[Treatment of periodontolysis (autodestructive process caused by parafunction) by means of an ATR splint].
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Clinical probing level and radiographic bone level were compared to histologic bone level around screw type oral implants in 4 monkeys (Macaca Fascicularis). Two implants in each monkey retained a fixed partial prosthesis in supra-occlusal contact with an antagonizing splint. These implants were brushed 1 x a week and subgingival cleaning was performed 1 x a month. Unloaded implants in the same monkeys were never cleaned and, additionally, a cotton cord was placed around these to promote plaque accumulation. After 18 months, intraoral radiographs of the implants were obtained and probing levels were recorded with a metal probe using a standardized force of 0.2 N (Vivacare TPS Probe) and again using a moderate, unstandardized pressure. Immediately afterwards the animals were sacrificed. Sections, approximately 50 microns thick, of the implants and surrounding tissue were cut. The average probing levels with unstandardized pressure were 1.1 mm and 3.9 mm coronal to the histologic bone levels for implants with plaque accumulation or excessive occlusal load, respectively. With standardized probing force, the difference between the probing levels and histologic bone levels were even larger. The radiographic bone levels were on average only 0.5 mm and 0.1 mm short of the histologic bone levels for the two groups of implants. Only the radiographic bone level revealed a statistically significant correlation with the histologic assessment.
Twenty individuals received an increased occlusal face height by orthodontic means (a partial bite-raising splint). After splint treatment some of the anterior teeth were capped at the new occlusal face height. The average increase from start of splint treatment till after crown cementation was 1.9 mm. The stability of the vertical relations of the face after this treatment was studied. The average observation time was 67 months, i.e. 5.5 years. The modes of reaction were highly individual. A certain average relapse of the occlusal face height did occur, mostly in the course of the first 6 months after crown cementation. However, in no case did the increased face height revert to basis. In the period from 6 to 67 months after crown cementation twelve out of nineteen patients showed practically completely stable vertical relations.
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After phase I splint therapy for the management of posterior condylar displacement, it is not unusual to find that a posterior open bite has been created. Finalization of a new occlusal position may be effected via occlusal equilibration, prosthodontics, orthodontics, orthognathic surgery, or a combination of these procedures. Stabilizing the occlusion with orthodontics in the new orthopedic jaw position requires a systemic approach. This article outlines a strategy for orthodontic finalization in phase II therapy. The splint-guided position is maintained while intra-arch and interarch malocclusions are corrected. The objective in treatment of posterior condylar displacement via splint therapy and orthodontics lies in the provision of a sound condylar position and the movement of the teeth and mandible into a stable and esthetic position.
It is well known that organic and organized occlusion should be according to the patterns of mandibular motions, which are determined for T.M.J. Presence of syntomatolojy either muscular or articular must be analysed before making any definite procedure. Knowledge and application of splints is essential to odontologist of general practice, to solve that syntomatolojy.
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This study investigated the effect of a maxillary fixed lingual arch with anterior bite plane on adult patients with craniomandibular disorders (CMD) and increased overbite. The sample comprised 11 patients with an increased overbite (greater than 5 mm) and a normal or Class II molar relationship. The main CMD symptoms were daily tension headache in the region of anterior temporal muscles and/or pain or clicking in the temporomandibular joint. Previous treatment with stabilization splints, removal bite plates, or occlusal grinding had not given satisfactory results. When the maxillary lingual arch with anterior bite plane was fitted, molar separation was approximately 4 mm, and occlusal contact occurred only between the acrylic bite plane and the lower six anterior teeth. The permanent appliance could be removed only by the orthodontist. All patients reported relief of CMD symptoms 1 to 2 weeks after initiation of treatment. After a mean time of 3 months, a flatter curve of Spee, molar contact, and reduced overbite could be seen in all cases. The excessive overbite had decreased approximately 3.4 mm. Subsequent treatment involved orthodontic or prosthetic therapy to normalize and stabilize the sagittal and vertical dimensions. After an average posttreatment observation period of 2 years, all patients remained free of CMD pain.
The purpose of this study is to show the effects of dental occlusion on visual focusing. Thirty subjects were divided into two groups: an experimental group who had worn mandibular orthopedic repositioning appliances and a control group who had not worn any oral device. All of the subjects underwent the same visual focusing tests with a Maddox rod and the Berens prismatic bars, from over five meters to 30 centimeters. The results seemed to confirm that the alteration of dental occlusion can induce some fluctuations in visual focusing. The phenomenon occurs after wearing a MORA (Mandibular Orthopedic Repositioning Appliance) for a while. Feedback effects are gradual after removing the mandibular splint.
The recommended treatments of craniomandibular disorders (CMD) are drug therapy, physiotherapy, relaxation procedures, occlusal therapy with and without splint. The purpose of this study is to carry out a survey of the literature on drug therapy in patients affected by CMD. It is essential to recognize the cause of pain (muscular or articular) and the phase of disorder (acute or chronic) in order to establish an adequate pharmacological protocol for each type of CMD. Non-steroidal anti-inflammatory drugs (NSAID) are generally accepted for treatment of internal derangement and myofacial pain, sometimes in association with benzodiazepine.
This chapter presents a method of measuring casts in a scientifically duplicatable manner, using the orthopedic relator to diagnose the plane of occlusion. This allows the practitioner to determine if occlusal equilibration is a viable treatment modality for a particular patient. For patients who do not meet the criteria for occlusal equilibration, a detailed technique for correcting the occlusal plane discrepancies through use of the orthopedic splint is presented.
We report a simple, effective method of managing displaced unilateral condylar fractures with occlusal disruption using vacuum-formed thermoplastic foil splints with bonded wire cleats. The cleats enable intermaxillary fixation in the form of orthodontic elastics to be used, which guide then maintain the occlusion in centric relation. A case is presented in which this technique was used successfully.
1. The subjective separation of the normal and the diseased periodontium for splinting purposes is artificial. With the exception of cases of secondary trauma from occlusion, the diseased periodontium should be treated in the same manner as the normal periodontium with regards to splinting. 2. Retionales for stabilization found to be valid are: I. Prevention of mobility A. Post acute trauma. B. In occlusal therapy. II. Prevention of drifting A. Replacement of missing teeth. B. Postorthodontics. III. In treatment of secondary trauma for occlusion. A. For functional stability. B. With unknown effects on the progression of periodontitis. 3. The relationship of trauma from occlusion and periodontitis is unclear at this time. 4. A need exists for a clinical test correlating histologic signs of trauma from occlusion and clinical findings. 5. Temporary splinting generally is not indicated during the initial or surgical phase of treatment of the periodontal patient, because mobility short of secondary trauma from occlusion does not impair healing.
Neuromuscular problems in the orofacial region are often caused by a disturbance of the occluso-articular relation. It is therefore often possible to alleviate the symptoms by appropriate occlusal corrections. However, since there is no guarantee of success in treatment, particular store is set by initial therapy with a programmed functional splint, which is without risk of introducing irreversible changes. This splint incorporates the essential features of the occlusion and is at the same time programmable to reposition malpositioned condyles. Definitive treatment measures are justified only when the symptoms have completely disappeared and when the position of the mandible has been controlled and fixed for a relatively long period.
The purpose of this study is to show the effects of dental occlusion on postural position. Thirty subjects were divided into two groups: an experimental group who wore mandibular orthopedic repositioning appliances (MORA) and a control group who wore no oral device. All of the subjects underwent the same Fukuda-Unterberger experimental stepping test to check their postural attitude. Any deviation of the subject during the test from his initial position was analyzed. The results seemed to confirm that altering dental occlusion by wearing an oral appliance could induce some fluctuations in dynamic postural attitude. The phenomenon occurs after prolonged wearing of a MORA. Feedback effects are gradual after removing the mandibular splint.
Tooth mobility can be a consequence of periodontal inflammation, attachment loss, and occlusal trauma. At times, this mobility may be tolerable, whereas at other times mobility may contribute to occlusal instability and/or patient discomfort. This article describes the clinical rationale for and the effects of splinting mobile teeth.
A wire splint and the technique of its application for jaw immobilization is described. Stainless steel wires 0.7 to 1 mm in diameter are used to form the smooth and looplike parts applied to dentition in such a manner that loops be located closer to gingival margin and smooth part be situated in the vicinity of incisive margins of the teeth. Usually, the smooth part is an extension of looplike part of the splint and serves to embrace the lateral teeth into the splint. Both ends of the smooth part can be twisted together. The results of clinical application of the splint are compared to most common techniques and suggest major advantages of the novel splint.