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Kireilyte M, Ancevicius P, Baltrusaityte A, Maciulskiene V, Zekonis G. Temporary Hydrostatic Splint Therapy and Its Effects on Occlusal Forces. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1051. [PMID: 39064477 DOI: 10.3390/medicina60071051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Revised: 06/11/2024] [Accepted: 06/21/2024] [Indexed: 07/28/2024]
Abstract
Background and objectives: This study analyzed and compared the distribution patterns of occlusal forces using T-Scan III before and after the hydrostatic temporary oral splint (Aqualizer Ultra) therapy in healthy subjects and subjects with temporomandibular disorders (TMDs). Materials and Methods: Fifty-one subjects were divided into groups based on anamnesis and responses to the Fonseca questionnaire. The first group, non-TMDs group (n = 19), and the second group, TMDs group (n = 32), had mild-to-severe TMDs, as identified by the Fonseca questionnaire. The non-TMDs group had an average age of 25.4 years (SD = 4.8, range 20-38) with 15 females (78.95%) and 4 males (21.05%). The TMDs group had an average age of 27.4 years (SD = 7.0, range 22-53) with 25 females (78.125%) and 7 males (21.875%). T-Scan III device was used for occlusal analysis before and after hydrostatic splint usage. Results: Significant differences were observed in the TMDs group for anterior and posterior right percentages of forces before and after hydrostatic splint usage. The analysis of force distribution per sector before and after hydrostatic splint therapy showed no significant differences in the non-TMDs group. Analysis of force distributions in the entire study population before and after hydrostatic splint therapy showed significant differences in the anterior and posterior right regions. Occlusal force increased by 32-56% in the front region and decreased in the posterior area after hydrostatic splint usage. Conclusions: Hydrostatic splint therapy is recommended as a part of full-mouth rehabilitation treatment for all patients regardless of the severity of TMDs.
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Affiliation(s)
- Mante Kireilyte
- Department of Prosthodontics, Faculty of Dentistry, Academy of Medicine, Lithuanian University of Health Sciences, LT-50106 Kaunas, Lithuania
| | | | - Ausra Baltrusaityte
- Department of Prosthodontics, Faculty of Dentistry, Academy of Medicine, Lithuanian University of Health Sciences, LT-50106 Kaunas, Lithuania
| | - Vita Maciulskiene
- Department of Dental and Oral Pathology, Faculty of Dentistry, Academy of Medicine, Lithuanian University of Health Sciences, LT-50009 Kaunas, Lithuania
| | - Gediminas Zekonis
- Department of Prosthodontics, Faculty of Dentistry, Academy of Medicine, Lithuanian University of Health Sciences, LT-50106 Kaunas, Lithuania
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Klepzig K, Wendt J, Teusch L, Rickert C, Kordaß B, Lotze M. Pain and salivary biomarkers of stress in temperomandibular disorders were affected by maxillary splints. J Oral Rehabil 2024; 51:1025-1033. [PMID: 38475974 DOI: 10.1111/joor.13678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 12/08/2023] [Accepted: 02/26/2024] [Indexed: 03/14/2024]
Abstract
BACKGROUND Longitudinal intervention studies on treatment options in temporomandibular dysfunction (TMD) including self reports and salivary biomarkers of stress are rare and the exact therapeutic function of occlusal splints widely unknown. METHODS We examined the therapeutic effects of a Michigan splint with occlusal relevance in patients with TMD using a placebo-controlled, delayed-start design. Two intervention groups received a Michigan splint, while one of them had a placebo palatine splint for the first 3 weeks. We collected pain intensities (at rest and after five occlusal movements), salivary measures associated with stress (cortisol and alpha-amylase) and self-reported psychological distress (stress, anxiety, catastrophizing) at baseline and 3 and 7 weeks after onset of intervention. RESULTS At baseline, we observed increased pain intensity and psychological distress in TMD patients compared to 11 matched healthy controls. Baseline anxiety was linked to movement pain intensity through stress. Over therapy reductions in pain intensity and morning cortisol were more pronounced in those patients starting immediately with the Michigan splint, while psychological distress decreased similarly in both groups. CONCLUSION Our results suggest that perceived stress plays a role for the association between anxiety and TMD pain and underlines the need for an interdisciplinary perspective on the pathogenesis and therapy of TMD in a setting where psychotherapeutic knowledge is still scarce or rarely applied.
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Affiliation(s)
- K Klepzig
- Functional Imaging Unit, Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - J Wendt
- Psychology, Potsdam, Germany
| | - L Teusch
- Functional Imaging Unit, Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - C Rickert
- Functional Imaging Unit, Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
| | - B Kordaß
- Department of Dental Radiology, Centre of Dentistry and Oral Health, University Medicine Greifswald, Greifswald, Germany
- Department of Clinical Dental CAD/CAM and CMD-Treatment, Centre of Dentistry and Oral Health, University Medicine Greifswald, Greifswald, Germany
| | - M Lotze
- Functional Imaging Unit, Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany
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Buchbender M, Keplinger L, Kesting MR, Adler W, Schmitt CM. A clinical trial: Aqualizer ™ therapy and its effects on myopathies or temporomandibular dysfunctions. Part I: Objective parameters. Cranio 2024; 42:1-9. [PMID: 33590803 DOI: 10.1080/08869634.2021.1885886] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Symptoms of temporomandibular dysfunction (TMD) may include pain in the muscles or restrictions opening the mouth. The aim of this study was to assess the effects of initial Aqualizer™ therapy. METHODS Group 1 received initial Aqualizer™ therapy before definitive hard splint; Group 2 received no initial therapy. Patients with arthrosis, partial/total prosthesis or undergoing splint therapy were excluded. Objective (temporomandibular joint palpation, temporomandibular joint auscultation, palpation of the chewing muscles, and mobility of the lower jaw) parameters were evaluated. The level of statistical significance was 5% (p < 0.05). RESULTS In 53 patients (Group 1 n = 25; Group 2 n = 28), a significant improvement (p < 0.001) was found in Group 1 in pain on palpation (masseter muscle, temporal muscle, post-mandibular region, lateral pterygoid muscle, and suboccipital region), but no significant differences in jaw mobility were found. CONCLUSION Aqualizer™ therapy produces significant improvement of primary symptoms.
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Affiliation(s)
- Mayte Buchbender
- Department of Oral and Maxillofacial Surgery, University of Erlangen- Nuremberg, Erlangen, Germany
| | - Lukas Keplinger
- Department of Oral and Maxillofacial Surgery, University of Erlangen- Nuremberg, Erlangen, Germany
| | - Marco R Kesting
- Head of the Department of Oral and Maxillofacial Surgery, University of Erlangen- Nuremberg, Germany
| | - Werner Adler
- Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen Nuremberg, Erlangen, Germany
| | - Christian M Schmitt
- Department of Oral and Maxillofacial Surgery, University of Erlangen- Nuremberg, Erlangen, Germany
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Buchbender M, Keplinger L, Kesting MR, Adler W, Schmitt CM. A clinical trial: Aqualizer ™ therapy and its effects on myopathies or temporomandibular dysfunctions. Part II: Subjective parameters. Cranio 2023; 41:479-485. [PMID: 33586626 DOI: 10.1080/08869634.2021.1885887] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE Temporomandibular dysfunction (TMD) reduces patients' quality of life (QoL). The aim was to assess the effects of initial Aqualizer™ therapy. METHODS Group 1 (initial Aqualizer™ therapy) before definitive splint therapy or Group 2 (no initial therapy). Patients with arthrosis, partial/total prosthesis, or were undergoing splint therapy were excluded. Subjective parameters were evaluated: duration and intensity of pain, influence on wellbeing, changes in the head/neck area, handling and improvement of the Aqualizer™, improvement in QoL. The statistical significance level was 5% (p < 0.05). RESULTS In 53 patients (Group 1 n = 25; Group 2 n = 28), the improvement in patients' well-being and intensity of pain in both groups was significant (p < 0.001). An improvement in QoL was found in 84% of patients in Group 1 and 75% in Group 2. CONCLUSION Initial Aqualizer™ therapy can decrease the intensity of pain and increase patients'.
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Affiliation(s)
- Mayte Buchbender
- Department of Oral and Maxillofacial Surgery, University of Erlangen- Nuremberg, Erlangen, Germany
| | - Lukas Keplinger
- Department of Oral and Maxillofacial Surgery, University of Erlangen- Nuremberg, Erlangen, Germany
| | - Marco R Kesting
- Head of the Department of Oral and Maxillofacial Surgery, University of Erlangen- Nuremberg, Erlangen, Germany
| | - Werner Adler
- Department of Medical Informatics, Biometry and Epidemiology, University of Erlangen Nuremberg, Erlangen, Germany
| | - Christian M Schmitt
- Department of Oral and Maxillofacial Surgery, University of Erlangen- Nuremberg, Erlangen, Germany
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Akbulut AS. The Effect of TMJ Intervention on Instant Postural Changes and Dystonic Contractions in Patients Diagnosed with Dystonia: A Pilot Study. Diagnostics (Basel) 2023; 13:3177. [PMID: 37891998 PMCID: PMC10606201 DOI: 10.3390/diagnostics13203177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 10/04/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023] Open
Abstract
(1) Background: The aim of the present study is to analyze the instant postural changes and changes in the dystonic contractions among patients with dystonia following the use of an intraoral device called a key integrative dynamic TMJ treatment appliance (KIDTA). (2) Methods: Twelve subjects, previously diagnosed with dystonia were enrolled. Their existing records were utilized to assess the changes in their posture and dystonic contractions. The posture analysis was conducted using a mobile application (APECS). The initial records (T0) and records acquired after the delivery of the KIDTA (T1) were utilized in the analysis. The Wilcoxon signed-rank test was performed to compare parameters between T0 and T1, with a significance level set at p < 0.05. (3) Results: Based on the Wilcoxon signed-rank test, statistically significant differences in T1 compared to T0 were observed in the severity of dystonic spasms, body alignment, head shift, head tilt, shoulder alignment, shoulder angle, axillae alignment, ribcage tilt, pelvic tilt, knee angle, and tibia angle (p < 0.05). (4) Conclusions: Within the limitations of the present pilot study, an intervention to the TMJ through a KIDTA appliance seems to mitigate the severity of dystonic contractions and improve the posture with respect to certain postural parameters.
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Perea-Lowery L, Gibreel M, Garoushi S, Vallittu P, Lassila L. Evaluation of flexible three-dimensionally printed occlusal splint materials: An in vitro study. Dent Mater 2023; 39:957-963. [PMID: 37666693 DOI: 10.1016/j.dental.2023.08.178] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 08/23/2023] [Indexed: 09/06/2023]
Abstract
OBJECTIVE To evaluate and compare the mechanical properties, water sorption, water solubility, and degree of double bond conversion of three different commercially available three-dimensional (3D) printing resins used for the fabrication of flexible occlusal splints. METHODS A digital printer was used to generate specimens from the evaluated splint materials (KeySplint Soft, IMPRIMO LC Splint flex, and V-Print splint comfort). The specimens were equally divided and tested either dry or after water storage at 37 °C for 30 days. A three-point bending test was used to assess flexural strength, elastic modulus, and fracture toughness. A two-body wear test was performed using a dual-axis chewing simulator. Water sorption and water solubility were measured after 30 days. The degree of double bond conversion was determined by FTIR-spectrometry. All data for the evaluated properties were collected and statistically analyzed. RESULTS Both material and storage conditions had a significant effect on the flexural strength (P < 0.001), elastic modulus (P < 0.001), fracture toughness (P < 0.001), and wear (P < 0.001). The highest water sorption was noticed with IMPRIMO LC Splint flex (1.9 ± 0.0 %), while V-Print splint comfort displayed the lowest water solubility (0.2 ± 0.0 %). For the degree of conversion, it was statistically non-significant among the different materials (P = 0.087). SIGNIFICANCE Different flexible 3D-printed splints available in the market displayed variations in the evaluated properties and clinicians should consider these differences when choosing occlusal device materials. Among the tested flexible splint materials, KeySplint Soft had the greatest flexural strength, elastic modulus, fracture toughness, wear resistance, and degree of conversion. It also showed the lowest water sorption.
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Affiliation(s)
- Leila Perea-Lowery
- Department of Biomaterials Science and Turku Clinical Biomaterials Centre-TCBC, Institute of Dentistry, University of Turku, Turku 20520, Finland.
| | - Mona Gibreel
- Department of Biomaterials Science and Turku Clinical Biomaterials Centre-TCBC, Institute of Dentistry, University of Turku, Turku 20520, Finland
| | - Sufyan Garoushi
- Department of Biomaterials Science and Turku Clinical Biomaterials Centre-TCBC, Institute of Dentistry, University of Turku, Turku 20520, Finland
| | - Pekka Vallittu
- Department of Biomaterials Science and Turku Clinical Biomaterials Centre-TCBC, Institute of Dentistry, University of Turku, Turku 20520, Finland; City of Turku Welfare Division, Oral Health Care, Puolalankatu 5, 20101 Welfare Division, Turku FI-20101, Finland
| | - Lippo Lassila
- Department of Biomaterials Science and Turku Clinical Biomaterials Centre-TCBC, Institute of Dentistry, University of Turku, Turku 20520, Finland
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Orzeszek S, Waliszewska-Prosol M, Ettlin D, Seweryn P, Straburzynski M, Martelletti P, Jenca A, Wieckiewicz M. Efficiency of occlusal splint therapy on orofacial muscle pain reduction: a systematic review. BMC Oral Health 2023; 23:180. [PMID: 36978070 PMCID: PMC10053140 DOI: 10.1186/s12903-023-02897-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND This systematic review aims to examine the existing original studies to determine the effectiveness of occlusal splints (OSs) in the management of orofacial myalgia and myofascial pain (MP) in comparison with no treatment or other interventions. MATERIALS AND METHODS Based on the inclusion and exclusion criteria of this systematic review, randomized controlled trials were qualified, in which the effectiveness of occlusal splint therapy in the management of muscle pain was examined in comparison with no treatment or other interventions. This systematic review was conducted according to the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020. The authors searched three databases (PubMed, CINAHL (The Cumulative Index to Nursing and Allied Health Literature) and Scopus) for English publications published between January 1, 2010, and June 1, 2022. The last database search was carried out on June 4, 2022. Data were extracted from the included studies and assessed for risk of bias using the revised Cochrane risk-of-bias tool for randomized trials. RESULTS Thirteen studies were identified for inclusion in this review. In total, 589 patients were diagnosed with orofacial muscle pain who underwent education and various forms of therapy including different types of OSs, light emitting diode therapy, acupuncture, low-level laser therapy, device-supported sensorimotor training, Kinesio Taping, myofunctional therapy, and physical therapy. All studies included demonstrated a high risk of bias. CONCLUSIONS There is insufficient evidence regarding whether OS therapy in the treatment of orofacial myalgia and MP offers an advantage over other forms of interventions or no treatment. Further reliable clinical studies in this area are needed to improve the quality of research, which should be performed with larger groups of blinded respondents and controls. CLINICAL RELEVANCE Due to the large-scale nature of orofacial muscle pain, it is assumed that each dental clinician will meet patients with orofacial muscle pain repeatedly in daily practice; hence, the review of the effectiveness of OSs in the management of orofacial myalgia and MP is necessary.
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Affiliation(s)
- Sylwia Orzeszek
- Department of Experimental Dentistry, Wroclaw Medical University, Wroclaw, Poland
| | | | - Dominik Ettlin
- Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Piotr Seweryn
- Department of Experimental Dentistry, Wroclaw Medical University, Wroclaw, Poland
| | - Marcin Straburzynski
- Department of Family Medicine and Infectious Diseases, University of Warmia and Mazury, Olsztyn, Poland
| | - Paolo Martelletti
- Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
| | - Andrej Jenca
- Clinic of Stomatology and Maxillofacial Surgery, Faculty of Medicine, University Pavol Josef Safarik and Akademia Kosice, Kosice, Slovakia
| | - Mieszko Wieckiewicz
- Department of Experimental Dentistry, Wroclaw Medical University, Wroclaw, Poland.
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Ahmed MMS, Shi D, Al-Somairi MAA, Alhashimi N, Almashraqi AA, Musa M, Li N, Chen X, Alhammadi MS. Three dimensional evaluation of the skeletal and temporomandibular joint changes following stabilization splint therapy in patients with temporomandibular joint disorders and mandibular deviation: a retrospective study. BMC Oral Health 2023; 23:18. [PMID: 36639670 PMCID: PMC9837942 DOI: 10.1186/s12903-023-02720-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 01/05/2023] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Three-dimensional (3D) detailed evaluations of the mandibular mediolateral position, mandibular condylar position, and temporomandibular joint (TMJ) spaces following stabilization splints (SS) therapy in patients with temporomandibular joint disorders (TMD) and mandibular deviation (MD) have not been reported in the available literature. Accordingly, this study aimed to three-dimensionally analyze the skeletal and bony temporomandibular joint changes following stabilization splint therapy in adult patients with temporomandibular joint disorders and mandibular deviation. METHODS This study is a retrospective clinical study that enrolled 26 adult patients with TMD and MD with a mean age of 24.86 years. The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) was used to diagnose TMD. SS was adjusted weekly until occlusal contact stabilization occurred, and then adjusted monthly, patients were instructed to wear it at night for at least 10 h. The SS was removed after the elimination of TMD symptoms (TMJ/muscle pain on palpation, muscle spasm, and clicking) and having both condyles completely seated in a musculoskeletally stable position. Pre- and post-therapeutic Cone Beam Computed Tomography (CBCT) was analyzed. Mandibular mediolateral position, TMJ spaces, and mandibular condyle position were analyzed three-dimensionally using Mimics 21.0 software. Paired t-test or Wilcoxon rank-sum test was performed, and the significance level was considered at P < 0.05. RESULTS The treatment period with SS therapy was 10.07 ± 3.1 months. The deviated chin was improved in 69.23% of the sample; the range of improvement was > 0 mm ≤ 3.9 mm. The mandibular rotation was significantly decreased from 3.58 ± 2.02° to 3.17 ± 1.60. The deviated side's superior and posterior joint TMJ spaces were significantly increased from 2.49 ± 0.88 mm and 1.25 ± 0.79 mm to 2.98 ± 1.02 mm and 1.86 ± 0.72 mm, respectively. The value of the difference from the bilateral condyle head position to the X and Z axes significantly decreased from 2.50 ± 1.56 mm and 2.30 ± 1.57 mm to 1.64 ± 1.58 mm and 1.82 ± 1.11 mm, respectively. CONCLUSION The main positional effect of the stabilization splint treatment in TMD patients with MD includes considerable correction of mandibular deviation, improving facial asymmetry, and moving the condyle into a stable condylar position; these were done by promoting the mandible to rotate around the Z (roll) and Y (yaw) axes and by forward, downward, and outward condylar movement on the deviated side, respectively.
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Affiliation(s)
- Madiha Mohammed Saleh Ahmed
- grid.452438.c0000 0004 1760 8119Department of Stomatology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710061 Shaanxi People’s Republic of China ,grid.411125.20000 0001 2181 7851Department of Orthodontics, Faculty of Dentistry, Aden University, Aden, Republic of Yemen
| | - Danli Shi
- grid.452438.c0000 0004 1760 8119Department of Stomatology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710061 Shaanxi People’s Republic of China ,Department of Stomatology, The First Hospital of Ningbo, Ningbo, 315000 Zhejiang People’s Republic of China
| | - Majedh Abdo Ali Al-Somairi
- grid.412449.e0000 0000 9678 1884Department of Orthodontics, School of Stomatology, China Medical University (PRC), Shenyang, 110122 Liaoning People’s Republic of China
| | - Najah Alhashimi
- grid.412603.20000 0004 0634 1084Department of Pre-Clinical Oral Health Sciences, College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
| | - Abeer A. Almashraqi
- grid.412603.20000 0004 0634 1084Department of Pre-Clinical Oral Health Sciences, College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
| | - Mazen Musa
- grid.452438.c0000 0004 1760 8119Department of Stomatology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710061 Shaanxi People’s Republic of China ,grid.440840.c0000 0000 8887 0449Department of Orthodontics, Al Tegana Dental Teaching Hospital, University of Science and Technology, Omdurman, 11111 Khartoum Sudan
| | - Ning Li
- grid.440653.00000 0000 9588 091XDepartment of Orthodontics, Yantai Stomatological Hospital Affiliated to Binzhou Medical College, Yantai, 264000 People’s Republic of China
| | - Xi Chen
- grid.452438.c0000 0004 1760 8119Department of Stomatology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, 710061 Shaanxi People’s Republic of China
| | - Maged S. Alhammadi
- grid.411831.e0000 0004 0398 1027Division of Orthodontics and Dentofacial Orthopedics, Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia ,grid.412413.10000 0001 2299 4112Postgraduate Orthodontic Program, Department of Orthodontics, Pedodontics and Preventive Dentistry, Faculty of Dentistry, Sana’a University, Sana’a, Republic of Yemen
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Karaseridis K, Dermata A. Cerebral palsy: Oral manifestations and dental management. BALKAN JOURNAL OF DENTAL MEDICINE 2023. [DOI: 10.5937/bjdm2301001k] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023] Open
Abstract
Cerebral palsy is a set of non-progressive neuromuscular disorders caused by defects in the developing fetal brain. Its prevalence is about 2:1000. Although CP does not directly result in any particular oral abnormalities, some conditions are more prevalent or severe in CP patients than in the general population. The purpose of a paediatric dentist is to promote overall oral health wellness and to motivate parents and other primary caregivers to practice good oral hygiene at home. The aim of this article is to provide a general overview of dental health issues that affect people with CP and to analyze key preventative and practical management techniques for this common comorbidity.
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Diagnosis and Treatment of Myogenous Temporomandibular Disorders: A Clinical Update. Diagnostics (Basel) 2022; 12:diagnostics12122914. [PMID: 36552921 PMCID: PMC9776546 DOI: 10.3390/diagnostics12122914] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/15/2022] [Accepted: 11/19/2022] [Indexed: 11/25/2022] Open
Abstract
Myogenous temporomandibular disorders (M-TMDs) are the most common chronic orofacial pain, affecting the masticatory muscles and, thus, jaw movement. While a concise diagnosis is crucial to formulate a rational treatment plan, the similarities in clinical presentations that M-TMDs share with other neuromuscular disorders affecting the temporomandibular joint (TMJ) could easily confuse physicians. In addition to the basics, such as thorough history taking and meticulous clinical examinations, different imaging techniques are useful adjuncts to facilitate the diagnostic process. This review presents an overview of the current understanding on a variety of diagnostic and treatment modalities for M-TMD patients. It is essential to highlight that there is not a single treatment for all, and the benefits of multidisciplinary strategies have been noted for the effective management of myogenous TMD pain. Treatment modalities ranging from conservative to minimally invasive options are discussed in this review.
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Al-Thobity AM, Alkhaltham N, Aldhafiri R, Almasoud NN, Al-Harbi FA, Khan SQ, Gad MM. Effect of Occlusal Splint Therapy on Condylar Movements Recorded Using an Electronic Pantograph: A Prospective Clinical Study. J Int Soc Prev Community Dent 2022; 12:532-539. [PMID: 36532322 PMCID: PMC9753922 DOI: 10.4103/jispcd.jispcd_96_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 07/26/2022] [Accepted: 08/11/2022] [Indexed: 01/25/2023] Open
Abstract
AIMS AND OBJECTIVE The effect of occlusal splint therapy on the muscle activity has been addressed in the literature. However, its effect on condylar movements in subjects with normal and abnormal occlusions has not yet been investigated. This prospective clinical study addressed the effect of occlusal splint therapy on condylar movements in subjects with normal and abnormal occlusions using an electronic pantograph. MATERIALS AND METHODS Two groups of subjects were included in this study. The first group included subjects with normal occlusion, whereas the subjects in the other group were diagnosed with abnormal occlusion. The occlusal splint was fabricated, adjusted clinically, and delivered for each subject. Condylar movements were recorded using a Cadiax Compact II electronic pantograph at baseline, 2-, 4-, and 6-month follow-up periods to assess sagittal condylar inclination (SCI), immediate mandibular lateral translation (IMLT), and progressive mandibular lateral translation (PMLT). The t-test, one-way analysis of variance (ANOVA), and two-way ANOVA were used to compare the parameters between the groups and to assess the time effect on these parameters (α = 0.05). RESULTS Twenty subjects were recruited for this study (n = 10). Among them, 12 were women and eight were men, with a mean age of 34 years. In each group, insignificant differences were reported for each tested parameter at baseline and during the follow-up periods (P > 0.05). However, when comparing the two groups, the only significant difference was found in the SCI during the 6-month follow-up period (P = 0.014). CONCLUSIONS Occlusal splints had an insignificant effect on the parameters SCI, IMLT, and PMLT up to 6 months of follow-up for subjects with normal or abnormal occlusion. SCI increased substantially in normal occlusion subjects compared with abnormal occlusion subjects during the 6-month follow-up period.
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Affiliation(s)
- Ahmad M Al-Thobity
- Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia,Address for correspondence: Dr. Ahmad M. Al-Thobity, Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam 31441, Saudi Arabia. E-mail:
| | - Nora Alkhaltham
- Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Reem Aldhafiri
- Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Naif N Almasoud
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Fahad A Al-Harbi
- Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Soban Q Khan
- Department of Dental Education, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Mohammed M Gad
- Department of Substitutive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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12
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Effect of 3D Printer Type and Use of Protection Gas during Post-Curing on Some Physical Properties of Soft Occlusal Splint Material. Polymers (Basel) 2022; 14:polym14214618. [PMID: 36365611 PMCID: PMC9658356 DOI: 10.3390/polym14214618] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 10/25/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022] Open
Abstract
Despite the fact that three-dimensional (3D) printing is frequently used in the manufacturing of occlusal splints, the effects of the 3D printer type and post-curing methods are still unclear. The aim of this study was to investigate the effect of the printer type (digital light processing: DLP; and liquid crystal display: LCD) as well as the post-curing method with two different atmospheric conditions (air and nitrogen gas (N2)) on the mechanical and surface properties of 3D-printed soft-type occlusal splint material. The evaluated properties were flexural strength, flexural modulus, Vickers hardness (VHN), fracture toughness, degree of double bond conversion (DC%), water sorption, water solubility, and 3D microlayer structure. The printer type significantly affected all the evaluated properties. Flexural strength, flexural modulus, and fracture toughness were significantly higher when specimens were printed by a DLP printer, while VHN and DC% were significantly higher, and a smoother surface was noticeably obtained when printed by an LCD printer. The post-curing at an N2 atmosphere significantly enhanced all of the evaluated properties except water sorption, 3D microlayer structure, and fracture toughness. The current results suggested that the printer type and the post-curing methods would have an impact on the mechanical and surface properties of the evaluated material.
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13
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Ferrillo M, Nucci L, Giudice A, Calafiore D, Marotta N, Minervini G, d'Apuzzo F, Ammendolia A, Perillo L, de Sire A. Efficacy of conservative approaches on pain relief in patients with temporomandibular joint disorders: a systematic review with network meta-analysis. Cranio 2022:1-17. [PMID: 36148997 DOI: 10.1080/08869634.2022.2126079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
OBJECTIVE The aim of this systematic review with meta-analysis was to evaluate the efficacy of conservative interventions in pain relief in patients with intracapsular temporomandibular disorders (TMD). METHODS PubMed, Scopus, and Web of Science were systematically searched until January 1st, 2022 to identify randomized controlled trials (RCTs) presenting patients with diagnosis of intracapsular TMD according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), conservative approaches as interventions, and pain intensity as outcome. RESULTS Out of 3372 papers, 13 RCTs were included, with 844 study participants. Most of them (n = 7) investigated the efficacy of splint appliance. Meta-analysis revealed that rehabilitative interventions had a significant overall effect size of 0.75 [0.17, 1.34], reporting splint appliance and laser therapy as significantly effective treatments. CONCLUSION Findings of this systematic review with network meta-analysis suggested that conservative approaches might be effective in pain relief of intracapsular TMD patients.
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Affiliation(s)
- Martina Ferrillo
- Dentistry Unit, Department of Health Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Ludovica Nucci
- Dentistry Unit, Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Amerigo Giudice
- Dentistry Unit, Department of Health Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Dario Calafiore
- Physical Medicine and Rehabilitation Unit, Department of Neurosciences, ASST Carlo Poma, Mantova, Italy
| | - Nicola Marotta
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Giuseppe Minervini
- Dentistry Unit, Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Fabrizia d'Apuzzo
- Dentistry Unit, Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Antonio Ammendolia
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
| | - Letizia Perillo
- Dentistry Unit, Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Alessandro de Sire
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
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14
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Poorna T A, John B, E K J, Rao A. Comparison of the effectiveness of soft and hard splints in the symptomatic management of temporomandibular joint disorders: A randomized control study. Int J Rheum Dis 2022; 25:1053-1059. [PMID: 35785423 DOI: 10.1111/1756-185x.14379] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 06/12/2022] [Accepted: 06/17/2022] [Indexed: 11/29/2022]
Abstract
AIM Splint therapy is a well-established modality in the management of temporomandibular joint disorders (TMDs). We aimed to evaluate and compare the effectiveness of hard and soft splints in the symptomatic management of TMDs using the modified Helkimo index. METHODS This study included 91 patients diagnosed with TMDs. Participants were randomly allocated into two treatment groups. All these patients were treated by hard or soft stabilization splint therapy. Group 1: hard splint group, n = 42 (mean age - 31.62 ± 8.5 years), 10 males and 32 females; group 2: soft splint group, n = 49 (mean age - 32.86 ± 9.06 years), 13 males and 36 females. The anamnestic and clinical dysfunction component of the modified Helkimo index was used to evaluate the outcomes at baseline (T0 ), first month (T1 ), and third month (T2 ). RESULTS Symptoms such as clicking of the joints, temporomandibular joint (TMJ) pain and muscle pain showed improvement in both groups (P < .05). Restriction and deviation of mouth opening did not show significant improvement in either group. The patients who underwent hard splint therapy showed an early improvement of symptoms at T1 (P < .05). However, there was no statistical difference in the improvement of symptoms between hard and soft splints at T2 . CONCLUSION Both hard and soft stabilization splints were effective in the symptomatic management of TMDs. However, hard splints provide an earlier reduction of symptoms.
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Affiliation(s)
- Anish Poorna T
- Department of Oral and Maxillofacial Surgery, Government Dental College, Kottayam, India
| | - Bobby John
- Department of Oral and Maxillofacial Surgery, Government Dental College, Kottayam, India
| | - Joshna E K
- Department of Oral and Maxillofacial Surgery, Government Dental College, Kottayam, India
| | - Arun Rao
- Department of Public Health Dentistry, Government Dental College, Kottayam, India
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15
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A Pragmatic Approach to the Management of Severe Awake Bruxism in an Adolescent with Cerebral Palsy and Global Developmental Delay. Case Rep Dent 2022; 2022:5288515. [PMID: 35070457 PMCID: PMC8776475 DOI: 10.1155/2022/5288515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 12/15/2021] [Indexed: 11/17/2022] Open
Abstract
Cerebral palsy is a neurological and motor condition characterised by muscle balance and posture impairments. Bruxism and malocclusion were frequently observed in patients with cerebral palsy, in contrast to other oral anomalies. The report outlines how severe awake bruxism is managed in a 16-year-old Korean boy who has nonverbal spastic cerebral palsy and global developmental delay. The treatment protocol involved the fabrication of soft occlusal splints of three and four millimetres in thickness, followed by the placement of stainless-steel crowns on all first permanent molars whilst video recording and a bruxism diary was kept. Fixed restorations demonstrate increased endurance in withstanding bruxism force in persons who are dependent on their caretaker.
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GIBREEL M, PEREA-LOWERY L, VALLITTU PK, GAROUSHI S, LASSILA L. Two-body wear and surface hardness of occlusal splint materials. Dent Mater J 2022; 41:916-922. [DOI: 10.4012/dmj.2022-100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Mona GIBREEL
- Department of Biomaterials Science and Turku Clinical Biomaterials Centre-TCBC, Institute of Dentistry, University of Turku
| | - Leila PEREA-LOWERY
- Department of Biomaterials Science and Turku Clinical Biomaterials Centre-TCBC, Institute of Dentistry, University of Turku
| | | | - Sufyan GAROUSHI
- Department of Biomaterials Science and Turku Clinical Biomaterials Centre-TCBC, Institute of Dentistry, University of Turku
| | - Lippo LASSILA
- Department of Biomaterials Science and Turku Clinical Biomaterials Centre-TCBC, Institute of Dentistry, University of Turku
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17
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Ozturk G, Bal B, Oral K. Electromyographic evaluation of the effect of hard and soft stabilizing appliances on masseter and anterior temporalis muscles in asymptomatic individuals. BALKAN JOURNAL OF DENTAL MEDICINE 2022. [DOI: 10.5937/bjdm20220812-002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Background/Aim: Stabilization appliances have traditionally been used for the treatment of temporomandibular disorders and bruxism. The aim of this study was to evaluate the effect of two appliances (hard and soft) with different thicknesses on the electromyographic (EMG) activities of masseter and anterior temporalis muscles. Material and Methods: 30 healthy subjects have been divided into two groups of 15, according to the appliance material used (soft, hard). For each subject in both groups, two appliances have been prepared with 3 mm and 6 mm thickness. EMG recordings of bilateral masseter and anterior temporalis muscles were taken for each appliance. Results: The results showed that, the decrease in average EMG values during maximum voluntary clenching with a 3-mm and 6-mm-thick hard appliance was statistically significant compared with the average EMG of maximum voluntary clenching in the intercuspal position. The increase in average EMG values during maximum voluntary clenching with a soft appliance of 3 mm and 6 mm thickness was statistically significant. Conclusions: The hard stabilization appliances decrease the activity of the masseter and temporalis muscles, while the soft appliances increase the activity of the masseter and temporalis muscles.
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18
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A Hybrid Oral Rehabilitation of Hypohidrotic Ectodermal Dysplasia: A Conservative Approach with Three-Year Follow-Up. Case Rep Dent 2021; 2021:7469595. [PMID: 34931149 PMCID: PMC8684530 DOI: 10.1155/2021/7469595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 11/07/2021] [Accepted: 11/10/2021] [Indexed: 11/18/2022] Open
Abstract
This case report presents a 19-year-old male patient with hypohidrotic ectodermal dysplasia, having a chief complaint of multiple missing teeth. Atraumatic extraction of the teeth with hopeless prognosis was done, and teeth with grade 2 mobility were submerged using cast dowel and coping. Following this, incremental increase in the vertical dimension was made using removable flexible splint of two-millimeter thickness. After facebow transfer and making appropriate eccentric bite records to program the semiadjustable articulator, wax-up was done at the desired vertical dimension (VD). The upper arch was finally restored using a long-span fixed partial denture and lower arch using bilateral attachment (Rhein 83) retained cast removable partial denture as a definitive prosthesis. Therefore, in conditions like hypodontia or oligodontia caused due to ectodermal dysplasia, attachment retained removable partial denture may prove beneficial by effectively distributing the occlusal forces. In clinical scenarios where implant is not feasible or not opted by the patient, this combination treatment may be a viable option.
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19
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Ram HK, Shah DN. Comparative evaluation of occlusal splint therapy and muscle energy technique in the management of temporomandibular disorders: A randomized controlled clinical trial. J Indian Prosthodont Soc 2021; 21:356-365. [PMID: 34810363 PMCID: PMC8617449 DOI: 10.4103/jips.jips_332_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Background: Contradicting evidence regarding the effects of occlusal splint therapy in the management of Temporomandibular disorder (TMD) and promising results shown by muscle energy technique. Aim: To determine and compare the effects of occlusal splint therapy, muscle energy technique, and combined treatment with education for self-management and counseling in the management of TMD. Study Design and Settings: Randomized clinical trial. Methodology: A total of 160 participants diagnosed with TMD according to Diagnostic Criteria/TMD axis I were randomly allocated into four treatment groups with equal allocation ratio using random numbers table. The main inclusion criteria were the presence of pain in the preauricular area, TMJ and/or muscles of mastication and maximum mouth opening <40 mm. Group A participants received muscle energy technique, Group B participants received occlusal splint therapy, Group C participants received combined treatment, and Group D participants received education for self-management and counseling (control). Control group treatment was provided to all the trial participants. Statistical Analysis: Intragroup comparison was made using Friedman test and Wilcoxon test while intergroup comparison was done using Kruskal–Wallis test and Mann–Whitney U test. Results: Intensity of pain on a visual analog scale and maximum mouth opening were measured at baseline, at 1 week, at 2 weeks, at 1 month, and after 3 months. Conclusion: Muscle energy technique, occlusal splint therapy and combined treatment significantly reduce pain compared to controls and muscle energy and combined treatment are superior to other groups for mouth opening improvements in patients with TMD.
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Affiliation(s)
- Hardik K Ram
- Dental Department, Government Hospital, Keshod, Gujarat, India
| | - Darshana N Shah
- Department of Prosthodontics, Ahmedabad Dental College and Hospital, Ahmedabad, Gujarat, India
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20
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Shousha T, Alayat M, Moustafa I. Effects of low-level laser therapy versus soft occlusive splints on mouth opening and surface electromyography in females with temporomandibular dysfunction: A randomized-controlled study. PLoS One 2021; 16:e0258063. [PMID: 34597318 PMCID: PMC8486092 DOI: 10.1371/journal.pone.0258063] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 09/13/2021] [Indexed: 12/25/2022] Open
Abstract
Background Low level lasers have been used as an alternative pain relief therapy for muscle and joint pain, since it induces analgesic, anti-inflammatory, and biomodulation effects of the physiological cell functions. The effectiveness of low-level laser therapy in temporomandibular joint dysfunction (TMD) treatment, however, is not well established. Although Surface electromyography (sEMG) has been suggested as a complementary means in TMD diagnosis, the effect of conservative treatments on muscle activity has not yet been thoroughly correlated with (sEMG) findings. Purpose To assess the efficacy of low-level laser therapy (LLLT) as compared to occlusive splint therapy (OST) on the TMJ opening index (TOI) and sEMG of masticatory muscles. Materials and methods 112 female subjects suffering from unilateral myogenous TMD, aged 21–30 years-old, were recruited and divided into three groups: LLLT; soft occlusive splint therapy OST and a waitlist group as controls. Outcome measures TMJ opening index (TOI), Visual analogue scale (VAS), surface electromyography (sEMG). Results A significant reduction was reported in TOI, VAS and the sEMG within the LLLT and OST groups as well as significant decrease in all outcomes between groups in favor of the LLLT group (P< 0.0001). Meanwhile, there was a weak significant difference within the control group probably attributed to the analgesic. Post-hoc pairwise comparisons between groups [control vs occlusive splints, control vs low-level laser and low-level laser vs occlusive splints] revealed significant differences in the VAS and TOI [P = 0.0001; 95% CI: 0.9–2.2, 1.61–4.01, 0.65–1.96]. Conclusions Findings support an evident short term therapeutic effect of the LLLT on improving VAS, TOI and sEMG in females suffering from myogenous TMD.
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Affiliation(s)
- Tamer Shousha
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Faculty of Physical Therapy, Cairo University, Cairo, Egypt
- * E-mail:
| | - Mohamed Alayat
- Faculty of Physical Therapy, Cairo University, Cairo, Egypt
- Physical Therapy Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Mecca, KSA
| | - Ibrahim Moustafa
- Department of Physiotherapy, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
- Faculty of Physical Therapy, Cairo University, Cairo, Egypt
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21
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Rosentritt M, Huber C, Strasser T, Schmid A. Investigating the mechanical and optical properties of novel Urethandimethacrylate (UDMA) and Urethanmethacrylate (UMA) based rapid prototyping materials. Dent Mater 2021; 37:1584-1591. [PMID: 34417024 DOI: 10.1016/j.dental.2021.08.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 08/06/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study is focused on testing experimental rapid prototyping materials for occlusal splints made from Urethandimethacrylate (UDMA) and Urethanmethacrylate (UMA). METHODS Materials were mixed from UDMA and UMA in ratios of 1.0:0.0, 0.75:0.25, 0.5:0.5, 0.25:0.75 and 0.0:1.0. Specimens were printed using digital light processing (DLP). After post-processing, the specimens underwent testing on flexural strength, modulus of elasticity, hardness, wear behavior, surface roughness, gloss and color stability. All tests were performed after 24 h (baseline) and 10 days of water storage (aging). Splints underwent cyclic pull-off and insertion testing, which was alongside simulated using finite element analysis. RESULTS The mechanical properties were significantly influenced by changes in the UDMA:UMA ratio. Statistical analysis revealed that increased amounts of UMA correlated with a decrease in flexural strength (92.0 to 30.7 MPa), modulus of elasticity (2.4 to 0.6 GPa), hardness (155.1 to 102.0 N/mm2) and wear resistance (-1394.9 to -1742.1 μm). Materials with higher amounts of UMA were also more likely to be influenced by water storage. Specimens with 75% and 100% UMA content were partly not analyzable due to soft consistency. Optical properties showed only minor influence from UMA content and aging. Differences in surface roughness (3.9 to 2.4 μm) and color stability were insignificant. Gloss was partly influenced by the UDMA:UMA ratio and water storage. Mean survival rates for cyclic pull-off and insertion testing ranged from 2537 to 23,857 cycles. A correlation between the amount of UMA and survival rates was observed. SIGNIFICANCE The addition of up to 25% UMA showed promising results, complying with clinical standards and delivering acceptable results in the cyclic pull-off and insertion test. Further investigation on increments between 0 and 25% UMA could help to find an optimum.
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Affiliation(s)
- Martin Rosentritt
- UKR University Hospital Regensburg, Department of Prosthetic Dentistry, 93042 Regensburg, Germany
| | - Christina Huber
- UKR University Hospital Regensburg, Department of Prosthetic Dentistry, 93042 Regensburg, Germany
| | - Thomas Strasser
- UKR University Hospital Regensburg, Department of Prosthetic Dentistry, 93042 Regensburg, Germany
| | - Alois Schmid
- UKR University Hospital Regensburg, Department of Prosthetic Dentistry, 93042 Regensburg, Germany.
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22
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Li DTS, Leung YY. Temporomandibular Disorders: Current Concepts and Controversies in Diagnosis and Management. Diagnostics (Basel) 2021; 11:diagnostics11030459. [PMID: 33800948 PMCID: PMC8000442 DOI: 10.3390/diagnostics11030459] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 03/04/2021] [Accepted: 03/05/2021] [Indexed: 12/17/2022] Open
Abstract
Temporomandibular disorders (TMD) are a group of orofacial pain conditions which are the most common non-dental pain complaint in the maxillofacial region. Due to the complexity of the etiology, the diagnosis and management of TMD remain a challenge where consensus is still lacking in many aspects. While clinical examination is considered the most important process in the diagnosis of TMD, imaging may serve as a valuable adjunct in selected cases. Depending on the type of TMD, many treatment modalities have been proposed, ranging from conservative options to open surgical procedures. In this review, the authors discuss the present thinking in the etiology and classification of TMD, followed by the diagnostic approach and the current trend and controversies in management.
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Kashiwagi K, Noguchi T, Fukuda K. Effects of soft occlusal appliance therapy for patients with masticatory muscle pain. J Dent Anesth Pain Med 2021; 21:71-80. [PMID: 33585686 PMCID: PMC7871186 DOI: 10.17245/jdapm.2021.21.1.71] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 12/17/2020] [Accepted: 01/08/2021] [Indexed: 11/15/2022] Open
Abstract
Background The options for stabilization appliance therapy for masticatory muscle pain include soft occlusal and hard stabilization appliances. A previous study suggested that hard stabilization appliance therapy was effective for patients with local myalgia who developed long facets on their occlusal appliances. The objective of this study was to identify patients in whom a soft occlusal appliance should be used to treat masticatory muscle pain by analyzing the type of muscle pain present and patient factors that influenced the effectiveness of this treatment. Methods The study included 42 patients diagnosed with local myalgia or myofascial pain according to the Diagnostic Criteria for Temporomandibular Disorders Diagnostic Decision Tree. The analysis of patient factors included variables believed to be associated with temporomandibular disorders. First, a temporary screening appliance was used for 2 weeks to assess each patient for bruxism during sleep. Soft appliance therapy was then started. For each patient, the effectiveness of the appliance was evaluated according to the intensity of tenderness during muscle palpation and the treatment satisfaction score at one month after starting treatment. Results Data from 37 of the 42 patients were available for analysis. Twenty-five patients reported satisfaction with the appliance. In logistic regression analysis, the odds ratio for reduction of facet length was 1.998. Nineteen patients showed at least a 30% improvement in the visual analog scale score. The odds ratio for local myalgia was 18.148. Conclusion Soft appliance therapy may be used in patients with local myalgia. Moreover, patients who develop short facets on the appliance surface are likely to be satisfied with soft appliance therapy. Soft appliance therapy may be appropriate for patients with local myalgia who develop short facets on their occlusal appliance.
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Affiliation(s)
- Kosuke Kashiwagi
- Division of Special Needs Dentistry and Orofacial Pain, Department of Oral Health and Clinical Science, Tokyo Dental College, Tokyo, Japan
| | - Tomoyasu Noguchi
- Division of Special Needs Dentistry and Orofacial Pain, Department of Oral Health and Clinical Science, Tokyo Dental College, Tokyo, Japan
| | - Kenichi Fukuda
- Division of Special Needs Dentistry and Orofacial Pain, Department of Oral Health and Clinical Science, Tokyo Dental College, Tokyo, Japan
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Zhang SH, He KX, Lin CJ, Liu XD, Wu L, Chen J, Rausch-Fan X. Efficacy of occlusal splints in the treatment of temporomandibular disorders: a systematic review of randomized controlled trials. Acta Odontol Scand 2020; 78:580-589. [PMID: 32421379 DOI: 10.1080/00016357.2020.1759818] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE This systematic review aimed to assess the efficacy of occlusal splints in the treatment of temporomandibular disorders (TMDs). MATERIAL AND METHODS This systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Four databases (Medline via Pubmed, Web of Science, Embase and Scopus) were searched, the last search was conducted on April 2020. Randomised controlled trials (RCTs) employing the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) or Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) as diagnostic criteria and including occlusal splint as one of the experimental groups were included in the present study. The data from the included studies were extracted and assessed for risk of bias. RESULTS Eleven studies were included. The sample size ranged from 12 to 96 subjects. The male to female ratio was 0 to 25%. The mean length of follow-up was 4 months. Occlusal splint had a positive effect on mandibular movements in all included studies. Seven studies showed a positive effect of occlusal splint on chronic pain reduction and pain intensity, while two others showed improvement of temporomandibular joint clicking sounds and locking of the jaws. Moreover, improvements in mouth opening, depression, and anxiety symptoms, were reported in four studies. CONCLUSIONS An occlusal splint can be considered as a non-invasive treatment approach for patients with TMD, especially those with signs and symptoms of restriction of mandibular movement and pain. Moreover, the present findings highlighted an urgent need of a standardised consensus regarding the prognostic evaluation of TMD.
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Affiliation(s)
- Si-Hui Zhang
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Kai-Xun He
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Chen-Jing Lin
- Institute of Stomatology & Research Center of Dental and Craniofacial Implants, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Xiang-Dong Liu
- Institute of Stomatology & Research Center of Dental and Craniofacial Implants, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Ling Wu
- Institute of Stomatology & Research Center of Dental and Craniofacial Implants, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Jiang Chen
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Xiaohui Rausch-Fan
- Division of Conservative Dentistry and Periodontology, School of Dentistry, Medical University of Vienna, Wien, Austria
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25
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Wang S, Li Z, Ye H, Zhao W, Liu Y, Zhou Y. Preliminary clinical evaluation of traditional and a new digital PEEK occlusal splints for the management of sleep bruxism. J Oral Rehabil 2020; 47:1530-1537. [PMID: 32841412 DOI: 10.1111/joor.13083] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 07/23/2020] [Accepted: 08/11/2020] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To compare the manual time and preliminary clinical effects between the digital manufactured occlusal splints for sleep bruxism patients with those of traditional hard splints. METHODS Sixteen individuals (18 to 44 y/o) with clinically diagnosed sleep bruxism were selected based on the inclusion criteria. All patients were divided into two groups, and a random control method was applied. Digital splints (test group) were designed and milled using CAD/CAM. Hard splints (control group) were made of transparent acrylic resin in laboratory office. The manual time spent including impression obtaining, splint production and clinical occlusal adjustment was recorded. A visual analog scale was used to report the subjective evaluations. The maximum depth loss and volumetric loss of the occlusal surface of splints in posterior tooth were measured. SPSS software was used for statistical analysis (P = .05). RESULTS Comparing with control group, the manual time spent in test group was significantly less in all of three procedures (P < .001). The VAS scores for retention were not significantly different (P = .086), but the wearing comfort scores of test group were significantly higher (P < .001). Both maximum depth loss (P = .007) and volumetric loss in test group were significantly less than control group (P = .005). CONCLUSION In the current study, the digitally manufactured splints exhibit significantly improved comfort and time efficiency than traditional hard splints. Moreover, the new milling material (PEEK) has better wear resistance than acrylic resins.
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Affiliation(s)
- Shimin Wang
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | - Zheng Li
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | - Hongqiang Ye
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Wenyan Zhao
- Department of Implantology, Yinchuan Stomatology Hospital, Yinchuan, China
| | - Yunsong Liu
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
| | - Yongsheng Zhou
- Department of Prosthodontics, Peking University School and Hospital of Stomatology, National Clinical Research Center for Oral Diseases, National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Beijing, China
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Al-Moraissi E, Farea R, Qasem K, Al-Wadeai M, Al-Sabahi M, Al-Iryani G. Effectiveness of occlusal splint therapy in the management of temporomandibular disorders: network meta-analysis of randomized controlled trials. Int J Oral Maxillofac Surg 2020; 49:1042-1056. [DOI: 10.1016/j.ijom.2020.01.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 12/27/2019] [Accepted: 01/03/2020] [Indexed: 11/30/2022]
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Prathap V, Tarun S, S LS, Balasubramanian S, Panneerselvam E, Vb KR. Do Splints Play a Role in the Management of Condylar Postfracture Syndrome After Mandibular Angle Fractures?-A Randomized Controlled Clinical Trial. J Oral Maxillofac Surg 2019; 78:241-247. [PMID: 31704268 DOI: 10.1016/j.joms.2019.09.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Revised: 09/23/2019] [Accepted: 09/24/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE Fractures of the mandibular angle can result in condylar postfracture syndrome (CPFS) due to indirect injury to the condylar region. Studies evaluating early intervention for CPFS are lacking. In the present study, we evaluated the efficacy of interocclusal splint therapy for the prevention and early management of CPFS. PATIENTS AND METHODS A prospective randomized controlled clinical trial was designed and included patients who required open reduction and internal fixation for a unilateral angle fracture. The patients were divided into 2 groups. The study group received interocclusal splints postoperatively and the control group did not receive such splints. The patients were followed up at 2 weeks and 1, 2, and 3 months. The primary outcome measure was the presence or absence of CPFS after 3 months. CPFS was defined as the presence of any 1 of the clinical signs of temporomandibular joint dysfunction. The secondary outcomes included the mean pain scores and degree of mouth opening, which were evaluated at each follow-up visit. RESULTS The study included 40 patients, with 20 patients each randomized to the study and control groups. At the end of 3 months, CPFS was present in 2 patients in the study group and in all 20 patients in the control group. The mean pain scores were significantly lower in the study group than in the control group, and the mean mouth opening was significantly greater. CONCLUSIONS The use of interocclusal splints was found to be effective in the prevention and early management of CPFS. The use of splints also resulted in decreased pain and an improved mandibular mouth opening.
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Affiliation(s)
- Vikranth Prathap
- Consultant and Private Practitioner, Department of Oral and Maxillofacial Surgery, SRM Dental College and Hospital, Ramapuram, Chennai, India
| | - Swetha Tarun
- Postgraduate Trainee, Department of Oral and Maxillofacial Surgery, SRM Dental College and Hospital, Ramapuram, Chennai, India
| | - Logitha Sri S
- Postgraduate Trainee, Department of Oral and Maxillofacial Surgery, SRM Dental College and Hospital, Ramapuram, Chennai, India
| | - Sasikala Balasubramanian
- Reader, Department of Oral and Maxillofacial Surgery, SRM Dental College and Hospital, Ramapuram, Chennai, India.
| | - Elavenil Panneerselvam
- Reader, Department of Oral and Maxillofacial Surgery, SRM Dental College and Hospital, Ramapuram, Chennai, India
| | - Krishnakumar Raja Vb
- Professor and Head, Department of Oral and Maxillofacial Surgery, SRM Dental College and Hospital, Ramapuram, Chennai, India
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Garrigós-Pedrón M, Elizagaray-García I, Domínguez-Gordillo AA, Del-Castillo-Pardo-de-Vera JL, Gil-Martínez A. Temporomandibular disorders: improving outcomes using a multidisciplinary approach. J Multidiscip Healthc 2019; 12:733-747. [PMID: 31564890 PMCID: PMC6732565 DOI: 10.2147/jmdh.s178507] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 08/16/2019] [Indexed: 12/19/2022] Open
Abstract
Patients with temporomandibular disorders (TMD) can become very complex. This article aims to highlight the importance of the multimodal and multidisciplinary approach in this type of patients to improve clinical outcomes. At present we have innumerable techniques and tools to approach this type of patients from a biopsychosocial model where active and adaptive type treatments are fundamental. There are various health professions that have competence in the treatment of TMD, however, although in the most complex cases should be treated simultaneously, still too many patients receive unique treatments and only from one point of view. This review exposes the treatments available from a clinical-scientific perspective and also emphasizes the importance of working in specialized units with those professionals who have competencies on the different conditions that may occur.
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Affiliation(s)
- Miriam Garrigós-Pedrón
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, España.,Motion in Brains Research Group, Instituto de Neurociencias y Ciencias del Movimeinto (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, España.,CranioSPain Research Group, Instituto de Neurociencias y Ciencias del Movimeinto (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, España
| | - Ignacio Elizagaray-García
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, España.,Motion in Brains Research Group, Instituto de Neurociencias y Ciencias del Movimeinto (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, España.,CranioSPain Research Group, Instituto de Neurociencias y Ciencias del Movimeinto (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, España
| | | | - José Luis Del-Castillo-Pardo-de-Vera
- CranioSPain Research Group, Instituto de Neurociencias y Ciencias del Movimeinto (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, España.,Departamento de Cirugía Oral y Maxilofacilal, Hospital Universitario La Paz, Madrid, España
| | - Alfonso Gil-Martínez
- Departamento de Fisioterapia, Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, España.,Motion in Brains Research Group, Instituto de Neurociencias y Ciencias del Movimeinto (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, España.,CranioSPain Research Group, Instituto de Neurociencias y Ciencias del Movimeinto (INCIMOV), Centro Superior de Estudios Universitarios La Salle, Universidad Autónoma de Madrid, Madrid, España.,Departamento de Cirugía Oral y Maxilofacilal, Hospital Universitario La Paz, Madrid, España.,Departamento de Fisioterapia, Hospital Universitario La Paz, IdiPAZ, Madrid, España
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Kim KW, Ha IH, Lee YJ, Kim MR, Shin BC, Song MY, Cho JH. A clinical practice guideline for temporomandibular disorders in traditional Korean medicine: An evidence-based approach. Eur J Integr Med 2018. [DOI: 10.1016/j.eujim.2018.10.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Sriharsha P, Gujjari AK, Dhakshaini MR, Prashant A. Comparative Evaluation of Salivary Cortisol Levels in Bruxism Patients Before and After Using Soft Occlusal Splint: An in vivo Study. Contemp Clin Dent 2018; 9:182-187. [PMID: 29875558 PMCID: PMC5968680 DOI: 10.4103/ccd.ccd_756_17] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Introduction Bruxism is defined as a nonfunctional activity or a parafunctional habit characterized by the unconscious repetitive motion of clenching and/or grinding of the teeth. Soft occlusal splints have been considered as the first-line strategy for treating nocturnal bruxism. Cortisol is a major steroid hormone secreted by fascicular zone of the adrenal cortex, belonging to the glucocorticosteroidal group of hormones. Clinical studies have shown that when humans are placed under stress, the hypothalamic-pituitary-adrenocortical axis is activated, leading to an increase in cortical secretion. However, the effect of splint is questionable by some researchers, and best way to perceive the effect of soft splints in patients with bruxism is by evaluating the stress levels. Materials and Methods A total of 20 individuals suffering from bruxism were selected from the Outpatient Department of Prosthodontics and Crown and Bridge, JSS Dental College and Hospital, Mysore. Saliva samples were collected before and after using the occlusal soft splints and subjected to enzyme-linked immunosorbent assay for determining the salivary cortisol levels. Results The collected data were subjected to appropriate descriptive statistics, paired sample t-test, and one sample t-test. The paired sample t-test shows that intragroup comparison of the mean cortisol level in the study group shows near significant values, which means there is a decrease in the salivary cortisol levels in patients after using soft occlusal splint, but statistically nonsignificant. Conclusion In the present study, it has been found that 70% of individuals after using the soft occlusal splint showed decreased cortisol levels.
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Affiliation(s)
- Pudi Sriharsha
- Department of Prosthodontics and Crown and Bridge, JSS Dental College and Hospital, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
| | - Anil Kumar Gujjari
- Department of Prosthodontics and Crown and Bridge, JSS Dental College and Hospital, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
| | - M R Dhakshaini
- Department of Prosthodontics and Crown and Bridge, JSS Dental College and Hospital, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
| | - Akila Prashant
- Department of Biochemistry, JSS Medical College, JSS Academy of Higher Education and Research, Mysore, Karnataka, India
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