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PubMed1983

Evaluation of occlusal splint therapy and relaxation procedures in patients with temporomandibular disorders.

Twenty-four patients were selected to participate in this study. Twelve patients were randomly selected to receive occlusal splint therapy and the other 12 to receive a simplified relaxation therapy technique. Observable pain scores, maximum comfortable interincisal distance, and maximum interincisal distances were recorded for each group before and after treatment. The occlusal splint group showed a significant decrease in total mean observable pain scores (decrease score of 10.5, t = 3.124; P less than 0.1). The relaxation group showed no significant decrease in total mean observable pain scores (decrease score of 1.8, t = 0.888; P = ns). The occlusal splint group showed a significant increase in the mean maximum comfortable opening (an increase of 12.4 mm, t = 5.085; P less than .01). The relaxation group showed no significant increase in the mean maximum comfortable opening (an increase of 2.3 mm, t = 0.734; P = ns). The occlusal splint group showed a significant increase in the mean maximum opening (an increase of 6.0 mm, t = 2.471; P less than .05). The relaxation group showed no increase in the mean maximum opening (decrease of 0.7 mm, t = 0.343; P = ns). This study suggests that occlusal splint therapy is a more effective treatment for the pain, tenderness, and limited mandibular opening associated with temporomandibular disorders than relaxation therapy. In this study, the relaxation technique used had no significant effect on the patients' pain, tenderness, or limited opening.

Adult↗
PubMed1990

The effects of an occlusal splint on the electromyographic activities of the temporal and masseter muscles during maximal clenching in patients with a habit of nocturnal bruxism and signs and symptoms of craniomandibular disorders.

The effects of a full arch maxillary plane occlusal splint on the level of electromyographic (EMG) activity in the anterior temporal and masseter muscles during maximal clenching were studied in 31 patients with a habit of nocturnal bruxism and signs and symptoms of craniomandibular disorders, before and after occlusal splint therapy. The results showed, before treatment, that the occlusal splint changed significantly (in 71% of patients) the level of EMG activity during maximal clenching. However, these changes were not consistent and differed between patients and even, in some patients, between muscles. After long-term occlusal splint therapy and improvement of the signs and symptoms of craniomandibular disorders, the number of patients who had an identical level of EMG activity during maximal clenching in the intercuspal position and on the occlusal splint tended to increase. Moreover, in these patients the level of symmetry of action in pairs of muscles during maximal clenching was strong, and the splint did not change this level of symmetry.

Adolescent↗
PubMed1989

[Application of occlusal splint for the patient with temporomandibular joint dysfunction. An application of silane coupling treatment: a case report].

The bite plane therapy has been one of the most useful treatment methods for patients with temporomandibular joint (TMJ) dysfunction. But the bite plane usually causes esthetic and articulation disturbances and it is occasionally difficult to use during mastication. The authors have fabricated a new type of bite plane, named occlusal splints, which covers each side of the premolars and molars. The occlusal splint was constructed by a hard-resin for the occlusal part and cast clasps for the retentive part and these parts were adhered after a pre-treatment of metal by the use of a silane coupling agent (Silicoater system). The patient was a 35 year-old man, with a chief complaint of left side reciprocal TMJ clicking. The anterior repositioning type of bite plane was applied for the treatment with the diagnosis of anterior disk displacement with reduction. But he complained of esthetic and articulation disturbances especially during working and eating. After four months we fabricated an occlusal splint that can be used for a long period of time. The patient was satisfied to use this occlusal splint and no symptoms of TMJ dysfunction were found with this appliance. It is suggested that the occlusal splint consisting of a hard-resin and cast clasps is a useful appliance especially for the purpose of use during working and eating, and for evaluating the properness of mandibular position.

Adult↗
PubMed1992

Acupuncture and occlusal splint therapy in the treatment of craniomandibular disorders. Part I. A comparative study.

One hundred and ten patients, 23 males and 87 females, participated in a comparative study of the effect of acupuncture and occlusal splint therapy. All the patients exhibited signs and symptoms of craniomandibular disorders (CMD) and had had pain for more than six months. The participants were randomly assigned to three groups; acupuncture treatment, occlusal splint therapy or control. The patients were evaluated before and immediately after treatment/control time. Ten different subjective and/or clinical assessment variables were used in the evaluation of the treatment effects. Both acupuncture and occlusal splint therapy reduced the symptoms as compared with the control group in which the symptoms remained essentially unchanged. In this short-term study, acupuncture gave better subjective results (p < 0.001) than the occlusal splint therapy.

Acetaminophen↗
PubMed1994

Influence of stabilization occlusal splint on craniocervical relationships. Part II: Electromyographic analysis.

The aim of this study was to determine the effect of stabilization occlusal splints on electromyographic (EMG) activity of sternocleidomastoid and trapezius muscles in subjects with spasm in the mentioned muscles. A full-arch maxillary stabilization occlusal splint was made for each of the 15 subjects. In the sternocleidomastoid muscle, tonic and saliva swallowing EMG activity decreased significantly with the splint, whereas maximal clenching activity did not change. In the trapezius muscle, no significant changes were observed with the occlusal splint. The different pattern in both muscles during tonic and swallowing EMG activity with the splint is attributed to differences in the synaptic inputs to the respective motoneuron pools, suggesting that a differential modulation of the motor neuron pools may exist of both muscles, of peripheral and/or central origin.

Adult↗
PubMed1988

Disk-repositioning onlays in the treatment of temporomandibular joint disk displacement: comparison with a flat occlusal splint and with no treatment.

Sixty-three patients with an arthrographic diagnosis of disk displacement with reduction were randomly assigned to three treatment groups: (I) onlays to maintain disk repositioning, (II) flat occlusal splint, or (III) untreated controls. Guidance for construction of the disk-repositioning onlays was established during arthrography to obtain a recaptured disk position relative to the condyle. The onlays were cemented to the teeth and maintained the new intercuspal position anteriorly and inferiorly. The flat occlusal splint was used at night only and was adjusted to maintain a maximal occlusal contact in centric relation and centric occlusion. Clinical examinations were performed before and after 6 months of treatment. The disk-repositioning onlays improved joint function and reduced joint and muscle pain when compared with the flat occlusal splint and with nontreatment. The signs and symptoms in the flat occlusal splint group were no different from those in the control group. It is concluded that disk-repositioning onlays are effective in reducing pain and dysfunction associated with disk displacement with reduction in patients in whom the disk can be maintained in a normal relationship to the condyle with the aid of such onlays. The symptoms, however, returned when the onlays were removed after 6 months; this raises the question of whether a permanent change in the intercuspal position is necessary for long-term success.

Adolescent↗
PubMed1988

An easily fabricated occlusal splint.

An easy and inexpensive method for fabrication of an occlusal splint has been described. It has a high degree of patient acceptance and is effective in treating TMJ dysfunction symptoms. If a hard acrylic occlusal splint is preferred, the aforementioned method can be used as an interim appliance until necessary appointments can be scheduled.

Dental Occlusion↗
PubMed1992

A modified occlusal splint to avoid tracheotomy for total midface osteotomies.

A modified occlusal splint is described which may be used to avoid tracheostomy when a total midface osteotomy is required. We demonstrate the accuracy of the modified splint by using the technique in a control subject who underwent alginate impressions, dental casts, and a face-bow transfer. A modified splint was constructed on the articulated dental models and was found to be accurate within the range of rotational movement of the temporomandibular joint. The technique is demonstrated in a patient with Crouzon's syndrome undergoing cranial vault reshaping and a monobloc (midface) advancement. The modified occlusal splint provides an alternative method of airway management when precise intraoperative occlusal relationships are important.

Child↗
PubMed1992

Acupuncture and occlusal splint therapy in the treatment of craniomandibular disorders. II. A 1-year follow-up study.

Eighty patients, of whom 22 were men and 58 women, participated in a 1-year follow-up study. All participants in the study showed signs and symptoms of craniomandibular disorders (CMD) and had had pain for more than 6 months at treatment start. The patients were randomly assigned to either acupuncture or occlusal splint therapy. Those patients who did not respond to either of the treatment modes were offered various additional therapies. The result showed that 57% of the patients who received acupuncture and 68% of the patients treated with occlusal splint therapy benefited subjectively (p < 0.01) and clinically (p < 0.001) from the treatment over a 12-month period. No statistically significant difference was found between the two groups as to the assessment variables. Those patients who received various additional therapies after acupuncture and/or occlusal splint therapy responded favorably to additional treatment in only a few instances. The study showed that acupuncture gave positive results similar to those of occlusal splint therapy in patients with primarily myogenic CMD symptoms over a 1-year follow-up period.

Activities of Daily Living↗
PubMed1992

The use of transcranial stimulation in the fabrication of an occlusal splint.

An alternative method for fabricating occlusal splints by means of electric transcortical stimulation is presented. Ensuing results in one patient suggest neuromuscular benefits. However, the centric occlusal position determined by this method is a painful procedure because of electric stimulation on the scalp. Further and extensive investigations must be carried out to assess the clinical benefits and limits of this method.

Dental Occlusion↗
PubMed1979

An evaluation of a polyvinyl occlusal splint for improving the health of inflamed maxillary supporting mucosa of complete denture patients.

A study was made to determine the effects of a polyvinyl occlusal splint on improving the health of inflamed maxillary supporting mucosa. Color slides were made before and after treatment of the maxillary supporting mucosa of 22 edentulous patients wearing dentures during a 15-day test period. The control group consisted of 13 patients, and the experimental group was comprised of nine patients who wore the occlusal splint over the maxillary denture. The 35 mm color slides taken before and after treatment were evaluated by 50 examiners to determine if the health of the maxillary supporting mucosa was better, the same, or worse after the 15-day test period. Fourteen of the examiners were retested to determine the reliability of the viewer. An observable change was noted in the experimental group at a p value less than 1 in 100,000. These findings indicate that the occlusal splint was effective in improving the health status in 64.7% of the experimental patients and that the experimental method was valid.

Dental Occlusion↗
PubMed1979

Occlusal splint fabrication.

There are many methods of fabricating an occlusal splint. The advantages of the technique described are as follows: (1) little intraoral adjustment is required, (2) there is ease in construction, and (3) only one set of diagnostic casts can serve for both occlusal analysis and splint construction. The disadvantage is that an occlusion with group function cannot be produced by this method.

Acrylic Resins↗
PubMed1996

Dimensional stability of occlusal splints.

Five fabrication techniques and two storage methods were used to construct and store specimens to investigate the dimensional stability of acrylic resin occlusal splints. A research model was developed to more closely approximate the tooth coverage limits of occlusal splints. Ten specimens were fabricated on individual stone casts for each of the five techniques. Four die pins were transferred to each specimen, and the distances between the inside diameters of the pins were measured over a 2-week period. After construction, initial measurement, and removal from the cast, each acrylic resin specimen was stored in either a wet or a dry environment. Measurements between pins were made and recorded at five time intervals. The sprinkle-on techniques resulted in less dimensional change than the dough application, the vacuum-adapted resin sheet and dough application, and the heat-cured denture processing techniques. Acrylic resin specimens stored in a wet environment showed less distortion 2 weeks after fabrication.

Acrylic Resins↗
PubMed1993

Effect of canine guidance of maxillary occlusal splint on level of activation of masticatory muscles.

The effect of canine guidance of a full-arch maxillary flat occlusal splint on the level of activation of the anterior and posterior, temporal, masseter and suprahyoid muscles during maximal clenching, were studied in 14 subjects without craniomandibular disorders. The results revealed that, the level of electromyographic activity of anterior and posterior temporal and suprahyoid muscles during maximal clenching on the occlusal splint in habitual closure was unchanged, as compared to biting in the intercuspal position (ICP), while the activity in the masseter muscle, on average, was increased slightly (13 percent). In contrast, the level of activation of the jaw elevator muscles decreased significantly during maximal clenching on the cuspid ramp of the splint, as compared to the biting in ICP or clenching on the splint. However, the degree of reduction of activity was not symmetrical, and was most pronounced in the masseter muscle of the biting side and in the anterior and posterior temporal muscles of the non-biting side. No significant difference was observed in the activity of the suprahyoid muscles.

Adult↗
PubMed1989

Postural and maximum activity in elevators during mandible pre- and post-occlusal splint treatment of temporomandibular joint disturbance syndrome.

Electromyograms (EMGs) of the temporal and masseter muscles in sixty patients with temporomandibular joint disturbance syndrome (TMJDS) and thirty controls were recorded and integrated on-line in the postural position and during maximum clenching, before and after occlusal splint therapy. Contrasting with the controls, the myoelectrical activity of the patients was higher in the postural position and lower during maximum clenching, whilst the former in percentage terms increased when compared to the latter. After treatment, the EMG indexes in some patients returned partially, and in others completely, to a normal level. Tenderness in the mandibular elevators, deviated opening and organic change in the TMJ increased the postural myoelectrical activity, in percentage terms, against that of maximum clenching. The myoelectrical activity of the mandibular elevators in the postural position and during maximum clenching was smaller in patients with the occlusal splint than in those without. The results show that the mandibular elevators in the patients with TMJDS were hyperactive and tense, and that the occlusal splint was useful for treating such dysfunction.

Adult↗
PubMed1990

[Biomechanically optimized construction of occlusal splints and subjective evaluation by probands].

In a double blind study twelve class I probands received occlusal splints with six different customized anterior guidances. The subjective feelings were rated using a psychologic scale. It was shown, that splints with a large "a" were better rated than splints with a small "a". "a" is the radius of the maximal curvature of the sagittal anterior tooth curvature. The transition between positive and negative ratings was very sharp and localized at the individual "a". These results suggest that occlusal splints can be optimized by including customized anterior guidances. A detailed technical description of the manufacturing of these splints is given.

Consumer Behavior↗
PubMed1989

A short-term evaluation of the effectiveness of stabilization-type occlusal splint therapy for specific symptoms of temporomandibular joint dysfunction syndrome.

To clarify the short-term effectiveness of stabilization-type occlusal splint therapy, a specific symptom approach was used toward 30 temporomandibular joint dysfunction patients with more than two major symptoms (temporomandibular joint and/or masticatory muscle pain, temporomandibular joint sounds, and limitation of mandibular movement). Eighty-seven percent of the patients with pain responded with this therapy and more than 50% had complete relief of pain 4 weeks after insertion of the splint. Temporomandibular joint sounds and limitation of mandibular movement responded more slowly than pain. These results suggest that the stabilization-type occlusal splint should be selected as a first choice among several therapies and that temporomandibular joint pain is particularly susceptible to this therapy.

Acrylic Resins↗
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↗