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PubMed1989

The immediate effects of a stabilization splint on the muscular symmetry in the masseter and anterior temporal muscles of patients with a craniomandibular disorder.

In 36 myogenous craniomandibular disorder patients, the immediate effects of a stabilization splint on the symmetry in the activities of the masseter and anterior temporal muscles during submaximal clenching at five clenching levels were investigated electromyographically. After the adjustment of the splint necessary at the time of delivery, 20 splints remained free from occlusal interferences throughout the treatment period and thus needed no further adjustment. These splints caused an immediate improvement in masseter muscle symmetry at the time of delivery (p less than 0.01). However, 16 splints needed further adjustment for occlusal interferences at the first recall, 2 weeks after delivery of the splint. These splints resulted in a small but statistically significant worsening in masseter muscle symmetry at the 10% clenching level (p less than 0.01). No such response was found for temporal muscle activity. The immediate changes in masseter muscle activity suggest that muscular symmetry is an objective basis in the evaluation of the treatment provided.

Adult↗
PubMed1985

The effect of acrylic bite plane splints and their vertical dimension on jaw muscle silent period in healthy young adults.

A significant question relative to treatment and disappearance of symptoms is raising the bite in combination with a maxillary bite plane splint in patients with TMJ muscle dysfunction. The objective of this research was to investigate the effect, if any, occlusal bite plane splints have on the latency and duration of the mention tap silent period and particularly whether the degree to which the bite is raised is of significance. Recordings were made in healthy young adults from both anterior temporal and masseteric muscles while subjects were clenching at their 70% maximum clenching effort. Placement of a splint significantly (P less than 0.05) prolonged the silent period duration (SPD). However, mean SPD values taken at two different vertical raised bites did not differ significantly (P greater than 0.05). The anterior temporal muscle SPD was less sensitive to a smaller change of vertical dimension than the masseteric SPD. Silent period latencies remained unchanged in all experimental conditions.

Acrylic Resins↗
PubMedDate not supplied

A clinical study on SSP (silver spike point) electro-therapy combined with splint therapy for temporo-mandibular joint dysfunction.

When the functional limits of the muscles related to the temporo-mandibular joint and adjacent tissue exceed their anatomical capability, pain, crepitation, and functional abnormality appear as the main complaints. Although the precise nature of the condition is unknown, pain at the temporo-mandibular joint sometimes in combination with muscular tension is assumed to be due to compression of the myoneural mechanism. It is reported that occlusal lifting using a splint enables the alleviation of this muscular tension. On the other hand, there are only a few reports on the usefulness of SSP therapy for Temporo-Mandibular Joint Dysfunction. We studied the efficacy of SSP therapy combined with splint therapy in 33 patients diagnosed as having Temporo-Mandibular Joint Dysfunction who consulted our department primarily due to pain, and report our findings below. Evaluation of the results was conducted 2 weeks later. Very beneficial results were seen in 6 cases. Beneficial results were seen in 7 cases. Slightly beneficial results were seen in 18 cases, while there were no changes found in 2 cases. When combined SSP and splint therapies were conducted for Temporo-Mandibular Joint Dysfunction, favorable results were seen in about 90% of the cases.

Acupuncture Analgesia↗
PubMed1985

Effect of occlusal adjustment on globus symptom.

Twenty-two patients seeking treatment for the globus symptom were examined for the presence of symptoms and signs of TMJ dysfunction. They were randomly divided into a treatment group (N = 13) and a placebo group (N = 9) and underwent either simple occlusal adjustment or mock adjustment, respectively. The result of occlusal adjustment was assessed immediately after completion of treatment. The effect of treatment on the globus symptom was assessed 2 to 3 months later in a double-blind study design. Binomial tests showed that there was a significant association between the success of occlusal adjustment and disappearance of the globus symptom. Three patients in the placebo group subsequently received occlusal adjustment and splint therapy. When all patients were interviewed 20 to 44 months later, only two of them reported no improvement. Both had unstable occlusion when the treatment was terminated.

Adult↗
PubMed1978

[The Michigan splint, a diagnostic and therapeutic aid for patients with disorders of the masticatory system. I. Construction on an articulator and fitted in the patient's mouth].

The Michigan splint is an occlusal appliance for patients with functional disturbances of the gnathic system. It helps to stabilize, reposition and to equilibrate and is a means of diagnosis and therapy. Form and function of the splint are described along with its construction. Special attention is given to the incorporation and the checking appointments with the patient. The splint helps to relax the masticatory musculature. Thereby the madibular recording is facilitated. It helps to make a correct functional analysis and to induce a proper occlusal therapy.

Humans↗
PubMed2003

Bruxism levels and daily behaviors: 3 weeks of measurement and correlation.

AIMS: To test whether 3-week duration recordings of sleep bruxism are correlated with daily behaviors. METHODS: Twelve patients with a sleep bruxism disorder were monitored to see if any daily behaviors (stress, physical activity, anger), jaw-pain/headache symptoms, or sleep quality were correlated with their sleep bruxism levels. A telemetric-based system was used for monitoring bruxism levels, which were detected with an intra-appliance piezoelectric film system. Bruxism was defined as a force applied to the occlusal surface of the splint at or above a level of 10% maximum voluntary contraction. Bruxism levels were recorded at night for at least 3 weeks on the 12 subjects in this study (6 females and 6 males). Patients used standard (100 mm) visual analog scaling methods during this period to rate their daily behaviors, sleep quality, and jaw-pain/headache symptoms in a diary. Correlation analysis was performed between these recorded variables. RESULTS: The subjects demonstrated both bruxism and sleep disturbance, and the mean bruxism score for the male subjects was significantly higher than that for the female subjects. Overall, no single diary variable was consistently correlated with the bruxism levels in these subjects. CONCLUSION: These data support the conclusion that bruxism is not strongly related to any of the subject's self-monitored daytime activities or sleep quality.

Activities of Daily Living↗
PubMed1989

Reduction and fixation of jaw fractures using acrylic splints.

This paper proposes the criteria for application of acrylic splints in the treatment of various types of maxillofacial fractures. These were based mainly on the number of remaining teeth that are important for the restoration of occlusion. The acrylic splints studied consisted of intermaxillary, lingual and labiolingual types that hold a dental arch and a cap type that covers a dental arch. It was found that the intermaxillary type was best indicated for the loss of multiple teeth, the lingual type for the predicted intraversion of bone fragments and the labiolingual as well as cap types for the deciduous or mixed dentition. Clinical application based on the above standard, which was attempted in our 60 patients, produced successful results. In addition, the usefulness of these acrylic splints as an intraoral apparatus was discussed.

Acrylic Resins↗
PubMed1989

[Tooth mobility and containment].

Periodontal destruction often leads to tooth hypermobility. In the presence of jiggling forces, traumatic occlusion can provoke a progressive mobility, and in certain cases, accelerate the periodontal destruction in presence of periodontitis. Treatment of infection alone is enough to stop the periodontal destruction. If the mobility becomes progressive, or if the hypermobility impedes the masticatory function of the patient, an occlusal adjustment and/or a splint are valuable to assure the longevity of a tooth. Tooth mobility is the physiological adaptation of the periodontium to the traumatic occlusion, and is, in itself, not an indication for splinting.

Dental Occlusion, Traumatic↗
PubMed2004

Treatment effect on signs and symptoms of temporomandibular disorders--comparison between stabilisation splint and a new type of splint (NTI). A pilot study.

The aim of the investigation was to compare the effect on signs and symptoms of temporomandibular disorders (TMD) of two different interocclusal appliances. Thirty patients with signs and symptoms of TMD received either a stabilisation splint or a new kind of splint based on the concept of nociceptive trigeminal inhibition (NTI). A clinical examination was performed and subjective symptoms were registered before start of treatment and after 3 and 6 months. All participants were offered to change to the other type of splint at the 3-month follow-up in case of no improvement or impairment of their symptoms. One subject in each group was lost early during the investigation. The mean time for taking impressions, to make inter-occlusal recording and to adjust the stabilisation splints was 17 minutes. The mean time to fit and adjust the NTI splints was 27 minutes. At the 3-month follow-up, 4 patients that had received NTI splints accepted the offer to change to stabilisation splints due to no improvement or impairment of their symptoms. These treatments were judged as failures. No one in the stabilisation splint group utilised the offer to change treatment. At the 6-month follow-up, 7 of the remaining 10 subjects with NTI splints reported some (n = 1) or significant (n = 6) improvement, 2 reported no change and one reported impairment. All 14 who had been treated with a stabilisation splint reported some (n = 2) or significant (n = 12) improvement. For all variables registered, the results were in favour for the stabilisation splint. One subject treated with a NTI splint exhibited an impaired occlusion at the 6-month follow-up.

Adolescent↗
PubMed2002

A review of the clinical management of mobile teeth.

The clinical management of mobile teeth can be a perplexing problem, especially if the underlying causes for that mobility have not been properly diagnosed. In some cases, mobile teeth are retained because patients decline multidisciplinary treatment that might otherwise include strategic extractions. This article discusses the relationship between occlusion and tooth mobility with an emphasis on identifying differences between increased mobility and increasing mobility. The indications, contraindications, and basic principles of tooth splinting are also reviewed. Provisional and definitive splints are defined and described with their respective occlusal considerations. Some mobile teeth can be treated through occlusal equilibration alone (primary occlusal trauma). Whereas mobile teeth with a compromised periodontium can be stabilized with the aid of provisional and/or definitive splinting (secondary occlusal trauma). It is important to consider splint therapy, because it may not only improve the prognosis of teeth, but may actually enhance the stability of the final prosthodontic treatment. The ultimate goal of successful management of mobile teeth is to restore function and comfort by establishing a stable occlusion that promotes tooth retention and the maintenance of periodontal health.

Dental Occlusion, Traumatic↗
PubMed1991

[Functional and orthodontic treatment of a patient with an open bite craniomandibular disorder].

In a 21-year-old man with open bite, myogenic headache and internal derangement of the temporomandibular joint clinical examination was supplemented by radiographs of the joints, cephalometric analysis, electromyographic recordings of the masticatory muscles and tracking of mandibular movements. His condition was characterized by reduced occlusal stability with contact limited to posterior molars, and weak elevator muscles with increased strain during posture and chewing. The purpose of the treatment was to eliminate symptoms with a reflex-releasing stabilizing splint. Secondly, to increase occlusal stability, primarily with the splint and later through orthodontic treatment aiming at closing the bite in the premolar region because the reduced occlusal stability seemed to be a significant etiologic factor. Treatment with the splint reduced signs and symptoms of craniomandibular disorders. During the following orthodontic treatment, contact was established on both premolars and molars, mainly due to extrusion of mandibular premolars. Analysis showed greater elevator strength and decreased muscular loading after treatment. A splint was used for retention accompanied by muscle training with exercise gum. Permanent training with gum was recommended after the retention period.

Adult↗
PubMedDate not supplied

[A splint construction technique for coadjuvant treatment of parafunctions].

In this paper, we introduce a technique of elaboration of soft acrylic's splints as soon as its respective indications. Its main advantage, in addition to his easy and quick making, is the creation of a inner tube between the splint and the occlusal surface that it provides a more even distribution of the pressures exercised by the mastication's forces on the teeth.

Acrylic Resins↗
PubMed1989

Influence of variation in anteroposterior occlusal contacts on electromyographic activity.

A full upper stabilization splint divided into three pairs of occlusal bilateral blocks was made for eight healthy young adult subjects. The three pairs of blocks allowed the location of the centric occlusal contacts to vary and to be distributed over equivalent periodontal surfaces. The electromyographic activity of the masseter and temporal muscles was recorded with surface electrodes during maximum voluntary clenching over the centric occlusal blocks. The electromyographic activity from the elevator muscles with the anterior blocks was significantly less than with the intermediate and posterior occlusal blocks. With use of the intermediate blocks, the activity from the elevator muscles was significantly less than with the posterior blocks. The elevator activity with the posterior blocks was similar to that with the full coverage splint.

Adult↗
PubMedDate not supplied

[Clinical aspects of cranio-mandibular disorders. III. Principles of elective therapy].

The therapeutic approaches on 406 patients of both sexes, agent between 9 and 78 (mean age 30.47) and suffering from cranio-mandibular disorders, have been analyzed, in order to evaluate the more frequent measures of treatment and to improve the management of pain and dysfunction of the stomatognathic system. Having confirmed the multifactorial aetiology, an individual treatment plan was worked out. Of the initial therapies, active gymnastics (63.58%), bland aspecific drugs (21.02%), assisted relaxation practices (7.17%) were of particular importance. As occlusion measures, stabilisation splint (44.61%) had precise instruction for use; in case of mandibular dislocation, a repositioning splint was constructed in articulator, in order to achieve a new therapeutic position (30.51%); sometimes, only a vertical dimension increase of previous prosthesis was made (14.35%). The specific symptom profiles of the diagnostic subgroups in which the sample was subdivided induced to adopt considerably different procedures, due to the basic pathology. The final therapy considered above all prosthetic (35.64%) and orthodontic (25.12%) rehabilitations, whether structural changes were necessary; moreover occlusal adjustment (5.64%); only few cases (2.05%) required a surgical consultation. A deliberate choice of conservative approach was evident in a remarkable number of patients (26.15%), treated in an absolutely reversible way.

Adolescent↗
PubMed1997

Histological evaluation of peri-implant bone at implants subjected to occlusal overload or plaque accumulation.

Breakdown of bone around oral implants following occlusal overload or plaque accumulation was evaluated in monkeys. 5 screw-type implants of pure titanium (Astra Tech) were inserted in the mandible of 4 monkeys (Macaca Fascicularis). 6 months after insertion of the implants a fixed partial prosthesis was mounted on the 2 implants in 1 of the lateral segments. The prosthesis was in supra-occlusal contact with an antagonizing splint and caused a lateral directed excessive occlusal load (overload). Implants retaining the prosthesis were brushed 1 x week and subgingival cleaning was performed 1 x month. The remaining implants were never cleaned and, additionally, a cotton cord was placed around the abutments of these implants to promote plaque accumulation. 6 out of 8 implants with occlusal overload became loose. 2 of these were lost, whereas the remaining 4 were retained in the jaws. After 18 months of occlusal load or plaque accumulation, the monkeys were sacrificed. Tissue blocks with the implants were infiltrated and embedded in acrylic resin. Approximately 50 microns thick sections of the implants and surrounding tissues were made. All implants with plaque accumulation were osseointegrated, but exhibited an average histologic marginal bone loss of 2.4 mm (range: 0.8-4.0 mm). Of the 6 implants with occlusal overload available for histologic analysis, 2 implants in 1 monkey had lost osseointegration completely and 2 other implants were osseointegrated in the apical part only, whereas the remaining 2 were still osseointegrated but exhibited a bone loss of 1.8-1.9 mm.

Alveolar Bone Loss↗
PubMed1997

[A fragmented ribbon splint for the treatment of tooth dislocations].

A simple, reliable, and easy-to-make splint is proposed for immobilization of the dislocated upper and lower incisors. The splint does not prevent correct occlusion, is hygienic and atraumatic. The process of immobilization of the dislocated tooth is accelerated if half-products are available. The splint consists of processes for fixation and the part fixing the tooth, its vestibular part involves the palatal surface of the tooth and is finished with an occlusion pad. The splint is fixed with bronze-aluminium wire to 2-3 healthy teeth on both sides of the dislocated tooth.

Equipment Design↗
PubMed1992

A comparative study of three therapeutic modalities in a temporomandibular disorder (TMD) population.

A comparative study of three treatment modalities, pharmacologic, occlusal appliance, and their combined use, was conducted to test their therapeutic efficacy on 61 temporomandibular disorder (TMD) patients. Alprazolam (Xanax) was used for the pharmacologic treatment; the occlusal appliance therapy consisted of a flat maxillary stabilization splint. Of the 61 patients, 19 received Alprazolam, 30 received occlusal appliance therapy, and 12 received combined therapy. Subjects were examined at two-week intervals for two months. Only 42 patients attended all follow-up visits. Eight parameters were studied: severity of pain, periodicity of pain, self-evaluated stress, muscle sensitivity to palpation, joint sensitivity to palpation, joint noises, limitation of opening, and limitation of lateral movement. No significant difference was found between the treatment modalities for most of the parameters. All three proved to be effective. Alprazolam increased the restricted mandibular movement, was least effective on joint sensitivity to palpation, and had no effect on joint noises. The combined treatment approach not only failed to prove superior to the other treatments, but showed less improvement in some parameters, possibly due to the small sample.

Alprazolam↗