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At least 577 records · Page 32Linked to original sources
PubMed1993

Mandible fragment fixation during reconstruction: the splint-and-plate technique.

One of the most popular methods of mandible fragment fixation is the precontoured reconstruction plate technique. Unfortunately, this method is not a reliable option when tumor distorts the mandibular contour or extends through the buccal cortex of the mandible. An alternative to the precontoured reconstruction plate is the splint-and-plate technique of mandible fragment fixation. An application of this appliance and method in 10 patients revealed the technique's advantages. The splint can be applied quickly and does not obstruct the ablative or reconstructive procedure. Further, the splint accurately keys the dentition and reliably maintains temporomandibular joint relationships. Finally, this technique provides a reference point to the exact position of the symphysis and angle when these landmarks have been resected.

Adult↗
PubMed2006

The efficacy of traditional, low-cost and nonsplint therapies for temporomandibular disorder: a randomized controlled trial.

BACKGROUND: Treatment recommendations for patients with painful temporomandibular disorders (TMDs) range from conservative treatments such as physiotherapy to aggressive and irreversible treatments such as restorative reconstruction and joint surgery. METHODS: The authors randomized 200 subjects diagnosed with TMD into three groups: usual conservative, dentist-prescribed self-care treatment without any intraoral splint appliance (UT); UT plus a conventional flat-plane hard acrylic splint (HS); and UT plus a soft vinyl (a low-cost athletic mouth guard) splint (SS). Subjects completed questionnaires and clinical examinations at three, six and 12 months. RESULTS: The authors observed no significant differences among the groups in TMD-related pain levels or other common signs and symptoms of TMD at baseline (BL) or at any follow-up. The changes from BL were comparable for all three groups. The authors did not note any significant differences at any follow-up for compliance with study protocols or for occurrences of adverse effects from either splint type. For HS versus SS, there were significant differences in rates of splint use, but these differences were not accompanied by differences in either self-reported symptoms or in clinical findings. CONCLUSIONS: All patients improved over time, and traditional splint therapy offered no benefit over the SS splint therapy. Neither splint therapy provided a greater benefit than did self-care treatment without splint therapy. CLINICAL IMPLICATIONS: These findings suggest that clinicians who treat patients with TMD should consider prescribing low-cost nonsplint self-care therapy for most patients.

Acrylic Resins↗
PubMed1996

[Clinical observation of TMJDS treated with pivot splint].

The pivot splint was applied to 50 patients with temporomandibular joint dysfunction syndrome that included 30 patients of anterior disc displacement without reduction, 12 patients of anteriordisc displacement with partial reduction and 8 patients of upward condyle displacement. The mouth opening and joint space of the TMJ tomographies before and after treatment were measured for each case. The results indicated that treatment with pivot splint was very effective for the patients with downward diplacemenr of the condyle. As a result, among 50 patients, 36 patients were cured (72%) and 14 patients were improved (28%). The results of 3 years follow-up indicated that original symptoms of the patients had no recurrence.

Adolescent↗
PubMedDate not supplied

Prevention of self-mutilation in patients with Lesch-Nyhan syndrome: review of literature.

There have been no standard methods established to prevent the self-mutilation seen in LNS. Preventive treatment must be developed, therefore, for each patient based on clinical findings. The first method to be utilized should be a nonsurgical splint or mouth guard. If it proves to be unsuccessful then the benefits of surgical procedures should be considered. In the future, the use of medication, such as carbamazepine, may prove to restructure the current approach advocated by the literature today.

Antimanic Agents↗
PubMed2001

Bruxism and orofacial movements during sleep.

Several issues remain to be clarified in the future research and management of SB. It is important to differentiate SB from other normal sleep orofacial activities and concomitant sleep disorders. Other orofacial activities may obscure the diagnosis of SB and may give an ambiguous clinical picture when evaluating treatment efficacy. Laboratory recordings provide a more specific diagnosis. Most of the clinical signs (e.g., tooth wear, masseter hypertrophy) are not exclusive to SB but could be concomitant with other habits or activities during wakefulness. No pathologic features in the central nervous system, such as a dysfunction of the dopaminergic system, have been observed in SB patients. Recent neurophysiologic studies have suggested that SB is a powerful microarousal event associated with central and autonomic nervous system activity during sleep. The additive contribution of psychosocial stress cannot be overlooked. There have been no recent major breakthroughs in SB management. Cognitive and behavioral managements, which include stress management, lifestyle changes, or improved coping mechanisms, may be beneficial. Oral splint appliances are useful to protect teeth from damage. A few medications (e.g., benzodiazepines, muscle relaxants) may be helpful for a short-term period, particularly when there is secondary pain, but controlled studies are needed to assess their efficacy, safety, and patient acceptance and tolerance.

Behavior Therapy↗
PubMed1981

Effects of occlusal treatment and intraarticular injections on temporomandibular joint pain and dysfunction.

The long-term effect (2 years) of occlusal treatment and intra-articular injections of a mixture of corticosteroid and local anaesthetic was investigated in two groups of patients with pain and dysfunction in the temporomandibular joint (TMJ). Fifteen patients were treated with injections and eighteen patients with occlusal adjustment. The TMJ was tender to palpation in all patients. The intra-articular injections were given once a week for three weeks. The occlusal treatment included splints, grinding on natural teeth and occlusal correction of complete dentures. The severity of the subjective symptoms and clinical signs was estimated before and after treatment. Both sorts of treatment reduced the subjective symptoms and the clinical signs significantly, but the reduction was significantly greater after the intra-articular injections. The effect of the injections was less efficient in patients with radiographic signs of remodelling of the TMJ and general joint symptoms. It was concluded that both intra-articular injections of corticosteroid combined with local anaesthetic and occlusal treatment have a long palliative effect on TMJ pain and dysfunction. The intraarticular treatment, however, had a greater effect on the clinical signs.

Adult↗
PubMed1995

The effectiveness of an extreme canine-protected splint with limited lateral movement in treatment of temporomandibular dysfunction.

This study suggests that a splint design incorporating extreme canine guidance with limited lateral movement may be effective in the treatment of temporomandibular dysfunction (TMD) symptoms. Fifty consecutively treated TMD patients were evaluated with the TMJ Scale before and after treatment. A group of 11 similar patients identified as having TMD, but who declined treatment, were used as a control group.

Acrylic Resins↗
PubMed1993

The treatment of mandibular fractures in children.

92 children with mandibular fracture were treated at our hospital between 1980 and 1989. Distribution and treatment of the fractures focus on a new classification based upon the stage of the dentition, site of the fracture and displacement of the tooth-bearing part of the mandible. The treatment rationale includes intermaxillary fixation by specially designed mini-arch bars with acrylic resin stiffening in cases with undisplaced fractures in the early stages of the dentition. With the help of this technique, invasive procedures for fracture immobilization become less common. The indication for miniplate osteosynthesis is limited to displaced or multiple fractures of the tooth-bearing part of the mandible. The combination of miniplates and monomaxillary splinting with mini-arch bars allows a shorter duration of intermaxillary fixation and hence early functional treatment of additional condylar fractures. Correctly applied miniplates neither injure the tooth germs nor lead to growth disturbances of the mandible. The classification and treatment of mandibular fractures in children are discussed.

Bone Plates↗
PubMed2004

An atypical Hallermann-Streiff syndrome. Focus on dental care and differential diagnosis.

The Hallermann-Streiff syndrome (HSS) is a rare congenital disorder characterized by dyscephaly, birdlike facies, hypoplastic mandible, congenital cataracts, microphthalmia, hypotrichosis, skin atrophy, proportionate short stature, and dental anomalies. A case of a 29-year-old man with atypical HSS with neither cataracts, hair and skin alterations, nor short stature is reported, with special consideration to oral findings and dental management. Dental extractions, scaling, restorations, and endodontics were performed under local anesthesia. Later, orthodontic rehabilitation with fixed brackets was carried out. Finally, a removable partial denture for the maxillary arch was designed using transparent acrylic, and this also served as a retention splint. Young patients with HSS and other similar syndromes must be involved in personalized oral health prevention programs as early as possible. Despite numerous systemic anomalies, some of these patients may undergo conventional dental procedures under local anesthesia in the dental office.

Adult↗
PubMed1992

Treatment of Class II high angle malocclusions with the Herbst appliance: a cephalometric investigation.

The purpose of this study was to examine the results of treatment of Class II malocclusions by using two different designs of the Herbst appliance. Cephalometric records from lateral headplates of 19 consecutively treated Class II cases were evaluated. The headplates were taken before and after the treatment stage in which the Herbst appliance was used. The patients were divided into two groups: the first group, normohypodivergent, was treated with the Herbst appliance attached to bands; the second group, hyperdivergent, was treated with the Herbst appliance attached to acrylic splints in which a high-pull headgear was also used. The results were compared between these groups and with a control group age-matched from Bolton standards to match the changes in the Herbst samples against what might be expected in case of normal growth during similar periods of time. The results of the investigation revealed the following: (1) 9 months of treatment resulted in Class I dental arch relationships in all 19 cases; (2) the Herbst appliance attached to bands did not significantly modify the vertical growth pattern of the normohypodivergent patients; and (3) in hyperdivergent patients, the use of a Herbst appliance attached to acrylic splints in conjunction with the use of a high-pull headgear allowed a better control of the vertical dimension, as assessed by the cephalometric parameters (FA, FMA, Go-Gn-SN). The clinician should be aware of the different dentofacial changes induced in the vertical plane by different designs of the Herbst appliance to better program treatment strategy.

Adolescent↗
PubMed2006

The treatment of temporomandibular disorders with stabilizing splints in general dental practice: one-year follow-up.

BACKGROUND: The authors evaluated temporomandibular disorder (TMD) outcomes in general dental practice one year after treatment with stabilizing splints (SS) or nonoccluding control splints (CS). METHODS: Seventy-two randomly allocated subjects completed initial treatment. The outcomes measures were a pain visual analog scale (VAS), muscle tenderness, temporomandibular joint (TMJ) tenderness, interincisal opening, TMJ clicks and headaches. After initial treatment, 81 percent of the subjects were found to have been treated satisfactorily. The dentists referred the remaining subjects to a dental hospital. At one year, the authors recalled 52 of the original subjects for evaluation. RESULTS: Improvements after initial treatment were maintained at one year for all outcomes, except for TMJ clicking, which returned to pretreatment levels. Eighty-one percent of the subjects rated their treatment as either good or excellent in reducing jaw pain. The authors found that subjects were aware of more of their TMJ clicks than dentists observed at the one-year clinical examination, but most subjects thought their clicking or the associated pain had been reduced. Fifty-five percent subjects had used their splints in the previous six months, but only 31 percent of these had done so daily. There were no significant differences between splint groups. CONCLUSION: At one year, a good response to TMD treatment in general practice had been maintained, but many subjects still had clicking TMJs. CLINICAL IMPLICATIONS: Trained dentists can manage TMD satisfactorily, with only a small proportion of patients needing specialist attention.

Adult↗
PubMedDate not supplied

Management of orofacial manifestations of Parkinson's disease with splint therapy: a case report.

Patients with Parkinson's Disease display a number of orofacial manifestations. These manifestations are secondary to motor and sensory deficits, resulting in bradykinesia, muscle rigidity and tremor, and difficulties with speech, swallowing, proprioception, tactile sensitivity, and hard- and soft-tissue trauma. This case describes the use of a bruxism splint which benefited a PD patient by diminishing the occurrence of orofacial pain secondary to muscle tremor and rigidity while reducing the cumulative damage to the oral structures common with the disease. The impact of therapy on sleep, speech, and swallowing difficulties is also discussed.

Articulation Disorders↗
PubMed1997

Effectiveness of the Michigan splint in reducing functional cervical disturbances: a preliminary study.

There is controversial evidence for a functional link between the masticatory apparatus and the cervical spine. The aim of this work was to perform a preliminary study to evaluate the effectiveness of the Michigan splint for the treatment of functional cervical disturbances. Forty patients with functional cervical disturbances were randomly organized into test and control groups. The patients in each group were examined by a physiologist to ascertain the extent of functional changes. The test group underwent splint therapy (Michigan type) during a two-month period. The other patients were sent home and did not receive active treatment. After two months, all patients were reassessed physiologically. Cervical pain and pain induced by epispinal or paraspinal pressure were reduced to a statistically significant extent in the treated group, compared with those in the control group.

Adolescent↗
PubMed1999

Predicting treatment compliance following facial pain evaluation.

The purpose of this study was to document compliance to treatment follow-up for facial pain patients referred for outside services. In addition, we generated a multidimensional model of the psychosocial constructs associated with chronic pain to determine whether these factors were predictive of compliance across recommended therapy modalities or with an overall measure of compliance. These constructs included pain report, depressive symptoms, anxiety, cognitive coping strategies, and physical activity reduction. The sample consisted of 80 facial pain patients evaluated at a tertiary care, facial pain clinic at a large university medical center. Compliance ratings ranged from 93% to 50% and are consistent with the literature that indicates that compliance differs across treatment modality. Furthermore, compliance rates were lower for the more nontraditional facial pain treatments performed by physical therapists or psychologists. Depression was negatively associated with compliance to medication changes, therapeutic injections, and splint therapy, but not psychological counseling or physical therapy. Increased pain was only associated with physical therapy. Measures of psychological distress (depression and anxiety) and pain were predictive of the overall measure of compliance. These results suggest that psychological distress can be a barrier for positive patient outcomes through reduced treatment compliance.

Adaptation, Psychological↗
PubMed2003

Effects of interocclusal appliances on EMG activity during parafunctional tooth contact.

To test the hypothesis that a flat plane interocclusal appliance affects the electromyographic (EMG) activity of the temporalis and masseter muscles in pain-free individuals, maxillary splints were fabricated for 20 individuals who reported no history, signs or symptoms of myofascial pain or arthralgia as determined by two trained, independent examiners. Subjects were instructed to establish light tooth contact, maximum clenching, and moderate clenching with/without the splint in place (as determined by random assignment) while EMG data from the left and right temporalis and masseter muscles were recorded. A 5-min biofeedback training session to relax the masticatory muscles was followed by a repetition of the tooth contact/clenching tasks with/without the splint in place. With the splint in place, the activity of the temporalis muscles decreased for all tasks, significantly for the left and right temporalis under maximal clenching and for the right temporalis under moderate clenching. In contrast, the activity of the masseter muscles increased under light and moderate clenching (significantly for the left masseter under moderate clenching) and decreased slightly under maximal clenching. The effectiveness of interocclusal appliances may be due to mechanisms other than redistribution of adverse loading.

Bruxism↗
PubMed2005

Longitudinal MRI follow-up of temporomandibular joint internal derangement with closed lock after successful disk reduction with mandibular manipulation.

We present a case of bilateral temporomandibular joint (TMJ) internal derangement with closed lock, which was followed over 11 years using serial MRI after successful disk reduction with mandibular manipulation. MRI of the bilateral TMJs before and after mandibular manipulation followed by anterior repositioning splint showed that the disk improved from non-reducible to reducible, and that the reducing disk persisted for 11 years, although minor changes in configuration and position of the disk occurred. These MRI findings suggest that non-surgical treatment with successful mandibular manipulation prevents progressive changes in the TMJ. This case report complements observations regarding the longitudinal course of TMJ internal derangement with closed lock after non-surgical treatment.

Adult↗
PubMed2005

The oral implications of caustic soda ingestion in children.

The morbidity related to caustic soda (sodium hydroxide) ingestion is well described in the literature. The majority of publications have concentrated on the effects to the trachea and gastrointestinal tract, with little reference to the oral and peri-oral areas. Accidental ingestion of sodium hydroxide-containing substances is fortunately rare; however the consequences can be devastating. Three cases of children who drank caustic substances are described. Treatment included fitting splints, injecting steroids, local surgical procedures, and the use of dynamic appliances to maintain mouth opening. Despite these interventions, all patients developed severe scarring, resulting in stenosis of the oral musculature and extra-articular ankylosis. There is perhaps a role for further investigation of early use of antiproliferative agents to prevent scarring, more aggressive surgery, and long-term physiotherapy appliance use. These patients require lifelong follow-up.

Burns, Chemical↗
PubMed1994

Bite force on single as opposed to all maxillary front teeth.

The relation of number of teeth to maximal clenching force was tested in 10 healthy female dental students. The maximal force in the interincisal position was tested by spreading the load with individual acrylic splints over a varying number of teeth in the anterior region. In the maxilla, one splint covered teeth 13-23; another covered tooth 11. In the mandible, one splint covered teeth 33-43 in all experiments. The maximal force in the incisal position was measured 10 times, five times with each splint. The maxillary splints were changed in random order. The tactile sensibility of tooth 11 and its antagonists was tested before and immediately after interincisal force measurements. A highly significant difference between maximal forces was seen in comparing biting between a single tooth and multiple teeth. In addition, bite force also showed a significant increase in both single tooth and multiple teeth successive biting trials during the experiments. Tactile sensibility between d 11 and its antagonist was not altered by the maximal bite force trials.

Acrylic Resins↗