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PubMed1977

[Prosthetic aspects in endosseous implantation].

Since 1975, 12 intra-osseous titanium blade implants have been applied to patients with unilateral or bilateral edentulousness of the terminal region of the mandible or with combined mandibular edentulousness. After taking impressions by means of individually fabricated transmitting copings and medium-flow silicone impression compounds, the temporary plastics bridges and the definite telescope bridge prostheses were made of precious metal alloys, using the "Biokop-Orthomat". Essential prerequisites for optimal functional performance of the implant bridge constructions are: creation of optimal occlusal conditions, tangential blocking of the remaining teeth by splinting one implant abutment with at least two natural teeth, and gingiva-free modelling of the telescope and crown margins at the implant abutment.

Dental Implantation, Endosseous↗
PubMed1984

Patients referred for stomatognathic treatment--a survey of 282 patients.

The signs and symptoms of mandibular dysfunction and the treatment results were studied in 282 patients referred to the Clinic of Stomatognathic Physiology, Luleå, Sweden. Seventy two per cent of the patients were women. The most common clinical finding was muscles tender to palpation, which was found in 60% of the patients, but other signs such as TMJ-clickings (27%) and limited mandibular movement (16%) were common, as were interferences in the retruded position (33%) and on the non-working side (19%). Splint therapy, therapeutic exercises for the lower jaw and occlusal adjustment in combination with counselling were by far the most common modes of therapy. More than half of the patients had completed the course of treatment within four visits and only a few patients needed more than ten visits. Eighty one per cent of the patients reported no or only mild symptoms after treatment but in a few cases fairly severe or very severe symptoms persisted. The investigation shows that most patients referred because of mandibular dysfunction can be cured or improved with relatively simple treatment methods and after a few visits. In some cases, however, the patients need more complex and time-consuming treatment.

Adolescent↗
PubMed1984

Conservative treatment of mandibular dysfunction. Clinical, experimental and electromyographic studies of biofeedback and occlusal appliances.

Two modes of treatment for mandibular dysfunction, electromyographic biofeedback and occlusal appliances, were studied. Thirty patients were randomly assigned to treatment with biofeedback or splints and it was shown that both therapies reduced signs and symptoms of mandibular dysfunction in the short and long-term perspective. An analysis of potentially useful clinical predictors of the treatment outcome indicated that laboratory diurnal biofeedback may be a useful alternative to splint therapy in cases where night-time bruxing is not the dominating feature. During biofeedback training, from the masseter or frontal muscle, the EMG activity in both muscle areas in 20 patients with acute or chronic mandibular dysfunction decreased within but not between six sessions, progressively more often for the masseter area. The results were valid irrespective of feedback or symptom duration. A simplistic neuromuscular learning model could not alone explain the positive effects on symptoms. It was shown that motivation was important. The EMG activity in the masseter area was greater during experimentally induced stress than under baseline or resting conditions, and greater in the patients than in matched controls. There was no difference between the pain side and the non-pain side. After the biofeedback training, the EMG activity during stress in the patients under identical conditions was lower and at the same level as in the controls, whose responsiveness had not changed. The anxiety level, expressed in TMAS scores, was greater in patients than in controls before but not after treatment. The influence on the integrated EMG activity in the masseter and temporal muscles after night-time use of appliances with different occlusal design was studied in 17 healthy subjects. After use of stabilisation splints, the activity in the temporal muscle was lower in the rest position and lower than after use of bite plates. The activity during gentle and maximal biting had not changed. The mean activity in a control group of 8 subjects had not changed at any functional level. A positive correlation between clinical signs and level of EMG activity in the temporal muscle in the rest position was observed in 19 patients with mandibular dysfunction. The patients also had less activity in the masseter and temporal muscles during maximal biting compared to healthy subjects. No change in EMG activity could be observed after night-time use of stabilisation splints or bite plates for six weeks, although the symptoms improved.(ABSTRACT TRUNCATED AT 400 WORDS)

Adolescent↗
PubMed2005

Indications for splinting implant restorations.

PURPOSE: The purpose of this article was to review the literature concerning the need to splint implants together when restoring them with a provisional restoration immediately after implant placement. METHODS: The literature is reviewed concerning the rationale for splinting teeth and reports concerning the efficacy of splinting implants together. Based on this team's experience with a prospective series of consecutive 2 to 5 unit provisionalization cases, guidelines are included with case examples for understanding the technique. CONCLUSION: As long as canine guidance is present, and occlusion is stable, multiunit single quadrant restorations do not need to be splinted when provisionalized.

Dental Abutments↗
PubMed1982

Combined method to determine the therapeutic position for occlusal rehabilitation.

Differences of opinion concerning the correct reference position for occlusal rehabilitation and the correct methods for diagnosis are partly due to the tendency to overemphasize either the clinical or radiologic approach. However, careful comparison of data from radiography, clinical examination, and occlusal analysis offers the best opportunity for correct diagnosis and treatment. A combined method has been described for the determination of mandibular displacement in the IP and the correct reference position for occlusal rehabilitation. Integration of data from radiology, clinical examination, and occlusal analysis allows location of the condyles and the lower midline, thus providing the best opportunity for a correct diagnosis. The selected therapeutic position is then achieved at the beginning of treatment through a splint constructed on casts mounted on an articulator.

Dental Occlusion, Balanced↗
PubMed1980

[The corrective phase of periodontal therapy].

After pointing to the hygienizing phase which must in any case precede, the author deals with the medicinal local and general treatment, the occlusal function diagnosis, the function analysis, and the fundamentals of the grinding therapy. Furthermore, the temporary splinting, the treatment of secondary malpositions and problems as well as methods of periodontal surgery are mentioned.

Dental Occlusion, Balanced↗
PubMed1996

Loss of osseointegration caused by occlusal load of oral implants. A clinical and radiographic study in monkeys.

The breakdown of bone around oral implants following excessive occlusal load or plaque accumulation was evaluated in monkeys. 5 screw type implants of pure titanium (Astra) were inserted in the mandible of 4 monkeys (Macaca Fascicularis). 2 implants were placed in each of the lateral segments and 1 in the frontal area. Each monkey was provided with 2 cemented splints covering the premolars and molars in the right and left side of the maxilla, respectively. 6 months after insertion of the fixtures, a fixed partial prosthesis was mounted on the 2 implants in one of the lateral segments. The prosthesis was in supra-occlusal contact with the antagonizing splint. Each prosthesis was replaced during the course of the experiment. The renewed prosthesis caused a lateral displacement of the mandible during occlusion, and therefore resulted in a lateral rather than axial excessive occlusal load. Implants retaining the prosthesis were brushed 1 x a week and subgingival cleaning was performed 1 x a month. The remaining implants were never cleaned and, additionally, a cotton cord was placed passively around each of these to promote plaque accumulation. 5 out of 8 implants with excessive occlusal load lost osseointegration (mobility and peri-implant radiolucency). The loss of osseointegration was observed 4.5 months to 15.5 months after the occlusal overload was commenced. None of the implants with plaque accumulation lost osseointegration, although an average loss of 1.8 mm in the radiographic bone level was assessed after 18 months.

Alveolar Bone Loss↗
PubMed1991

Bicuspid buildup (convertible) splint.

All clinicians using removable repositioning orthotics are faced with the dilemma of lack of patient compliance. The author has solved this problem by using a maxillary appliance with an anterior inclined plane with intraocclusal acrylic in the bicuspid area. After mandibular reposturing is accomplished, the inclined plane can be removed, thus converting the appliance to a bicuspid buildup splint. This conversion creates an appliance that is esthetic and allows for normal phonation and a new bicuspid-only centric occlusion.

Bicuspid↗
PubMed1989

Short-term effect of a stabilization splint on the asymmetry of submaximal masticatory muscle activity.

Ten healthy subjects continuously wore equilibrated maxillary full-arch stabilization splints in the retruded position for 7 days. The muscular activity balance of the masseter muscles during submaximal isometric clenching at 10% and 50% of the maximum voluntary contraction (MVC) did not change immediately on insertion of the splint, but was improved at the 50% level after 7 days (P less than 0.05). While the muscular balance of the anterior temporal muscles was not affected, either immediately on splint insertion, or after wearing it for 7 days, temporal muscle activity at 10% of the MVC was greater on the side to which the mandible moved from the retruded contact position (RCP) to the inter-cuspal position (ICP), both before (P less than 0.025) and after (P less than 0.01) wearing the splint. Splint removal after 7 days resulted in increased awareness of interferences in the ICP and increases in masseter muscle asymmetry (10%, P less than 0.025; 50%, P less than 0.05) when the electromyograms in the ICP after splint removal were compared with those on the stabilization splint before removal. After wearing the splint, the masseter muscle activity at the 10% level was greater on the side where premature contacts were present in the RCP (P less than 0.01). The use of masticatory muscle asymmetry indices in the evaluation of splint treatment for craniomandibular dysfunction is indicated since submaximal masticatory muscle activity is related to occlusal stability, premature contacts in the RCP and the direction of lateral slides from the RCP to the ICP.

Adaptation, Physiological↗
PubMed2001

Orthodontic finalization strategies in dysfunctional adult patients.

Although orthodontic treatment for the finalization of temporomandibular dysfunction (TMD) patients is often advocated, it represents a risk of failure. Furthermore, in the literature there are few articles that illustrate appropriate orthodontic strategies for the finalization of these patients. In this article the authors suggest a step-by-step clinical procedure in order to: 1. verify the rationale for orthodontic finalization in TMD patients; 2. illustrate the guidelines for correct orthodontic treatment; and 3. suggest a strategy to stabilize the mandible during orthodontic treatment and to retain that stabilization after treatment. If splint therapy is successful in relieving the TMD symptoms, a fixed posterior bilateral stop is used for occlusal stability. After one or two months during which the bilateral stop is shown to be adequate in maintaining TMJ health without a splint, orthodontic finalization can be performed with minimal risk of failure. The essential sequences of Class I, Class II, and Class III treatment for the finalization of TMD patients are also presented. The difficult goal of a long term stability in cases that have been orthodontically finalized is reached by the conversion of the posterior bilateral stops (crown build-ups) into permanent vertical stops.

Adolescent↗
PubMedDate not supplied

Comparisons of tactile thresholds between implant-supported fixed partial dentures and removable partial dentures.

This study compared the tactile sensitivity of splinted abutment and denture teeth of 16 fixed partial dentures (FPD) supported by blade implants and 16 removable partial dentures (RPD) in patients with Kennedy Class I and Class II edentulous conditions. No significant differences were noted between the tactile thresholds of the natural abutment teeth and artificial teeth in the FPD and RPD groups. The splinted abutment teeth required 45.4 g, or 5.4 to 5.8 times higher occlusal loads than did those needed for the comparable nonsplinted teeth, to detect the stimulus. A further increase of 54% in thresholds with the FPD and over 100% with the placement of the RPD indicated the superiority of the RPD in terms of load distribution as a result of the cross-arch splinting and mucosal support. Moderate positive correlations (r = 0.37 to 0.46; P < .05) between tactile thresholds and masticatory performance were found, signifying that reduced tactile perception was not responsible for the incomplete restoration of the masticatory function with RPDs or FPDs but might be contributing to increased masticatory performance within both treatment groups.

Analysis of Variance↗
PubMedDate not supplied

[Torectomy wound protection splint].

A case report of upper edentulous arch patient had been to remove torus palatinus. The post-operative wound was protected by the splint. It was made from thin clear plastic and was pressed under high pressure vacuum on the study model. The study model was made by taking impression with easily and conveniently technique. The study model is also representative the post-operative condition of upper edentulous arch. After the palatal torectomy the splint was inserted and immobilized by suturing with black silk #3/0.

Exostoses↗