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At least 523 records · Page 29Linked to original sources
PubMed2000

Changes in position of the temporomandibular joint disc and condyle after disc repositioning appliance therapy: a functional examination and magnetic resonance imaging study.

Disc-repositioning splints are routinely used in the treatment of anteriorly displaced discs. The rationale of these appliances is to direct the mandibular condyle anteriorly in the glenoid fossa and to recapture the disc onto the condyle. The stability of disc recapture depends on reestablishment of the occlusion and the adaptive capabilities of the temporomandibular joint. It could therefore be suggested that treatment success is potentially higher in the active growth period. In this case report, partial disc recapture was observed on magnetic resonance images after application of a maxillary disc-repositioning appliance. Orthodontic treatment was applied for the retention of disc recapture.

Child↗
PubMedDate not supplied

A modified dynamic mouth splint for burn patients.

The prevention and management of microstomia contracture is very important for the quality of life in a patient who has experienced facial burns. Mouth opening is important for speech, eating, dental hygiene, expression, social interaction, psychosocial well being, and administrating general anesthesia. Principles of scar management state a need for opposing horizontal, vertical, and circumferential forces for effective management of microstomia. At the Royal Brisbane and Women's Hospital, horizontal and circumferential stretch was provided well; however, a suitable vertical stretch component was required. After a literature review, we introduced and trialed a dynamic mouth splint. Subsequently, a modified dynamic mouth splint was developed. The presentation here of four case studies will demonstrate that the use of the splint in combination with current practice has improved mouth opening and consequently functional outcomes.

Adult↗
PubMedDate not supplied

Neuropathological chewing: a dental management protocol and treatment appliances for pediatric patients.

Neuropathological chewing in hospitalized, comatose patients can occur from severe brain damage following a closed head injury, hypoxia, and septic shock. The dental management protocol developed by the Department of Dentistry at the Royal Children's Hospital, Melbourne, Australia, is presented. Treatment appliances utilizing a mandibular cast-silver cap splint with acrylic bite blocks and a maxillary mouthguard with acrylic bite blocks are discussed.

Child↗
PubMed2001

The short-term effect of stabilization-type splints on the local asymmetry of masseter muscle sites.

Patients with temporomandibular disorders (TMD) may present with a cluster of joint and muscle disorders characterized primarily by pain, joint sounds and irregular or deviating jaw function. Maxillary stabilization-type splints represent the best standard therapy, so the purpose of this study was to evaluate changes in local cross-sectional dimensions (LCSD) of masseter muscle sites associated with short-term application of 'splint therapy' using the diagnostic approach of high-resolution gray-scale ultrasonography. The study included 29 patients who had signs and symptoms of temporomandibular disorders. Ultrasonographic investigation was performed with a linear (B-scan) 7.5 MHz small-part transducer to visualize the antero-superior, antero-inferior, medio-superior, medio-inferior, postero-superior and postero-inferior sites of the masseter muscle. To assess local muscle asymmetry patterns and to evaluate the respective effect of occluding splints, the 'absolute asymmetry index (AAI)' was used, with the mean maximum muscle diameter of the respective right and left sides calculated from three consecutive measurements before and after splint therapy. Comparing the pre-treatment with the 2-month follow-up values revealed a significant decrease in the overall mean asymmetry indices at the anterior (P < 0.01), medial (P < 0.05) and posterior (P < 0.05) muscle sites. There was no significant change in LCSDs at the various muscle sites (P > 0.05). The results of this study suggest stabilization-type splints to be effective in reducing local muscle asymmetries. Further studies are warranted to evaluate muscle-site specific effects in patient and non-patient groups and to relate these effects to pre-treatment variables like bite force, preferred chewing side, facial morphology and occlusion.

Adult↗
PubMed2005

Clinical comparison between two different splint designs for temporomandibular disorder therapy.

OBJECTIVE: To compare splint therapy in temporomandibular disorder (TMD) patients using two splint designs. MATERIAL AND METHODS: In a double-blind randomized parallel trial, 40 consenting patients were selected from the dental faculty pool of TMD patients. Two splint designs were produced: an ordinary stabilization (Michigan type) and a NTI (Nociceptiv trigeminal inhibition). The differences in splint design were not described to the patients. All patients were treated by one operator. A separate, blinded, examiner assessed joint and muscle tenderness by palpation and jaw opening prior to splint therapy, and after 2 and 6 weeks' and 3 months' splint use during night-time. The patients reported headache and TMD-related pain on a visual analog scale before and after splint use, and were asked to describe the comfort of the splint and invited to comment. RESULTS: Thirty-eight patients with mainly myogenic problems were observed over 3 months. A reduction of muscle tenderness upon palpation and self-reported TMD-related pain and headache and an improved jaw opening was seen in both splint groups (p < 0.05; paired t-test and Wilcoxon signed-ranks tests). There were no changes for TM joint tenderness upon palpation. No differences were noted between the two splint designs after 3 months for the chosen criteria of treatment efficacy (p > 0.05; Mann-Whitney U-test). CONCLUSION: No differences in treatment efficacy were noted between the Michigan and the NTI splint types when compared over 3 months.

Adult↗
PubMed2003

Bruxism force detection by a piezoelectric film-based recording device in sleeping humans.

AIMS: To test the reliability and utility of a force-based bruxism detection system (Intra-Splint Force Detector [ISFD]) for multiple night recordings of forceful tooth-to-splint contacts in sleeping human subjects in their home environment. METHODS: Bruxism-type forces, i.e., forceful tooth-to-splint contacts, during the night were recorded with this system in 12 subjects (6 bruxers and 6 controls) for 5 nights in their home environment; a laboratory-based nocturnal polysomnogram (NPSG) study was also performed on 1 of these subjects. RESULTS: All 12 subjects were able to use the device without substantial difficulty on a nightly basis. The bruxer group exhibited bruxism events of significantly longer duration than the control group (27 seconds/hour versus 7.4 seconds/hour, P < .01). A NPSG study performed on 1 subject revealed that, when the masseter muscle electromyogram (EMG) was used as a "gold standard," the ISFD had a sensitivity of 0.89. The correlation coefficient between the duration of events detected by the ISFD and the EMG was also 0.89. CONCLUSION: These results suggest that the ISFD is a system that can be used easily by the subjects and that has a reasonable reliability for bruxism detection as reflected in forceful tooth-to-splint contacts during sleep.

Adult↗
PubMed2005

Conservative therapy in patients with anterior disc displacement without reduction using 2 common splints: a randomized clinical trial.

PURPOSE: We performed a comparative evaluation of different types of splint therapy for anterior disc displacement without reduction (ADDWR) of the temporomandibular joint. PATIENTS AND METHODS: Seventy-four patients agreed to participate (65 females and 9 males). All patients were examined using a clinical temporomandibular joint disorder examination protocol, including muscle palpation, mandibular range-of-motion measurement, and joint sound detection. Additionally, the patients marked their pain (during chewing, mandibular movements, and rest position) and limitation levels on a visual analog scale. Bilateral magnetic resonance images were acquired, confirming ADDWR in at least one joint. After clinical examination and imaging, randomized splint therapy was provided: 38 patients received a centric splint, while 36 received a distraction splint. After 1, 3, and 6 months of therapy, outcome was evaluated using the Wilcoxon signed rank test for matched pairs. Success after 6 months was defined as improvement in active mouth opening of greater than 20% and pain reduction (on chewing) of at least 50%. Success was statistically verified using logistic regression test. RESULTS: The improvements in mouth opening were significant in both groups. The improvements in pain on chewing, pain during other functions, pain at rest, functional limitation on chewing, and other functions were also comparable in both groups. However, the logistic regression test suggested that patients using centric splints were treated more successfully than the others (confidence interval, 1.014 to 8.741, odds ratio = 2.785). CONCLUSIONS: Centric splints seem to be more effective than distraction splints. Therefore, before the surgical treatment of ADDWR, centric splints should be used instead of distraction splints.

Adolescent↗
PubMed2000

Evaluation of the Herbst Mandibular Advancement Splint in the management of patients with sleep-related breathing disorders.

Sleep-related breathing disorders such as snoring and obstructive sleep apnoea syndrome are the cause of significant social disruption and hypersomnolence. Several intraoral appliances for the treatment of these disorders have been described, especially where nasal continuous positive airway pressure is poorly tolerated. Mandibular Advancement Splints, such as the Herbst splint used in this study can also be offered to patients with mild to moderate sleep apnoea and simple snorers. The success and compliance rate noted in the literature are quite diverse. Few side-effects have been reported. We therefore undertook this study to assess: (1) the compliance; (2) the effectiveness; and (3) the side-effects in the long- and short-term. All patients for whom a Herbst splint had been prescribed in the last 18 months were sent a postal questionnaire regarding the above mentioned issues. In all, 179 questionnaires were posted and on analysis of the 132 returned it was noted that 82% of splints were worn and 88% of patients found the device to be effective. The long-term side-effects were minimal. In addition objective assessment on 10 patients with and without a jaw-retaining device was also obtained. We conclude that the Herbst Mandibular Advancement Splint is a justifiable option in selected subjects with sleep-related breathing disorders.

Female↗
PubMed1997

[Orthodontic treatment for the surgical correction of mandibular skeletal retrognathism].

The purpose of this paper is to discuss the combining orthodontic treatment that is based on seventeen consecutive patients of severe mandibular skeletal retrognathism who have been treated by orthognathic surgery. Not only the presurgical preparation, but also the presurgical and postsurgical orthodontic treatment and the use of interocclusal splints were introduced. The goals of orthodontic treatment for patients with orthognathic surgery are (1) decompensating the teeth, expanding the upper dental arch, (2) aligning the teeth, (3) leveling the curve of Spee, (4) making the shape and width of upper and lower dental arch harmonious, (5) getting the occlusal equilibrium and fine occlusal contact. The author's experience indicates that: in order to get satisfactory results of esthetics and function, the combination of surgical and orthodontic treatment, the presurgical and postsurgical orthodontic treatment is absolutely necessary and important.

Adolescent↗
PubMed1998

Case report KY: functional analysis of a follow-up chin cup patient with TMJ pain.

At 19 years 1 month, the patient returned to the clinic for a follow-up screening of chin-cup patients. She was the only TMJ dysfunction patient who agreed to undergo further treatment. Mandibular kinesiograph, computer-aided axiograph, and electromyograph records were gathered to aid in evaluating function. Splint therapy and orthodontic retreatment relieved the TMJ pain associated with balanced muscular activity and helped to achieve more normal movement of the mandible.

Cephalometry↗
PubMed1995

Treatment alternatives for patients with masticatory myofascial pain.

Alternative therapies are used by many people, and the dental literature has reported that some alternative therapies are comparable to splint therapy in the effective treatment of masticatory myofascial pain. The authors review the efficacy of alternative therapies and discuss their clinical implications. This review is intended to help dental practitioners to select alternative therapies they can use with or instead of splint therapy for treating patients who have a primary diagnosis of myofascial pain.

Acupuncture Analgesia↗
PubMed2000

Splints and stress transmission to teeth: an in vitro experiment.

OBJECTIVE: To determine the influence of hard and soft splints with two thicknesses on the stress transmission to the tooth supporting the splint and the opposite tooth. METHODS: Continuous vertical forces up to 500N were applied to two opposite first molar phantom teeth using a universal loading machine. Deformation was detected by strain gauges attached to the cervical area of the buccal and lingual aspects of the lower tooth. Strain, as a function of force, was collected and the slope, defined as the compliance (in microS/N) of the system, was calculated. RESULTS: The highest compliance was found with hard splints. When splints were constructed on the upper molar, the highest compressive compliance was registered on the buccal side (2.8 microS/N) and tension compliance on the lingual side (-0.35 microS/N). When constructed on the lower tooth, the opposite was found. Soft splints resulted in compression on both the buccal and lingual sides when adjusted to the upper or lower tooth. A higher compliance was found on the buccal side (1.26 microS/N), while on the lingual side, the values varied (0.48-0.78 microS/N). CONCLUSIONS: Soft splints are more efficient in protecting teeth against the damage of bending forces although there is an increase of compression forces. The tooth opposing a hard splint is exposed to a higher risk of bending forces.

Analysis of Variance↗
PubMed2002

Bone SPECT imaging of patients with internal derangement of temporomandibular joint before and after splint therapy.

OBJECTIVE: Temporomandibular joint (TMJ) patients with disc displacement without reduction have a misaligned disc-condyle structural relation. As the condition becomes chronic, painful osteoarthritic changes may occur. For these patients, splint therapy may help to position the condyle to a more structurally compatible and functional position and to decrease the loading force of articular surfaces. The aim of this study was (1). to evaluate osseous reactions and pain relief in patients with disc displacement without reduction after splint therapy and (2). to use single photon emission tomography (SPECT) bone imaging to compare the results with the opposite joint of the patient. STUDY DESIGN: Twelve patients, who presented with pain involving the TMJ and limited mouth opening and were confirmed by soft tissue imaging as having disc displacement without reduction, were included in the study. Each patient underwent bone SPECT imaging, after which semiquantitative evaluation of transaxial images was conducted. The ratios of affected TMJ to nonaffected TMJ, affected TMJ to occipital bone, and nonaffected TMJ to occipital bone were calculated. After 6 months of splint therapy, bone SPECT examinations were repeated. RESULTS: Before splint therapy, the ratios of affected TMJ to nonaffected TMJ and of affected TMJ to occipital bone were found to be significantly higher than the ratios after splint therapy (P < 0.005). CONCLUSION: Six-month splint therapy has a positive effect on the osseous reaction and pain related to internal derangements of TMJs.

Adolescent↗
PubMed1998

[Orthodontic preparation for orthognathic surgery. Various specific points].

Orthodontic preparation before orthognatic surgery must straighten teeth alignment to enable correct adaptation of the upper and lower arches. It must also rectify dento-alveolar abnormalities partially responsible for the dysmorphosis and which can hinder smooth articulation of the bones. Thus before and after the operation, the orthodontist will have to prepare and monitor the surgical splints used in posterior deficiencies.

Adult↗
PubMed1998

[Short-term effects of the Michigan splint on muscular and joint pain].

BACKGROUND: In 1966 Ramfjord and Ash proposed the Michigan's splint that, at present, is one of the splints widely accepted for the treatment of craniomandibular disorders (CMD). METHODS: For this study, thirty-one subjects were examined according to the protocol of the European Academy of CMD; each patient indicated the intensity of pain using a Visual Analogue Scale (VAS). After therapy with Michigan's splint, the visit was repeated and the patient indicated again the VAS. RESULTS: The results showed that the splint has short-term benefit effects on the muscular and articular pain, even if the effects are lesser on the articular pain. CONCLUSIONS: The Michigan's splint is a valid device for therapy of CMD, moreover it is very cheap, very easy to use and without contraindications.

Craniofacial Dysostosis↗
PubMed2000

Effects of intraoral splint wear on proteoglycans in the temporomandibular joint disc.

Intraoral splints are a common dental treatment for dysfunctions of the temporomandibular joint (TMJ), but their effects on the structures of the joint, specifically the disc, have not been well investigated. This study examined proteoglycans (PGs) of the TMJ disc of the miniature pig and tested for alterations resulting from intraoral splint wear. Sixteen female pigs were divided into three groups: control (C), control splint (CS), and protrusive splint (PS). Splinted groups received chrome-cobalt ramp splints which were worn continuously for 2 months. PG content within various disc locations was determined by colorimeteric assay. PG synthesis and type were examined by labeling with (35)S-sulfate and SDS-PAGE analysis. Average water content of the disc was 77.1%, which places it at the high end of the normal range for collagenous biomaterials (60-80%). PGs migrating to the positions typical of aggrecan, biglycan, and decorin on SDS-PAGE were present in all locations of all groups. The highest content and synthesis of PGs were always found in the intermediate band of the disc regardless of group (P < 0.05), supporting the notion that this band encounters heavy compressive loading during function. The joints of animals from both splinted groups showed a high frequency of gross pathology. Biglycan synthesis was increased in both splinted groups (P < 0.05). Newly synthesized biglycan had a shorter migration distance in the intermediate bands of the CS group, suggesting increased hydrodynamic size. These findings suggest that intraoral splint wear may cause disc damage or remodeling.

Animals↗
PubMed1997

Ehlers-Danlos syndrome, fibromyalgia and temporomandibular disorder: report of an unusual combination.

An unusual case of temporomandibular disorder in the presence of both fibromyalgia and Ehlers-Danlos syndrome is presented. Some of the problems in treating these patients are discussed. It is suggested that early conservative treatment of the temporomandibular disorder with a stabilization splint and physical therapy is effective, and this approach should be attempted before any surgical intervention is chosen.

Adolescent↗