMed1992

Temporomandibular joint disk displacement without reduction. Treatment with flat occlusal splint versus no treatment.

A flat occlusal splint has been extensively used in the treatment of patients with temporomandibular joint disk displacement without reduction, but no studies with untreated controls have assessed its effect. We randomly assigned 51 patients with temporomandibular joint pain and arthrographically verified disk displacement without reduction to be treated with a flat occlusal splint or to serve as untreated control subjects in a 12-month clinical trial. Pain symptoms disappeared in about one third of the patients in each group. Another third of the patients in the control group improved. Sixteen percent of the patients in the control group and 40% of the patients treated with a flat occlusal splint were worse at the end than at the beginning of the study. Joint pain and muscle tenderness decreased more frequently in the nontreatment controls than in the treatment group. A statistically significant benefit of a flat occlusal splint over nontreatment control subjects could not be identified in this study of patients with painful disk displacement without reduction. The use of a flat occlusal splint in this patient group should therefore be reconsidered.

Adolescent↗
PubMed1990

Soft occlusal splint therapy in the treatment of migraine and other headaches.

Fifty-seven patients suffering from migraine, tension headache or tension vascular headache were prescribed a soft occlusal splint for night-time wear. Dental, psychosocial/psychiatric and neurological data were recorded prior to commencement of therapy and at the conclusion of a 3 month treatment period. A statistically significant number of patients presenting with migraine or tension vascular headache experienced marked improvement or complete relief of headache symptoms, but most patients suffering from tension headache failed to benefit from splint therapy. A majority of patients displaying intercurrent features of craniomandibular dysfunction experienced reduction in these symptoms also. There was a statistically significant association between TMJ improvement and headache type. Prior to treatment, patients who subsequently benefited from splint therapy in terms of headache improvement had experienced significantly fewer headaches than patients who failed to respond, although headache intensity and duration were similar in both groups. It is suggested that headache type and frequency may be prognostic indicators of the likely success of dental splint therapy in treatment of headache. Nevertheless, the use of occlusal splints in the treatment of patients complaining of headache in the absence of evidence of craniomandibular dysfunction should not be embarked upon until medical examination has excluded the possibility of organic neurological disorder.

Adolescent↗
PubMed1994

The efficacy of oral splints in the treatment of myofascial pain of the jaw muscles: a controlled clinical trial.

Oral splints are widely used in the treatment of myofascial pain of masticatory muscles, even though their mechanism of action is unknown. The present study evaluated the therapeutic efficacy of splints using a parallel, randomized, controlled and blind design. Following a sample size estimation, 63 subjects were recruited and assigned to 3 groups: (1) passive control: full occlusal splint worn only 30 min at each appointment; (2) active control: palatal splint worn 24 h/day; and (3) treatment: full occlusal splint worn 24 h/day. On each of 7 visits over 10 weeks, subjects rated on 100 mm visual analogue scales their pain intensity and unpleasantness at rest and after experimental mastication. The effect of pain on the quality of life was also rated on category scales. All pain ratings decreased significantly with time, and quality of life improved for all 3 groups. However, there were no significant differences between groups in any of the variables. These data suggest that the gradual reduction in the intensity and unpleasantness of myofascial pain, as well as the improvement of quality of life during the trial, was non-specific and not related to the type of treatment.

Adolescent↗
PubMed2005

The effects of splinting on outcomes for epicondylitis.

OBJECTIVE: To evaluate the effects of splinting on outcomes for injured workers with epicondylitis. DESIGN: Retrospective cohort study using propensity score methodology to statistically control for all observed pretreatment differences between patients with and without splints. SETTING: Nationwide network of 253 occupational medicine clinics. PARTICIPANTS: All injured workers (N=4614) receiving primary care for lateral or medical epicondylitis (International Classification of Diseases, 9th Revision, codes 726.31 or 726.32). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Physician-prescribed rates of duty restrictions and lost time, treatment duration, specialist referrals, and medical and physical therapy (PT) visits and charges. RESULTS: Overall, patients with splints had higher rates of limited duty ( P <.001), more medical visits and charges ( P <.001), higher total charges (medical and PT, P <.001), and longer treatment durations ( P <.01) than patients without splints. Evaluating differences for patients who did and did not receive PT, significant differences remained for rates of limited duty ( P <.05), medical visits ( P <.01), and medical charges ( P <.01). CONCLUSIONS: Splinting patients with epicondylitis may not optimize outcomes, including rates of limited duty, treatment duration, and medical costs.

Adult↗