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At least 505 records · Page 28Linked to original sources
PubMed1995

Follow-up examination of the temporomandibular joint disk after splint therapy by magnetic resonance imaging--a case report.

A 38-year-old female patient presented with temporomandibular joint (TMJ) pain, bilateral clicking and intermittent locking. The patient was treated with a splint in order to decrease the symptoms and to obtain a proper disk-condyle relationship. The effect of the splint therapy was investigated after one month and after one year and five months using magnetic resonance imaging (MRI) with splints in place. After treatment for one year and six months, the clicking sound of the right TMJ disappeared, and she became free from locking. With the aid of MRI, it was found that the disk of the right TMJ had changed from an anterior position with reduction to a superior position. In the left TMJ, the disk changed from an anterior position without reduction to an anterior position with reduction. MRI gave important information on the disk position and the efficacy of the splint therapy.

Adult↗
PubMed2005

[Technique of direct vertical bite reconstruction with composite and a splint as template].

Excessive loss of dental hard tissues caused by mechanical, chemical or traumatic influences--or a combination of these factors--poses difficulties for subsequent prosthetic tooth restorations. Traditionally reconstructive treatment to restore affected teeth has been provided using rather invasive methods like porcelain-fused-to-metal crowns or ceramic overlays. For patients with a tooth substance loss caused by an acidic diet, where a payment of the costs by the social insurance cannot be expected, a less expensive treatment modality would be of interest. The presented case report describes an alternative treatment modality of vertical tooth substance loss by using direct adhesive composite restorations. To establish a simple and controlled build-up, a mini-plast splint based on an ideal wax-up was used.

Adult↗
PubMed2005

The effect of a mandibular advancement splint in subjects with sleep-related breathing disorders.

OBJECTIVE: This study assessed the effectiveness of a mandibular advancement splint (MAS) in subjects with sleep-related breathing disorders using both objective and subjective outcome measures. DESIGN: The study was carried out as a retrospective analysis. SETTING: The study was conducted within the Sleep Studies Unit at the Queen Victoria Hospital, East Grinstead, between May 1997 and March 2000. SUBJECTS AND METHODS: Twenty subjects with obstructive sleep apnoea (OSA) and six with non-apnoeic snoring, diagnosed by overnight polysomnography, were fitted with a monobloc appliance between May 1997 and March 2000. MAIN OUTCOME MEASURES: The subjects were analysed for changes in the respiratory disturbance index (RDI) and Epworth Sleepiness Scale (ESS) scores. In addition each subject completed an outcome questionnaire following fitting of the appliance. RESULTS: Variability in response measured by the change in the respiratory disturbance index was found with no correlation to the baseline recording. Although median RDI values improved in both groups, significantly so in the obstructive sleep apnoea group (p<0.05), seven subjects exhibited an increased RDI score following mandibular advancement splint therapy. The median Epworth Sleepiness Scale scores decreased in both the OSA group and the non-apnoeic snorers although not significantly. Twenty-one of the 26 subjects completed the outcome questionnaire revealing an 81% reduction in snoring. Side-effects were generally transient and minor. Eighty-six per cent of the subjects' partners reported better quality of sleep as a result of MAS therapy. CONCLUSIONS: The monobloc appliance significantly improved the Respiratory Disturbance Index in the obstructive sleep apnoea group. Some subjects had increased RDI scores following splint therapy. This supports the need for an objective assessment in the follow-up of patients treated with mandibular advancement splints.

Adult↗
PubMed1993

A comparison of electromyographic activity between anterior repositioning splint therapy and a centric relation splint.

The purpose of this study was to compare the electromyographic activity of masticatory muscles (temporal and masseter) with the use of an anterior repositioning splint and a centric relation superior repositioning splint. Twenty-six consecutive patients, who referred with the chief complaint of temporomandibular pain and/or headache were selected from one of the author's practices. All these subjects were diagnosed as having internal derangement of the temporomandibular joint. Ten normal subjects were used as controls. Surface electromyographic recordings were taken of each subject prior to the beginning of clinical therapy for the patients. The results show significantly less masseter and temporal muscle activity with anterior repositioning splint therapy compared to the centric relation superior repositioning splint therapy.

Adolescent↗
PubMed1999

[Effects of muscular position splint on maxillomandibular realignment].

OBJECTIVE: To study the effects of muscular position splint on maxillomandibular realignment. METHODS: The changes of occlusal impression on splint in 102 craniomandibular disorder (CMD) patients were recorded after wearing the splint 1 week, 2 weeks, 1 month, two to three or six months. If there appeared instability of occlusal impression when biting, the original impression was cleared and new soft resin was placed on its surface in order to get a new impression. The splint was always adjusted to fit well. When the signs and symptoms of CMD disappeared, the splint was worn off. Finally, whether the muscular contact position harmonized with the intercuspal position (ICP) or not was recorded. RESULTS: There appeared two different conditions: 1. The original occlusal impression remained unchanged in 66 patients; 2. Being unfitted in 36 patients, occlusal analysis revealed that 12/102 patients had abnormal occlusion including premature anterior teeth contact (2 cases), natural defective vertical dimension (1 case) and deflected ICP (9 cases). These abnormal occlusion could not be determined before treatment. CONCLUSION: The muscular position splint can correct the abnormal muscular position. On the premise that the muscular position is normal, the muscular position splint can be used to judge whether the ICP is normal.

Adolescent↗
PubMed1994

The use of magnetic resonance imaging to determine splint position in the management of internal derangements of the temporomandibular joint.

Internal derangements of the temporomandibular joint (TMJ) can elicit symptoms of pain, clicking and noises described subjectively as popping, grinding or grating. These symptoms may be the precursor of a more severe disease process such as degenerative joint disease (DJD) or osteoarthritis. The most common factor predisposing to degenerative changes within the TMJ is a displaced meniscus. Maintenance of a proper anatomic meniscal-condylar relationship is essential in preventing DJD. In the past, non-surgical treatment utilizing intraoral orthotic devices has been attempted to "recapture" the meniscus. The position of the meniscus was then evaluated merely by clinical examination due to the lack of modalities available to verify the meniscal position. The advent of magnetic resonance imaging (MRI) has changed this scenario. The meniscal position can now be visualized, thus enabling the practitioner to treat patients more effectively. Three case reports are presented in this study demonstrating the use of splint therapy utilizing MRI to determine meniscal position.

Adult↗
PubMed2000

[Comparison of treatment options for myogenous temporomandibular dysfunction].

A randomized clinical trial which included a follow-up of one year was applied to 118 myogenous TMD-patients. The therapies investigated were: physiotherapy of the masticatory system or splint therapy for patients without occlusal interferences, and occlusal adjustment therapy or the combination of splint and occlusal adjustment therapy for patients with pronounced occlusal interferences. Counseling, which yielded a reduction of 27% of the scored pain intensity, will most likely eliminate any further need for treatment of patients with a low level of myogenous TMD signs and symptoms. Otherwise, physiotherapy might be preferred as a starting option with respect to splint therapy because of 1. A similar efficacy; 2. A shorter treatment duration so that either chronic facial pain is earlier relieved or a patient can undergo a second type of therapy earlier; and 3. Lower costs. One third of the patients selected had pronounced occlusal interferences. Using stringent criteria it might be possible to apply occlusal adjustment therapy without involvement of splint therapy yielding a similar therapy efficacy and with advantages of a shorter treatment duration and lower costs. All types of therapy diminished not only facial pain but also pain of neck and shoulder areas.

Adult↗
PubMed2005

A case of Tourette syndrome presenting with oral self-injurious behaviour.

Self-injurious behaviour (SIB) is deliberate harm to the body without suicidal intent, and the condition occurs in a number of psychiatric, behavioural and developmental disorders. This case report describes a 4-year-old female with SIB who presented to a paediatric dentist after the self-extraction of teeth as a result of oral motor tics. The girl repetitively ground her teeth in a monophasic lateral motion that resulted in luxation of her maxillary right primary canine, and produced generalized oral and facial pain. The parents consulted the dentist about their child's complaint of toothache. The oral findings were unexcephonable except for a mobile primary canine, but there was a history of unusual behaviour including hyperactivity, and after multidisciplinary consultation and exclusion of other systemic diseases, the subject was diagnosed as suffering from Tourette syndrome (TS). Preventive treatment using a dental splint was provided. Noncontingent reinforcement therapy was successfully used to diminish the subject's SIB.

Behavior Therapy↗
PubMed1997

The pattern of splint usage in the management of two common temporomandibular disorders. Part I: The anterior repositioning splint in the treatment of disc displacement with reduction.

OBJECTIVE: To examine whether the anterior repositioning splint is suitable treatment for temporomandibular joint disc displacement with reduction and to determine the most appropriate pattern of usage. DESIGN: Prospective random control clinical trial. SETTING: Dental school clinic unit. SUBJECTS: Three groups of patients were treated, wearing the splint either during the day or at night or all the time. RESULTS: 69% of patients could be classed as improvers, by subjective and objective assessments, at final review (3 months after treatment with an anterior repositioning splint). 88% of patients who wore the splint for 24 hours per day improved over the 3-month period; this improvement was statistically significant when compared with the other two groups. CONCLUSIONS: An anterior repositioning splint is an appropriate method of treatment for disc displacement with reduction. Patients should wear the splint 24 hours a day.

Adolescent↗
PubMed1995

Dental splint prescription patterns: a survey.

A random sample of U.S. dentists was surveyed with a mailed questionnaire to determine the number of splints that they fabricated over the preceding year for bruxers, patients with myofascial pain-dysfunction syndrome and patients with TM joint pain. The results indicate that a significant number of dentists treat these disorders with dental splints. Estimates are provided for the dental profession's yearly splint output for each disorder.

Age Factors↗
PubMed2007

Impact of sleep nasendoscopy on the outcome of mandibular advancement splint therapy in subjects with sleep-related breathing disorders.

AIM: To evaluate the impact of positive sleep nasendoscopy, with simultaneous mandibular advancement, on the outcome of mandibular advancement splint therapy in 120 subjects with sleep-related breathing disorders. METHODOLOGY: Overnight polysomnography and sleep nasendoscopy were performed prior to splint therapy. Follow-up sleep studies, with the appliance in situ, were undertaken for those patients with obstructive sleep apnoea. Subjective outcome measures assessed daytime sleepiness and snoring. RESULTS: One hundred and seven (89 per cent) subjects completed the study. Follow-up sleep studies confirmed the efficacy of treatment, with patients showing a mean reduction in apnoea/hypopnoea index (from 18.9 to 4.9, p<0.001), Epworth sleepiness scale scores (from 11 to seven, p<0.001) and partner-recorded snoring scores (from 14 to eight, p<0.001). CONCLUSION: Sleep nasendoscopy, with concomitant mandibular advancement to mimic the treatment effect, could be of prognostic value in determining successful mandibular advancement splint therapy.

Adult↗
PubMed2005

[Individualized clinical evaluation of tooth movement. Treatment of Class II: molar splints and structural effects].

The presentation of a synoptic chart allowing a dental arch analysis and Class II correction strategy is presented and followed by a study on 30 patients in mixed dentition and 37 growing patients in permanent dentition. These patients presenting a Class II malocclusion have been treated by Class II mechanics and lower molar individualised splint enhancing the vertical lower face height and skeletal Class II correction. This study shows a good vertical stabilization of the facial planes during the treatment, a significant growth of the lower face but it is noticed a posterior rotation of the occlusal plane in the mixed dentition sample.

Adolescent↗
PubMed1998

The treatment of temporomandibular disorders through repositioning splint therapy: a follow-up study.

The purpose of this study was to investigate the effectiveness of repositioning splint therapy as a conservative treatment modality for TMD patients. The treatment sequence of 160 randomly sampled TMD patients was monitored in order to assess different aspects of the patients' response to splint therapy. Included among these aspects were the pretreatment symptoms; the treatment duration required for initial and final alleviation of symptoms; the number of patients requiring surgery; and the particular appliance and its wear pattern utilized to maintain the treatment results. The treatment success was based on the remission of symptoms including but not limited to pain to palpation, headaches, earaches, jaw locking, and joint noises. Eighty-nine and four tenths percent (89.4%) of the patients experienced a complete remission of symptoms and did not require any surgical intervention. The average time for initial improvement was 22.3 days, while the average time for complete remission of symptoms was 4.3 months. The results of the study indicate that repositioning splint therapy is an effective treatment modality for the conservative treatment of temporomandibular disorders.

Acrylic Resins↗
PubMed1998

Effect of two types of mandibular advancement splints on snoring and obstructive sleep apnoea.

Snoring and obstructive sleep apnoea (OSA) both seem at least to be associated with narrowing of the upper airway and sleep-induced loss of muscle-tone. Mandibular advancement splints (MAS) have been proposed as a relatively simple method to increase oro- and hypo-pharyngeal dimensions thereby increasing the size of the airway. However, data on their effectiveness are conflicting and there are no clear indications as to which design is most effective or when they should be used. The effects of two designs of splint (types A and B) have been evaluated in 14 and nine subjects, respectively, using the Epworth Sleepiness Score (ESS) and domiciliary sleep monitoring on separate nights. Both splints reduced the median ESS (type A from 12 to 4.5; P = 0.003, type B from 7 to 4; P = 0.005). The apnoea-hypopnoea index was not affected by type A, but was reduced from 7.1 to 0.8; P = 0.005 by type B splints. There was evidence of a small improvement in overnight oxygen saturation for type B splints (P = 0.02). The splints were well tolerated and continued to be used nightly by 18 subjects. Mandibular advancement splints may offer a simple and effective alternative for the treatment of snoring and mild OSA in selected patients. Splint design may have considerable bearing on efficacy.

Adult↗
PubMed2003

Tourette's syndrome with rapid deterioration by self-mutilation of the upper lip.

A case of Tourette's syndrome is presented in a thirteen-year-old boy with obsessive-compulsive symptoms including self-mutilation of the upper lip. His upper lip injury was caused by complication of picking with fingernail, and self-biting with the lower anterior teeth. It became rapidly worse and the median part of the upper lip collapsed. But the placement of an acrylic splint was able to prevent further damage of the upper lip.

Adolescent↗
PubMed1999

Centric relation registration using an anterior deprogrammer in dentate patients.

A technique is described for registering centric relation in dentate patients using an anterior deprogrammer to prevent muscle splinting. Properly executed, the patient is able to close into centric relation unassisted, eliminating the possibility of operator-induced error associated with commonly accepted manipulative techniques. Verification is possible visually when articulating casts by confirming the precise alignment of the mandibular incisors with occlusal markings on the deprogrammer attached to the maxillary cast.

Centric Relation↗
PubMed1998

The short-term effect of stabilization-type splints on local cross-sectional dimensions of muscles of the head and neck.

STATEMENT OF PROBLEM: Patients with temporomandibular disorders may have a cluster of joint and muscle disorders characterized primarily by pain, joint sounds, and irregular or deviating jaw function. PURPOSE: This study evaluated changes in local cross-sectional dimensions of muscles of the head and neck associated with short-term application of "splint therapy" using the diagnostic approach of high resolution gray-scale ultrasonography. MATERIAL AND METHODS: The study included 15 subjects with signs and symptoms of temporomandibular disorders, 10 in the internal derangement type (IDT) III-a group, and 5 in the myalgia type I (MT I) and myalgia type II (MT II) group. Ultrasonographic investigation was performed with a linear (B-scan) 7.5 MHz small-part transducer to visualize the anterior temporalis, anterior and deep masseter, anterior and posterior digastric, and sternocleidomastoid muscles. The absolute asymmetry index was used to assess local muscle asymmetry patterns and to evaluate the respective effect of occluding splints, with the mean maximum muscle diameter of the respective right and left sides calculated from 3 consecutive measurements before and after splint therapy. RESULTS: A comparison of pretreatment with 2-month follow-up values revealed a slight decrease in the overall mean local cross-sectional dimensions in the internal derangement type III-a group (0.3 mm) and a moderate decrease in the myalgia type I/II group (3.3 mm). With an overall mean pretreatment absolute asymmetry index of 1.3% for the internal derangement type III-a group and 0.5% for the myalgia type I/II groups, the 2-month follow-up showed the internal derangement type III-a group to be associated with a moderate (1.2%) and the myalgia type I/II groups with a slight (0.1%) decrease in the respective overall mean pretreatment absolute asymmetry indices. CONCLUSION: This study suggests that stabilization-type splints are effective in the reduction of local muscle thicknesses and asymmetries. Further studies are necessary to evaluate muscle-site specific effects in patient and nonpatient groups and to relate these effects to variables such as bite force, preferred chewing side, facial structure, and occlusion.

Adult↗