Interocclusal appliance therapy as assessed by three-dimensional reconstructions of MRI scans of temporomandibular joints.
Explore the source record for details and available documents.
Humans↗
SEARCH · Search PubMed
Results for “Occlusal Splints”
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.
[Treatment of obstructive sleep apnea syndrome with a mandibular positioning device and other nonsurgical modalities].
The therapeutic approach to a patient with obstructive sleep apnea syndrome (OSAS) must be individualized because of the heterogeneity in the pathogenesis of the disorder. Although nasal continuous positive airway pressure (CPAP) is effective no matter what the pathogenesis, risk factors for this disorder should be identified in each patient. Nasal CPAP will be discussed by others. Weight loss is one of the best nonsurgical treatments of OSAS and it should be strongly recommended to obese patients with the disorder, even though only a few achieve satisfactory weight reduction. Sleeping in the lateral position or upright may be effective in some patients with OSAS. Acetazolamide, medroxyprogesterone, or protriptyline may also have a role in some patients, although the efficacy must be weighed against the considerable side effects. The cross-sectional area of the oropharynx measured by computed tomography in patients with OSAS was significantly lower than that in control subjects. Lateral cephalograms revealed a retarded mandible in many patients. A dental device designed to advance the mandible 2 to 7 mm and to eliminate the airway obstruction at the base of tongue was used in 20 consecutive patients (17 men and 3 women, average age 53.8 years) to treat the obstructive sleep apnea. The body mass index of the patients was 27.6 +/- 4.2 kg/m2 (mean +/- SD). The device moved the mandible forward (p = 0.038) and increased the airway space in the lower part of the oropharynx (p = 0.031) as assessed with lateral cephalograms. After nightly use of the device for 24 to 211 days, overnight polysomnography was performed for two nights: without the device for the first night and with it for the second night. The apnea index was reduced from an average of 30.7 to 18.5 events/hour (60.4% of the pretreatment value, p = 0.004). The number of desaturations (more than 5% decrease from the base line SaO2) decreased and the lowest level of SaO2 increased: from 26.5 to 14.4 events/hour (p = 0.009) and from 63.6 to 70.1% (p = 0.005), respectively. Not every patient improved sufficiently. Eleven of 20 patients were classified as good responders, because of a reduction in apnea index of at least 50% of the pretreatment value, and the remaining nine patients were classified as poor responders. Use of the device reduced the severity ratings of snoring and excessive daytime sleepiness not only in the good responders but also in the poor responders. No serious complications were observed. The mandibular positioning device is an effective treatment for some patients with OSAS. The effectiveness of the device should be predicted from polysomnographic and cephalometric data, and from CT measurements of the upper airway and other characteristics of the patients.
Adult↗
Centric relation treatment.
Explore the source record for details and available documents.
Arthroscopy↗
Reconstruction with different free flaps in oro-facial cancer patients.
In 75 patients following ablative surgery of head and neck cancer, reconstruction was attempted with free tissue transfer techniques under magnification. It was possible to do free tissue transfers in 69 cases. In 6 cases it was not possible to harvest free flaps successfully and alternative reconstructive procedure was carried out due to unavoidable circumstances and various reasons: 1. unsuitable venous drainage, as in Anterior Rib Osteomyocutaneous Composite Flap, AROCF (2 cases), 2. injury to vessels during flap harvest, as in parascapular flap (1 case), 3. residual disease unable to excise (2 cases) and 4. unsuitable proposition (1 case), due to emergency curfew imposed suddenly. These 6 cases were not included in the study. Free tissue transfer was successful in 64 cases (92.7%) and there was a total failure in 5 cases where delayed secondary salvage surgery was performed. Out of 69 cases, in 65 cases reconstructions were carried out immediately, primarily as one-stage operative procedure. Their functional, cosmetic results and complications during the operative and post-operative period are analyzed and discussed. Inter-maxillary fixation was never used to maintain the bite alignment. All cases were given a bite guide prosthesis in the early post-operative period, to improve the bite alignment when it was necessary.
Adolescent↗
Modern restorative management of advanced tooth-surface loss.
This article describes the restorative management of a case of advanced, localised tooth-surface loss using modern materials and techniques. Particular emphasis is placed on the conservation of tooth structure while providing restorations with optimum physical and aesthetic characteristics.
Adult↗
Pain management. Temporal tendonitis.
Explore the source record for details and available documents.
Anti-Inflammatory Agents↗
[Treatment of obstructive sleep apnea syndrome using a mandibular advancement prosthesis: review of the literature].
The treatment of OSAS with prosthetic devices displacing forward and lowering the mandible in order to increase the size of the pharyngeal airway is seldom used at present. Some recent publications attracted our interest and we deemed it of interest to review them. Our work is mostly concerned with objective results as assessed by polysomnography, and also with cephalometric changes caused by the device. In spite of equivocal results at polysomnography, which seldom met commonly accepted criteria of successful treatment, indiscutable therapeutic successes have been reported. Therefore, this simple, reversible and cheap devices could be advocated in cases of mild or moderate OSAS. However, their role in the therapeutic armamentarium of OSAS as well as their indications and efficacy need to be better assessed.
Cephalometry↗
Responsibilities of the dental profession in recognizing and treating sleep breathing disorders.
The recognition and treatment of snoring and obstructive sleep apnea are two medical areas where dentistry can play a valuable role. Oral appliance therapy has been accepted by the American Sleep Disorders Association as an appropriate treatment modality for some patients. It is essential, however, that dentists work as part of the treatment team and not assume responsibility for diagnosis and treatment without the involvement of a physician or sleep specialist. There are currently more than 35 different oral appliances on the commercial market designed to ameliorate the symptoms and/or treat snoring and obstructive sleep apnea. Dentists interested in pursuing this area should receive sufficient training and education and commit to the study of oral appliance therapy for sleep disordered breathing with the same intensity and integrity applied to the rest of their clinical practice.
Adult↗
Application of myofunctional therapy in cases with craniomandibular disorders.
Modern technology for diagnosis and treatment planning in the management of craniomandibular disorders is described. Three cases are presented to demonstrate how myofunctional therapy is used to 1) stop the damaging hyperactivity of masticatory and perioral muscles and 2) to restore normal muscle function at rest and for chewing and swallowing.
Adolescent↗
Changes in the upper airway of patients who wear a modified functional appliance to treat obstructive sleep apnea.
This study was designed to investigate changes that occur in the upper airway of patients with obstructive sleep apnea who use a modified functional appliance. The experimental group included 10 men, all diagnosed with obstructive sleep apnea. Nuclear magnetic resonance imaging was carried out on each patient. One image was taken when the patient was in maximum habitual occlusion and another was taken while the patient wore the appliance. From the images gained, a three-dimensional reconstruction of the upper airway from the palatal plane was achieved. The images revealed statistically significant increases in the volume of the upper airway with the use of a modified functional appliance. Three-dimensional studies of the upper airway show greater detail and therefore seem likely to have more validity than two-dimensional studies.
Adult↗
Dental pulpalgia contributing to bilateral preauricular pain and tinnitus.
The case of a patient with bilateral preauricular pain and tinnitus is reported. Minimal relief was obtained with traditional temporomandibular disorders therapy, and complete relief was obtained after endodontic therapy. Pulpal conditions that can refer pain are discussed, and recommendations are made to help practitioners identify a possible pulpal etiology for symptoms and tests of temporomandibular disorders.
Dental Pulp Diseases↗
An overview of bruxism and its management.
Bruxism is a mandibular parafunction and it can be regarded as a forcible clenching or grinding of the dentition or a combination of both. Because bruxist behavior can be exhibited during both waking and sleeping hours, neither aspect should be ignored by the practitioner as a potential contributing factor of disturbances of the masticatory system. This article provides a general overview of bruxism relative to epidemiology, etiology, characteristics, diagnosis, and management.
Bruxism↗
Intraoral orthotic therapy.
Despite the unanswered questions on the physiologic mechanisms that explain the effectiveness of intraoral orthotics on reducing symptoms of TMD, there is still a plethora of documentation that intraoral orthotics, when appropriately used in the management plan, can contribute to the relief of TMD symptoms. The clinician is encouraged to evaluate fully each particular patient case in an effort to develop a differential diagnosis that leads to an effective management plan, which, in turn, addresses the cause(s) as best as possible. Before commencing any intraoral orthotic therapy for a TMD, the clinician should be confident that the patient will benefit from the therapeutic approach to be employed or, at least, that the resultant effect, or lack thereof, on the symptoms will provide additional diagnostic information. The clinician also needs to take into account that approximately 40% of patients suffering from TMD demonstrate a favorable response to intraoral orthotic therapy just from a placebo effect. As with any treatment, a good patient-dentist relationship concomitant with patient education can allay patient concerns and anxieties, which, in and of themselves, can contribute to a positive and favorable response to intraoral orthotic therapy.
Facial Pain↗
Secondary management of congenital and acquired craniomaxillofacial deformities. Individualized treatment planning.
Late treatment of craniofacial disorders with concomitant abnormalities of the jaw are the most challenging cases a craniofacial surgeon faces. This article details the principles of preoperative, individualized treatment planning using anthropometric guidelines in a simple but systematic scheme for facial analysis. Seventeen skeletally mature patients without cleft lip and palate or hemifacial microsomia, aged 15 to 65 years, underwent simultaneous orthognathic and craniofacial surgery for a variety of complex craniofacial disorders. The basic clinical approaches outlined in this article permit the surgeon to develop a flexible but accurate treatment plan and proceed with confidence in the management of patients with widespread craniomaxillofacial deformities.
Adolescent↗
Management of TMD caused by temporal head trauma.
This report followed the management of a 56-year-old female suffering from TMD caused by trauma to her temporal head area. The management consisted of occlusal devices until her condition stabilized followed by prosthodontic rehabilitation to obtain and maintain a physiologic maximum intercuspation.
Combined Modality Therapy↗
The Tanner Mandibular Appliance.
Explore the source record for details and available documents.
Acrylic Resins↗