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PubMed2005

A simple and effective method of preventing inadvertent occlusion of chest tube drains: the corrugated tubing splint.

Inadvertent occlusion of tube thoracostomy drains by normal patient positioning can be not only a nuisance but also a potentially life-threatening problem. A method of splinting the pliable chest tube drains by using corrugated ventilator circuit tubing is described. This relatively simple and quick technique can help to prevent this undesired and potentially dangerous occlusion of chest tube drains.

Chest Tubes↗

PubMed1991

Preliminary studies on the use of MRI in the diagnosis of TMJ disc displacement.

The temporomandibular joints of seven patients exhibiting clinical signs and symptoms of TMJ dysfunction were scanned using a 0.3T magnetic resonance system. Images were obtained with the mandible in open and closed positions. Patients were also scanned wearing a maxillary occlusal splint. Images obtained showed varying degrees of disc displacement and pathological changes in the joint depending on the severity of the clinical symptoms presented. In all patients, splints were shown to distract the joint slightly and place the condyle, disc and fossa in a more favourable relationship.

Dental Occlusion↗

PubMed1987

Response to occlusal treatment in headache patients previously treated by mock occlusal adjustment.

Headache patients who had received mock occlusal adjustment and who, after the placebo treatment, were judged to have moderate to severe mandibular dysfunction were offered further treatment. The present study reports the results of occlusal treatment in 19 patients who were willing to undergo further treatment. Statistically significant reduction after occlusal treatment (occlusal adjustment, aided in some cases by temporary use of occlusal splints) was observed in clinical signs (P less than 0.05) and subjective symptoms (P less than 0.01) of mandibular dysfunction and in the frequency of headache (P less than 0.05). The results are complementary to our earlier clinical studies and corroborate the conclusion that improvements after occlusal treatment exceed those after placebo treatment.

Dental Occlusion, Balanced↗

PubMed1982

Assessment of the therapeutic position for orthodontic diagnosis and treatment.

The authors discuss the influence of mandibular displacement in intercuspal position (ICP) on orthodontic planning and treatment. The correct therapeutic position in orthodontics should be assessed on the basis of clinical and radiographic parameters. Posteroanterior cephalograms can be of great diagnostic value; deviation from the norm of some measurements is highly indicative of a mandibular displacement in ICP. A repositioning occlusal splint is then constructed in the therapeutic position before the definitive orthodontic treatment is started; the splint should lead to improvement of the clinical and cephalometric data.

Adolescent↗

PubMed1987

The uptake of horseradish peroxidase in monkey temporomandibular joint synovium after occlusal alteration.

We conducted an electron microscopic study on the alterations in the temporomandibular joint (TMJ) synovium of the monkey after it was subjected to unilateral bite-raising, by means of a maxillary occlusal splint. The uptake of intravenously injected horseradish peroxidase (HRP) by type A cells was demonstrated in the disturbed TMJ. The uptake of HRP decreased three to six wk after occlusal alteration, and was the same as in normal type A synovial cells after 16 wk.

Animals↗

PubMed1989

Treatment for acute craniomandibular dysfunction symptoms in edentulous patients with unserviceable or no existing complete dentures.

This article describes techniques to make unserviceable complete dentures rapidly serviceable and to facilitate using them in the diagnosis and treatment of acute craniomandibular dysfunction symptoms in edentulous patients. A technique is described to make complete dentures rapidly in the event that the complete dentures cannot be made serviceable or the patient has no complete dentures. This technique uses the TRIAD visible light-cure system. Once the complete dentures are made, they can be used alone or in conjunction with an occlusal splint for the diagnosis and treatment of acute craniomandibular dysfunction symptoms.

Dental Occlusion↗

PubMedDate not supplied

Occlusal therapy in the management of chronic orofacial pain.

Review of the literature indicates that most routine orofacial dysfunctions are characterized by deep pain. Various disorders of the masticatory systems, particularly musculoskeletal conditions, are thought to be triggered by occlusal disharmonies. The pain component develops following a pattern of bruxism, muscle hyperactivity, fatigue and spasm. Treatment for most disorders has been to modify the occlusion, although the rational for doing so appears questionable.CRITICAL ISSUES IN THE FIELD OF OCCLUSION RELATED TO OROFACIAL PAIN ARE REVIEWED: occlusal disharmonies, coincidence of retruded-intercuspal contact positions, non-working side interferences, maximum intercuspation of teeth, occlusal adjustment, and occlusal appliances.The studies reviewed fail to support the clinical objective of obtaining equal contact at retruded and intercuspal positions and that the lateral pterygoid muscles stabilize the temporomandibular joint. The relationship between non-working side interferences and pain dysfunction is also not readily supported by controlled studies. Occlusal adjustment appears to be unsatisfactory as a modality for management of pain: not all patients improved following treatment, some relapse occurs even with the most stable contacts, and other treatments such as intra-articular injections of corticosteroids reduced symptoms more readily. Occlusal splints seem to reduce most clinical signs and symptoms on both a short-term and long-term basis. Placement of mandibular orthopedic repositioning appliances results in reduction of pain in some patients, but usually this treatment is followed by extensive rehabilitation.Six major areas are suggested for clinical studies that attempt to relate occlusion to management of orofacial pain. These include: establishment of an ideal jaw position, sequencing of symptoms in the pain history, relationship of pain to other symptoms, development of physiological methods to assess how occlusal modification affects pain perception and pain tolerance, and determination of which treatment modalities produce the most effective relief of pain.

Chronic Disease↗

PubMed1989

[Therapeutic aspects of functional pathology of edentulous patients with temporomandibular osteoarthritis].

We reviewed the fundamentals aspects for diagnosis of temporomandibular joint (TMJ) osteoarthritis and its treatment in edentulous patients with the following objectives: to eliminate the inflammatory process, to obtain neuromuscular mandible centricity and to decrease the traumatic effects in the TMJ. We used occlusal splints and dentures that allowed the stabilization of intermaxillary relations in centric areas when it was harmonized the maximum intercuspidation and the muscular centric position. We described, also the treatment and in our opinion the neuromuscular intermaxillary relations are the start point to obtain definitive stability for the oral rehabilitation in edentulous patients.

Dental Occlusion, Centric↗

PubMed1988

Gnathologic assessment of centric slides in postretention orthodontic patients.

After 2 weeks of "deprogramming" with an occlusal splint, 92 subjects with a history of comprehensive orthodontic therapy had an average centric slide that was comparable not only to that of an untreated control group, but also to equivalent estimates reported in the literature. It is suggested that for modern man a CO-CR difference may be a normal, physiologically significant by-product of the nature and pattern of mandibular function and the tooth attachment mechanism. Moderate changes in the magnitude of a given patient's centric slide would therefore be expected to regress, not to the population mean, but rather to the CO-CR difference that was present before treatment.

Adult↗

PubMed1980

Condylar remodeling after occlusal therapy.

Seven men and 15 women with TMJ pain dysfunction syndrome were selected. After clinical examination, polytomography of the TMJ was performed in centric occlusion in different planes. Open-mouth projections were also made in three patients, frontal tomography in one patient, and transcranial radiographs in 16 patients. Occlusal analysis was performed on the articulator. Twenty patients showed various patterns of condylar displacement with flattening of the anterior, superior, or posterior condylar walls in 11 patients, including three with arthritic lesions. Therapy included occlusal splints (21 patients), selective grinding (seven patients), prosthodontic rehabilitation (10 patients), and orthodontic treatment (two patients). After therapy, tomographic examination was repeated at intervals of 9 to 44 months. A distinct reshaping of the condyle was seen in seven patients. The new shape tended to be rounded. The three patients with degenerative changes before treatment showed regression of the lesions. No change was seen in condyles which were rounded before therapy.

Adolescent↗

PubMed1987

Effect of occlusal (mechanical) stimulus on bone remodelling in rat mandibular condyle.

Mechanical load influences the remodelling of skeletal tissues. In the mandibular condyle, occlusal alterations and the consequent mechanical stimulus induce changes in chondrocytes and cartilage mineralization. In the present study we quantified in the mandibular condyle the effect of occlusal interference on remodelling of the subchondral bone. Computerized histomorphometry after 5-21-day exposure to the influence of a unilateral occlusal splint revealed an increased rate of trabecular remodelling, consisting of enhancement in osteoblast and osteoclast numbers and activities. The bone formation parameters reached their high values on Days 5 or 9 and remained stable thereafter. Bone resorption showed a gradual increase throughout the experimental period. These results further characterize the temporomandibular joint reaction to occlusal alterations. It is suggested that the present increase in bone turnover together with the known enhancement in chondrogenesis are part of a process of functional adaptation in response to mechanical stimulus.

Animals↗

PubMed1995

Laboratory procedures for the fabrication of maxillary occlusal bite plane splint.

Clear communication between the dentist and laboratory technician is important for the production of quality work and the saving of valuable chair time at delivery. This article discusses the laboratory procedures used in the fabrication of occlusal bite plane splint. Traditional heat curing, microwave heat processing, and visible light curing techniques are discussed.

Acrylic Resins↗

PubMed1989

Value of EMG analysis of mandibular elevators in open-close-clench cycle to diagnosing TMJ disturbance syndrome.

The EMGs of the temporal and masseter muscle, in sixty patients with temporomandibular joint disturbance syndrome (TMJDS) and thirty normal controls, were recorded during rhythmical open-close-clench cycle movement and before and after occlusal splint therapy. The duration of the muscle contraction before initial tooth contact (DMC), the latent period (LP) and the silent period (SP) of the myoelectrical activity were used as indices for exploring their diagnostic value. In contrast with the controls, DMC, LP and SP lengthened in the patients. The DMC was prolonged in those patients where there were TMJ sounds, the inter-cuspated position did not coincide with the muscular contact position and there was deviated mandibular movement. An increase of the SP was related to tooth contact on the balancing side. After treatment, the DMC and SP in the patients returned to the level of the controls. It was found that the internal correction rate of Fisher's linear discriminate function established for the DMC and SP of the temporal and masseter muscles was 80.9% and 85.1% respectively. The results show that the DMC and SP of the temporal and masseter muscles have some value in diagnosing muscular dysfunction and discriminating therapeutic effectiveness.

Adult↗

PubMed2005

Fabrication of a craniofacial implant surgical and treatment planning guide.

A procedure is described to fabricate a surgical guide to assist in the placement of craniofacial implants for prosthetic auricular rehabilitation. An impression is made of the defect, and a wax pattern of the missing ear is completed and evaluated on the patient. The definitive wax prosthesis is processed in acrylic resin. An occlusal maxillary splint is also fabricated. The occlusal splint and the acrylic resin ear are joined together using an extraoral acrylic resin bar. The resulting surgical guide provides proper orientation of the acrylic resin ear while remaining securely attached to the maxillary arch. This surgical guide can also be utilized for pretreatment radiographic examination.

Acrylic Resins↗

PubMed2001

[Otalgia and tinnitus in patients with craniomandibular dysfunctions].

AIMS OF THE STUDY: The high prevalence of ear, nose, and throat symptoms in patients with craniomandibular disorders seems to depend on the connection between both phenomena. The present study evaluates the connection between craniomandibular disorders (CMD) and otalgia or tinnitus, investigates the correlation between specific diagnoses of CMD with otalgia or tinnitus, and estimates the effects of treatment of CMD on these ear symptoms. PATIENTS AND METHODS: The information from case histories, clinical examinations, and treatment results of 221 patients with CMD were coded and evaluated by computer. All patients received conservative treatment with occlusal splints, training in self-observation of parafunction, massage of the masticatory muscles, and heat therapy. At least 1 year after the first examination, all patients were reevaluated. According to their complaints, the patients could be divided into three groups: (1) CMD patients without ear symptoms (n = 134 = 61%), (2) CMD patients with otalgia (n = 80 = 37%), and (3) CMD patients with tinnitus (n = 8 = 3.8%) (one patient with tinnitus and otalgia). RESULTS: Otalgia correlated significantly with CMD and the specific CMD diagnoses of anterior disk displacement (ADD) without reduction and osteoarthrosis. Of the reevaluated patients with otalgia, 90% had no ear pain and 10% reported reduced or less frequent ear pain. Only one of the eight cases with tinnitus noted reduced noises; the remaining seven perceived no influence on their ear noises from therapy. CONCLUSIONS: Due to the treatment results, otalgia has to be interpreted as a possible symptom of CMD and not as a separate diagnosis.

Adult↗

PubMed2003

Treatment of recurrent temporomandibular joint dislocation with intramuscular botulinum toxin injection.

Recurrent dislocation of the mandibular condyle poses a difficult problem for affected patients. In the course of time, dislocations often become more frequent and more difficult to avoid. Even with good patient compliance, conservative treatment is often not sufficient. Operative procedures have also been described for the treatment of temporomandibular joint dislocation. However, these interventions are invasive, involving open arthrotomy with possible complications, and cannot safely guarantee a successful outcome. On the other hand, botulinum toxin injections into the lateral pterygoid muscles offer the option of a predictable and prolonged period without renewed dislocation. We present the results of this treatment carried out in 21 patients with recurrent temporomandibular joint dislocation. Four patients were treated following unsuccessful physical therapy and the use of occlusal splints. The remaining 17 patients were treated for a number of conditions resulting in dislocation, including some with senile dementia and mental impairment in whom compliance with conservative measures was poor or completely absent. Injections were given on a 3-month basis in order to have a sustained effect. Within the study period of 6 months to 3 years, only two of the 21 patients suffered further dislocation. There were no side effects recorded as a result of treatment.

Adult↗

PubMed1983

Surgical correction of mandibular prognathism with a functionally stable osteosynthesis of the mandibular body.

Several methods have been described for the surgical correction of mandibular prognathism. Current techniques favour surgical correction at the site of the anomaly itself and in the case of skeletal mandibular prognathism it is the mandibular body that must be cut and shortened. The authors describe two methods of oblique ostectomy and of sagittal splitting with ostectomy of the mandibular body, by which a planned and measured reduction of the size of the mandible can be achieved. The techniques provide a functionally stable osteosynthesis, the optimum conditions for post-operative bone healing and so reduce the period of intermaxillary immobilisation. The special problems of articular derangements of the temporo-mandibular joint due to a stable osteosynthesis can be avoided by the combined use of zygomatico-mandibular positioners and occlusal splints.

Female↗

PubMed1979

Iatrogenic TMJ difficulty: cervical traction may be the etiology.

Patients in cervical traction for the treatment of cervical spine syndromes frequently complain that the traction makes them worse. It is possible that such patients may be suffering from TMJ symptoms. The physician treating a patient with cervical traction should consider prescribing an occlusal splint for patients without posterior teeth. The splint should be designed to distribute the stresses through the mandible to the maxillae via the teeth, splint, and TMJ.

Cervical Vertebrae↗