[Temporomandibular joint sounds during treatment with bite splints].
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Adult↗
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Results for “Occlusal Splints”
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Adaptability of the adult primate craniofacial complex to asymmetrical lateral forces.
The adaptability of the adult craniofacial skeleton to altered functional relationships has been reported. An experimental quantification of these changes is lacking, however, and the possible underlying mechanisms of the alterations have not been explained. The purpose of this investigation was to evaluate the effect that lateral displacement of the mandible has on the dentoalveolar, craniofacial, and neuromuscular system in the adult rhesus monkey. Ten adult monkeys were studied; five served as controls, three were fitted with bilaterally inclined mandibular splints designed to deviate the mandible toward the left on closure, and two animals had flat splints to provide even occlusal contact. Pretreatment and posttreatment assessment of dentoalveolar and craniofacial change was made from mounted study casts, cephalometric head films, electromyograms and computed tomograms. Axial computed tomographic scans were used to evaluate potential changes in bone density at the lower part of the mandible, the condyle, the coronoid process, the neck of the condyle, and the zygomatic arch by means of a one-way analysis of variance. Changes in the measured variables were not observed in the control animals or in the animals with flat splints. Animals with inclined splints, however, demonstrated attrition and intrusion of maxillary molars and mild proclination of the maxillary incisors. Posttreatment computed tomographic scans in these animals showed significantly increased bone density in the right coronoid process (p less than 0.05) and bilaterally at the necks of the condyles (p less than 0.005). Resting electromyographic activity remained low and was not significantly different among the three groups.(ABSTRACT TRUNCATED AT 250 WORDS)
Adaptation, Physiological↗
Microsurgical tubal reanastomosis--the role of splints.
Tubal reanastomosis was performed in 32 patients using microsurgical techniques. In 25 women, occlusion was due to prior sterilization. A splint was not used during or after repair. Intrauterine pregnancy occurred in 21 (84%) and fetal loss in 6% of 17 potentially viable pregnancies. The mean midluteal serum progesterone level of previously sterilized patients (13.4 +/- 1.0 ng/ml) was similar to the level in normal partners of infertile men (12.9 +/- 1.5 ng/ml) and in women with other tubal causes of infertility (14.3 +/- 1.1. ng/ml). Seven patients with occlusion due to disease achieved postoperative patency; there were 4 (57%) intrauterine pregnancies and 1 tubal gestation. The author concludes that a splint is not necessary in performing tubal reanastomosis and that there is no clinical or laboratory evidence of luteal insufficiency in this group of previously sterilized women.
Fallopian Tubes↗
[The Silcadraht adhesive splint--a new methods for the treatment of luxated teeth].
Splints for the immobilization of dislocated teeth have been attached to teeth with the enamal-cauterization-cement technique for the last six years at the Innsbruck Hospital. Semicircular silica wires proved to be so satisfactory with 92 patients that this method has now replaced the traditional splinting methods at our hospital. The secondary advantages are the simple production of the splint, painless application and removal, and complete protection of the periodontium. Occlusal disturbances are avoided, because the splints do not cover any of the occluding tooth surfaces.
Acid Etching, Dental↗
Managing bruxism and temporomandibular disorders using a centric relation occlusal device.
This article discusses the rationale, indications, and fabrication of the centric relation occlusal (CRO) device in the management of bruxism and temporomandibular disorders. Five methods of fabricating occlusal devices are briefly discussed. Two methods, preferred by the authors, are discussed in detail, including the laboratory phase. One method uses heat-cured acrylic resin, and the other method uses a heat-vacuum machine, thermoplastic splint resin material, and autopolymerizing clear acrylic resin. The use of the CRO device in the successful management of bruxism and temporomandibular disorders has been previously documented in the literature. Some patients may not successfully adjust to the wearing of occlusal devices (splints), which are not well-defined in terms of occlusal morphology, anterior guidance, and their relativity to centric relation. This problem usually is overcome when the dentist uses precise skill in the fabrication and delivery of a CRO device with mutually protected articulation.
Acrylic Resins↗
Stabilisation splint therapy for temporomandibular pain dysfunction syndrome.
BACKGROUND: Pain dysfunction syndrome (PDS) is the most common temporomandibular disorder (TMD). There are many synonyms for this condition including facial arthromylagia, TMJ dysfunction syndrome, myofacial pain dysfunction syndrome, craniomandibular dysfunction and myofacial pain dysfunction. The aetiology of PDS is multifactorial and many different therapies have been advocated. OBJECTIVES: To establish the effectiveness of stabilisation splint therapy in reducing symptoms in patients with pain dysfunction syndrome. SEARCH STRATEGY: Electronic databases (including the Cochrane Oral Health Group's Trials Register; the Cochrane Central Register of Controlled Trials (CENTRAL); The Cochrane Library Issue 2, 2003; MEDLINE (1966 to June 2001); EMBASE (1966 to June 2001)) were searched. Handsearching of relevant journals was undertaken and reference lists of included studies screened. Experts in the field were contacted to identify unpublished articles. There was no language restriction. SELECTION CRITERIA: Randomised or quasi-randomised controlled trials (RCTs), in which splint therapy was compared concurrently to no treatment, other occlusal appliances, or any other active intervention. DATA COLLECTION AND ANALYSIS: Data extraction was carried out independently and in duplicate. Validity assessment of the included trials was carried out at the same time as data extraction. Discrepancies were discussed and a third reviewer consulted. The author of the primary study was contacted where necessary. The studies were grouped according to treatment type and duration of follow up. MAIN RESULTS: Twenty potentially relevant RCTs were identified. Eight trials were excluded leaving 12 RCTs for analysis. Stabilisation splint therapy was compared to: acupuncture, bite plates, biofeedback/stress management, visual feedback, relaxation, jaw exercises, non-occluding appliance and minimal/no treatment. There was no evidence of a statistically significant difference in the effectiveness of stabilisation splint therapy (SS) in reducing symptoms in patients with pain dysfunction syndrome compared with other active treatments. There is weak evidence to suggest that the use of SS for the treatment of PDS may be beneficial for reducing pain severity, at rest and on palpation, when compared to no treatment. REVIEWER'S CONCLUSIONS: There is insufficient evidence either for or against the use of stabilisation splint therapy for the treatment of temporomandibular pain dysfunction syndrome. This review suggests the need for further, well conducted RCTs that pay attention to method of allocation, outcome assessment, large sample size, and enough duration of follow up. A standardisation of the outcomes of the treatment of PDS should be established in the RCTs.
Acupuncture Therapy↗
A simplified technique for fabrication fo night guards.
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Acrylic Resins↗
A procedure for making a bruxism device in the office.
Microtrauma to the temporomandibular joint, the masticatory muscles, and the dentition can be significant in mandibular parafunctional activity such as nocturnal clenching and bruxing. Intraoral therapy can be useful in helping to reduce the deleterious effects of this activity. This article presents an in-office procedure for a device to reduce a delay in starting treatment and the time needed for adjustment of the device in the mouth.
Bruxism↗
The immediate effect of the variation of anteroposterior laterotrusive contacts on the elevator EMG activity.
A unilateral maxillary splint divided into three occlusal blocks was built for eight healthy young adults. The three blocks allowed the anteroposterior location of the laterotrusive contacts to vary and to distribute the occlusal force over equivalent periodontal surfaces. The ipsilateral masseteric and temporalis electromyogram (EMG) activities were recorded with surface electrodes during maximal voluntary clenching. The elevator EMG activity with the anterior occlusal block in place was significantly lower than with the intermediate or posterior blocks. The reduction for both elevators with the intermediate block in place did not show a significant variation in comparison to the posterior block of the three blocks inserted. The elevator activity with the three occlusal blocks did not differ from that recorded with the posterior block alone. Neurophysiologic and biomechanical explanations are given related to this laterotrusive elevator muscular behavior.
Adult↗
Immediate occlusal loading of Osseotite implants in mandibular edentulous patients: a prospective observational report with 18-month data.
PURPOSE: To evaluate the efficacy of treatment consisting of placement and immediate occlusal loading of implants in 27 patients with edentulous mandibles. MATERIALS AND METHODS: Twenty-seven patients were treated in two private practice settings. One hundred fifty-one implants were placed and immediately occlusally loaded with fixed implant prostheses (15 cement-retained, 12 screw-retained) on the day of implant placement. The implant-retained prostheses were inserted within 5 hours of implant placement. Patients were followed for at least 18 months. The required criteria for immediate occlusal loading was primary implant stability of at least 30 Ncm of insertion torque. The implant prostheses were removed at least 12 months post-placement and the implants were evaluated for primary clinical stability and radiographic bone apposition to implants. RESULTS: At the 12-month follow-up appointments, cumulative survival rates of 98.0% and 100% were recorded for implants and prostheses, respectively. Three implants failed within 3 months. All other implants were clinically successful. CONCLUSIONS: Immediate occlusal loading of multiple, splinted mandibular implants is an effective treatment when implants are stable at insertion and are rigidly splinted with implant-retained prostheses.
Adult↗
Occlusion, TMDs, and dental education.
The paradigmatic shift to evidence-based dentistry (EBD) that relates to occlusal therapy, selective occlusal adjustment (OA) and stabilization splints therapy (SS) for TMDs has had an unfavourable impact on the teaching of many of the important aspects of occlusion needed in dental practice. The teaching of OA systematically in dental schools has been nearly abandoned because of the belief that OA is an irreversible procedure and gives the impression that it is without merit elsewhere in the management of occlusion. However, a particular dose of knowledge and practice of occlusion that is necessary for all aspects of dental care should be taught systematically in dental schools. The uses and misuses of OA and SS and their limitations should be emphasized because of their importance to bring clinical reality into the dental curriculum. Thus, and irrespective of EBD induced contradictions, OA and SS should still have a significant place in systematically teaching of occlusal therapy. However, there are many more aspects of the management of occlusion that should to be considered. Hopefully, because of their importance, other aspects of the management of occlusion will once again become a significant part of the dental curriculum.
Dental Occlusion↗
[Protraction--it's use and abuse].
1. Protraction devices can be used to close excess spaces by moving posterior teeth forward, to protract maxillas, to rotate arch segments in cleft palate patients and to remove hyper anterior contacts in patients with TMJ derangements. 2. There are three types of protraction headgears: Chin support with cranial straps (Hickham), chin support with a forehead pad (Face mask) and zygoma support with a headband (Suborbital). They all have specific advantages and disadvantages. 3. The force magnitude from a protraction gear varies according to the desired effect from between app. 400 grams/side to move the maxillary anterior teeth forward and 800 grams/side to encourage maxillary sutural expansion. 4. The centers of rotation of the jaws and the dentition are located apically to the attachment of the protraction device. Therefore not only the intended mesially oriented force is produced but also the undesired side effect of both jaws moving around their centers of rotation. To avoid these negative effects the protraction elastics should always leave the arch in the canine area. 5. Basically Class III cases are due to either a short maxilla and/or a long mandible with variations in the vertical. App. 60% of all Class III cases have a short maxilla indicating the need for protraction. About 50% of the total Class III patient population would need surgery to finish with an ideal occlusion. However, many types of compromise treatments can be acceptable. 6. A good occlusion can only be accomplished in the presence of normal function. In Class III patients special attention should be given to possible nasal obstruction as well as to tongue posture and function. ENT cooperation and tongue spikes are often necessary to resolve these problems. 7. Class III elastics tend to rotate the maxilla and mandible counterclockwise. The resulting change in molar relationship is only due to the rotation of the occlusal plane which is unstable. Also because of the extrusional side effect there is an increase in vertical dimension which usually is undesirable. 8. Intraorally the protraction device can either be attached to a bonded acrylic expansion appliance or to a cemented Hyrax depending on the developmental stage of the dentition. To avoid traumatic occlusion conditions a modified splint should be used with the protraction gear in adults. 9. In all growing Class III patients overcorrection of overjet and overbite is very important. This way not only possible relapse is prevented but also the change of a posteriorly displaced mandible is avoided which could be a later cause for TMJ derangement. 10. When deciding whether the deformity is in the maxilla or in the mandible--the individualized Jacobson templates are very helpful.
Adolescent↗
[Treatment of bruxism and bruxomania by vestibular stops].
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Bruxism↗
Bite plane therapy: theory and fabrication.
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Dental Occlusion↗
[Three bite splints for purposes of classification].
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Bruxism↗
[Optimal preparation procedures for repositioning splints].
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Dental Occlusion↗
Effect of splinting and interproximal contact tightness on load transfer by implant restorations.
STATEMENT OF PROBLEM: To circumvent the difficulty of achieving a passive framework fit, some authors have suggested that multiple adjacent implants be restored individually. This protocol requires that each unit be able to withstand mastication forces. Non-splinted restorations have numerous interproximal contacts that require adjustments prior to placement, with an unknown outcome relative to load transfer. PURPOSE: This in vitro simulation study examined the effect of splinting and interproximal contact tightness on passivity of fit and the load transfer characteristics of implant restorations. MATERIAL AND METHODS: A photoelastic model of a human partially edentulous left mandible with 3 screw-type implants (3.75 x 10 mm) was fabricated. For non-splinted restorations, individual crowns were fabricated on 3 custom-milled titanium abutments. After the units were cemented, 5 levels of interproximal contact tightness were evaluated: open, ideal (8 microm shim stock drags without tearing), light (ideal +10 microm), medium (ideal + 50 microm), and heavy (ideal + 90 microm). For splinted restorations, five 3-unit fixed partial dentures were fabricated, internally adjusted with silicone disclosing material, and cemented to the model. Changes in stress distribution under simulated non-loaded and loaded conditions (6.8 kg) were analyzed with a polariscope. RESULTS: In the simulated alveolar structures, non-splinted restorations with heavier interproximal contacts were associated with increased tensile stresses between implants; occlusal loads tended to concentrate around the specific loaded implant. Splinted restorations shared the occlusal loads and distributed the stresses more evenly between the implants when force was applied. The load-sharing effect was most evident on the center implant but also was seen on the terminal abutments of the splinted restorations. CONCLUSION: The results of this in vitro study suggest that excessive contact tightness between individual crowns can lead to a non-passive situation. In this experiment, splinted restorations exhibited better load sharing than non-splinted restorations.
Birefringence↗
The importance of splinting of teeth in the therapy of periodontitis.
AIM: The deep periodontal disease often leads to dental mobility with further aggravation of the symptomatology. The aim of the paper is to verify the importance of splinting of teeth in the therapy of periodontitis on the basis of parameters commonly studied [probing depth (PD), bleeding on probing (BOP), plaque index], and the role of the occlusal trauma as primary factor or second leading factor in periodontal diseases. METHODS: Thirty patients suffering from periodontitis have been treated with the splinting of teeth, neither preceded nor followed from topical and systemic pharmacological therapy, nor from surgical or non surgical treatment of the periodontal tissues involved. During the 4 visits provided by the study, T0 (0 days), T1 (30 days), T2 (90 days) and T3 (180 days), PD, BOP and plaque index have been estimated. RESULTS: From the comparison of the T0 PD and BOP with the T3 PD and BOP, a significant improvement of these parameters is observed (P<0.05). CONCLUSION: On the basis of the clinical data obtained in this research, the authors suggest that the therapy by means of splinting improves the prognosis of teeth affected by periodontal disease; occlusal trauma and dental mobility cause the aggravation of periodontal lesions.
Bite Force↗