SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
We report a clinical case of Eagle's syndrome which required dental intervention due to the presence of exacerbated symptoms indicating an association with a temporomandibular disorder. The therapeutic dental procedures used were an occlusal splint and temporary removable partial dentures. Surgical removal of the styloid process on the left side was later performed as a medical option.
Pain is a major public health problem. The management of orofacial pain may be a difficult challenge to the medical and dental professions. Ideally, severe cases of this type of pain should be treated by a team drawn from several disciplines such as neurology, otolaryngology, dentistry and psychiatry. Trigeminal neuralgia patients develop brief, very severe unilateral pain, usually radiating from the upper or lower jaw toward the ear, and confined to the distribution of the trigeminal nerve. The pain may be triggered by chewing, shaving or exposure to cold wind. Most patients respond to carbamazepine, with phenytoin or baclofen as an alternative. Intractable pain may require surgical treatment. Horton's syndrome (cluster headache) is always unilateral and is often associated with unilateral lacrimation and rhinorrhoea. The pain is extreme, and its typical localisation the eye, forehead, temple, jaws, or teeth. Treatment with ergotamine and sumatriptan has been used with some success, calcium blockers (e.g., verapamil) being used as prophylaxis. Atypical facial pain is a continuous ache with intermittent episodes, localised to non-muscular, non-joint facial areas. The pain may be unilateral or bilateral, and may persist for many years. Typically, these patients consult a variety of specialists, such as dentists and otolaryngologists. Surgical procedures such as tooth extraction or sinus surgery, even if skillfully executed, exacerbate the condition, are are thus contraindicated. If the patient does not respond to reassurance, antidepressants may be tried. In sinusitis, the pain location is dependent upon which paranasal sinus is affected. Routine diagnostic nasal endoscopy and coronal plane computed tomography enable subtle pathological changes that are related to chronic pain to be identified. If medical treatment fails to afford relief, surgery should be considered. Pain, limited range of jaw motion, and joint noises are the common characteristics of temporomandibular disorders. Treatment usually consists of non-surgical means such as splints, occlusal equilibration, and non-steroidal anti-inflammatory drugs. Surgical treatment is indicated in a few carefully selected cases. Most dental pain is attributable to caries or periodontal disease. When pus is present, drainage affords excellent pain relief. Acute pericoronitis involving mandibular third molars responds to irrigation, removal of maxillary third molar trauma, and--in cases of serious infection--antimicrobial therapy. Early recognition of a case of chronic pain improves the chances of successful management, and avoids frustration and disillusion both to patient and doctor.
The author presents an attempt of using ultrasonographic technique in diagnosis, planning and observation of treatment results of temporo-mandibular joint pain dysfunctions. Temporo-mandibular joint pain dysfunctions are interchangeably also called temporo-mandibular joint functional disorders. The assessment of pain symptoms in temporo-mandibular joint dysfunctions pain symptoms is principally based on a subjective estimation by the examining practitioner. There is no univocal definition of the disease or a simple index evidencing important symptoms in decision making. Additionally X-ray technique examinations, being hitherto used, in early stages of the disorder do not allow to diagnose it, and are also burdensome to a patient. The aim of this study was to confirm visibility of anatomical elements of the temporo-mandibular joint in an ultrasound examination, assess the mobility of the articular disc before, during and after prosthetic treatment with and without the use of ultrasound technique, and to determine the period of time necessary to obtain a therapeutic effect. The study material consisted of 180 patients, 128 women and 52 men, aged 20 to 60 years, treated by applying prostheses because of temporo-mandibular joint pain dysfunction, in the Department of Prosthetic Dentistry of the Pomeranian Medical Academy. The patients were divided into 2 groups, control and study group. The control group consisted of 90 patients, 63 women and 27 men. In this group prosthetic treatment planning and observation of results was based on a subjective estimation of the practitioner. The study group here comprised 90 patients, 65 women and 25 men, aged 26 to 60 years. In this group prosthetic treatment planning and observation of treatment results were carried on with the use of ultrasound technique. Data from both groups concerning history, results of examinations carried out by ultrasound technique, and the assessment of ultrasound examination were noted on standard examination records used in the Department of Prosthetic Dentistry. For the need of this study an own ultrasound technique was elaborated which allowed for analyzing the ultrasound image in a static situation and during functioning. The ultrasound examination was accomplished with the use of Acuson 128 XP apparatus, linear probe 7.5 MHz. In both groups prosthetic treatment was carried out using different prosthetic methods such as: splints, occlusal adjustment on fixed prosthetic restorations in therapeutical occulus et height in abnormal occlusion. In the study group the therapeutical occulus height was determined under the control of ultrasound technique. Statistical analysis of the obtained results was performed with the use of chi-square test and chi-square test with Yates correction. On the basis of the accomplished study it has been determined that the ultrasound technique makes it possible to visualize morphological elements and facilitates functional observation of the temporo-mandibular joint, articular disc, mandibular condyle and lateral pterygoid muscle in a degree which allows for planning the treatment and the observation of results (Tab. 1-6). The use of ultrasound technique in determining spatial position of the mandible in temporo-mandibular joint permitted to objectively estimate examination results in the study group. A small number of publications on the use of ultrasound technique in functional examination of the temporo-mandibular joint accessible in foreign literature and general reference on the subject in Polish literature do not allow for an objective comparison of obtained study results.
Controversy surrounds the diagnosis and treatment of TMJ pain dysfunction syndrome (TMJPDS). This is also reflected in the widely divergent recommendations in splint design. A study was undertaken to examine the comparative success rates of treatment by two occlusal splints with apparently diametrically opposed modes of action and to determine whether there were any factors which could be utilised to predict the success of splint therapy. Sixty-eight TMJPDS patients were randomly distributed into one of two comparable groups and were treated solely with an occlusal splint for night time wear. One group was treated with a stabilisation splint (SS) and the other with a localised occlusal interference splint (LOIS). The success rate at review with the SS was 67.6% and with the LOIS was 80.9%. This difference was not statistically significant. Pretreatment occlusal analysis demonstrated three indicators of successful splint therapy which appeared to be independent of design. These were the absence of centric relation occlusion, the existence of non-working side interferences and an absence of ideal anterior guidance.
20 patients (18 - 50 years) with pathological attrition of upper and/or lower anterior teeth were treated, as a temporary measure, by means of a partial chrome-cobalt splint covering the palatal surfaces of the six upper front teeth. Tantalum implants to provide reference points were placed in the basal portion of upper and lower jaw bones. Lateral cephalometric radiographs were taken with and without the splint at the beginning of treatment and thereafter every two months till the difference between measurements was as small as possible. Changes in the occlusal face height were evaluated. Measurement reliability proved to be very high. Continuous use of the splint caused intrusion of the front teeth and eruption of the others in all patients. The intrusion was on an average 1.05 mm and the eruption 1.47 mm after 6 - 14 months, indicating a possible potential for tooth eruption in human adults. More eruption than intrusion appeared to take place in the youngest age groups. Sexual differences could not be established. Use of the splint did not cause the common symptoms of mandibular dysfunction. Lisping was the most serious complaint.
Explore the source record for details and available documents.
Occlusal appliances are used as a reversible treatment modality of temporomandibular disorders. This article describes a protocol to produce a stabilization splint with a minimum of chair time, and an improved compliance, aiming at an overall improvement of the therapeutic potential. Maintaining the existing occlusion in stead of using centric relation is part of the procedure. The main phases of the protocol are the initial clinical phase of impressions and recording treatment position of the mandible, the technical phase, the control phase, and the insertion of the appliance.
Explore the source record for details and available documents.
PURPOSE: This study assessed the effect of using an occlusal stabilization splint in the maxilla for 6 weeks on certain parameters of chewing movements in subjects with and without temporomandibular disorder symptoms. MATERIALS AND METHODS: Twelve male and 30 female temporomandibular disorder patients with and without a prior whiplash incidence, and individuals without signs and symptoms of temporomandibular disorders participated. The participants formed three groups matched according to gender and age (n = 3 x 14). A maxillary stabilization splint was used during sleep for 6 weeks. An optoelectronic system (MacReflex, Qualisys) was used to record chewing movements at baseline, before using the splint, and after 6-weeks' use of the splint. Calculated parameters were the duration of the chewing cycles, the spatial displacement, and the mean velocity of the mandible while chewing paraffin wax for 20 seconds. RESULTS: On a group basis, the use of an occlusal stabilization splint for 6 weeks did not change the jaw movement parameters in a predictable pattern as recorded under the conditions of this study. On an intraindividual basis, large variations in changes of chewing parameters over time were observed. CONCLUSION: The use of an occlusal stabilization splint for 6 weeks did not alter the jaw movements when chewing a substance with a soft consistency.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Twenty-two subjects with clinically diagnosed unilateral anterior disk displacement were followed up for two years. Seventeen of the patients were women and five were men, with ages ranging from 17 to 68 years (median 27 years). In 20 cases the duration of locking at the time of the examination was less than 6 months; the other two cases had experienced locking for more than 6 months but less than one year. Case histories were recorded and clinical examinations performed according to accepted principles, followed by calculation of Helkimo's anamnestic dysfunction index Ai and clinical dysfunction index Di. The patients were treated using full coverage splints combined with occlusal adjustment. Follow-up examinations were made after 6 months, one year and two years. At the time of the first visit, 17 patients had severe subjective symptoms such as difficulty in opening the mouth wide and pain on movement of the mandible, while five experienced locking without subjective symptoms. All patients apart from one belonged to Di III and had a maximal mouth opening capacity ranging from 24 to 38 mm. During follow-up, one patient was treated surgically because of continuous severe symptoms; in one case, spontaneous disk reduction was confirmed by MR imaging. At the last examination the rest of the patients (n = 20) had a mouth opening capacity ranging from 31 to 60 mm and belonged to Di II. However, eight patients were completely symptom free and 12 had only mild symptoms. All patients regarded their condition and good as were able to manage well.(ABSTRACT TRUNCATED AT 250 WORDS)
Explore the source record for details and available documents.
Occlusal bite splint therapy and the application of sound principles of functional occlusion resulted in a definitive diagnosis and successful orthodontic re-treatment of a patient with chronic disorder of the left temporomandibular joint. This case report demonstrates that latent mandibular growth and orthodontic retention can produce anterior premature centric contacts. The anterior prematurities prevented the posterior teeth from occluding without the left condyle first dislocating from the glenoid fossa. Occlusal bite splint therapy allowed the mandible to move to a position of greater maxillomandibular stability, illustrating the need for anterior freedom for the mandible. The patient became asymptomatic 1 month after slight intrusion and changing of the axial inclination of the maxillary incisors, which provided a freedom of centric occlusion and allowed the condyle to seat in the fossa. TMJ radiographs supported the clinical findings.
The present study describes an experimental approach for inducing bruxism and trauma from occlusion in animals. Gold occlusal cap splints overlaying the maxillary premolar and molar teeth were inserted in eight Macaca irus monkeys. The cap splints were designed to raise the vertical dimension of occlusion by 3--4 mm and were adjusted to a balanced occlusion with the mandible in an unstrained retruded position. The splint on the right side (test side) was given a tight occlusion with the opposing mandibular teeth, whereas the splint on the left side (reference side) had only small occlusal contact areas. Before insertion of the splints, the monkeys had slight gingivitis but no alveolar bone loss. The cap splints were in situ for 4 weeks. During this period the monkeys showed distinct signs of bruxism. The mandibular teeth on the test side showed increased mobility and there was radiographic evidence of breakdown of marginal and interradicular alveolar bone. Mean GI increased significantly on the test side and in two animals gingival abscesses developed. Deep intrabony pockets persisted adjacent to these teeth. Only slight gingival and radiographic changes were seen adjacent to the teeth on the control side. From the present experimental study there was no overall clinical or histological evidence that bruxism had caused a progression of gingivitis to destructive, chronic marginal periodontitis.
Explore the source record for details and available documents.
Composite resin bite-raising splints were fabricated on both sides of the upper jaw in rats. EMG activity of the deep masseter muscle was monitored continuously for 24 h before and up to 4 weeks after treatment. Together with the EMG activity, measurements of the neuromuscular junction area and muscle fibre histochemistry were made. EMG activity showed great variability immediately after splint fabrication. Some of the animals showed increased EMG activity, while others exhibited less activity 48 h after splint application. Overall, the fluctuation lasted for about 4 days, and after approximately 7 days all the animals exhibited decreased EMG activity, followed by a gradual increase in activity towards baseline levels. The neuromuscular junction territory increased significantly 5-10 days after splint application. Histochemical characterization of the deep masseter muscle revealed that it contained the three main types of muscle fibre: slow oxidative (SO), fast-oxidative-glycolytic (FOG) and fast glycolytic (FG). The frequency distribution of fibre types did not change after bite-raising splint treatment. These findings indicated that splint treatment in rats is effective in reducing EMG activity, while the muscle type characteristics remain stable. The effect of lower activity on the motor end-plates suggested that the neuromuscular junctions are quite sensitive to functional changes.