Therapy for Temporomandibular Disorders: 3D-Printed Splints from Planning to Evaluation

Does curve of Spee affect the precision of 3D-printed curvature-adaptive splints?

OBJECTIVES

This study aimed to propose a standardized protocol for the fabrication of three-dimensionally (3D)-printed curvature-adaptive splints (CASs) and assess the precision of CASs on dentitions with different depths of the curve of Spee (COS).

METHODS

76 lower dental resin models, each exhibiting one of the four types of COS (0-, 2-, 4-, and 6-mm deep), were selected and digitally scanned. CASs were designed, 3D printed, and grouped into C0, C2, C4, and C6, corresponding to the four types of COS depths. To assess precision, the CASs occluded with the resin model were scanned as a whole and compared with the originally designed ones.

RESULTS

In terms of translational deviations observed in the CASs, the mean value of absolute sagittal deviation (0.136 mm) was significantly higher than those of vertical (0.091 mm) and transversal deviations (0.045 mm) (P < 0.01). Regarding rotational deviations of the CASs, the mean deviation in pitch (0.323°) was significantly higher than those in yaw (0.083°) and roll (0.110°) (P < 0.01). However, when comparing the accuracy of CASs across C0, C2, C4, and C6 groups, no statistically significant difference was found. Additionally, the translational deviations, rotational deviations, and RMSE of all groups were significantly lower than the clinically acceptable limits of 0.5 mm, 1°, and 0.25 mm, respectively (P < 0.01).

CONCLUSIONS

The depth of the COS has no significant impact on the precision of CASs, as evidenced by the absence of statistically significant differences in translational, rotational deviations, and RMSE among all groups (C0, C2, C4, and C6). Moreover, despite relatively high deviations in the sagittal dimension and pitch, all dimensional deviations and RMSE remained statistically significantly lower than the corresponding clinically acceptable limits (CALs) in all groups.

CLINICAL SIGNIFICANCE

This standardized protocol incorporating "curvature-adaptation" represents an optimized approach to fabricating diverse 3D-printed splints tailored to dentitions with different anatomical features in contemporary digital dentistry.

Clinical effect of digitalized designed and 3D-printed repositioning splints in the treatment of anterior displacement of temporomandibular joint disc

OBJECTIVE

To compare the treatment effectiveness of digitized and 3D-printed repositioning splints with that of conventional repositioning splints in the treatment of anterior displacement of the temporomandibular joint disc.

METHODS

This retrospective study included 96 patients with disc displacement of the anterior temporomandibular joint. They were treated with either digitally designed and 3D-printed repositioning splints or traditional splints and followed up for at least six months. Changes in signs and symptoms such as pain and mouth opening before and after treatment were recorded to evaluate treatment outcomes.

RESULTS

During the first month of treatment, both the digitally designed and 3D-printed repositioning splint groups (Group B) and the traditional repositioning splint group (Group A) showed significant increases in mouth opening, with increases of 4.93 ± 3.06 mm and 4.07 ± 4.69 mm, respectively, and there was no significant difference between the two groups. Both groups had a significant reduction in visual analog scale (VAS) pain scores, with Group B showing a greater reduction of 1.946 ± 1.113 compared to 1.488 ± 0.978 in Group A (P < 0.05). By the sixth month, Group B's mouth opening further improved to 38.65 ± 3.22 mm (P < 0.05), while Group A's mouth opening did not significantly improve. Regarding pain, Group A's VAS score decreased by 0.463 ± 0.778 after one month, and Group B's score decreased by 0.455 ± 0.715; both groups showed significant reductions, but there was no significant difference between the two groups.

CONCLUSION

Compared with traditional repositioning splints, digitally designed and 3D-printed repositioning splints are more effective at reducing patient pain and improving mouth opening. 3D-printed repositioning splints are an effective treatment method for temporomandibular joint disc displacement and have significant potential for widespread clinical application.

Fully digital workflow of an occlusal device including digital facebow record: A clinical report

In many current digital workflows for the production of occlusal devices and dentures, the traditional facebow record for the individual determination of the hinge axis has been omitted. A novel digital facebow record procedure including a scannable occlusal fork is described as a straightforward to use, cost-effective, and less time-consuming alternative to close this gap in fully digital prosthetic workflows.

Literature Review of an Anterior Deprogrammer to Determine the Centric Relation and Presentation of Cases

The increasing demand for dental aesthetics, articulation corrections, and solutions for pain and frequent bruxism demands quick and effective restorative dental management. The biomedical research aimed to create a beneficial, ecological, and readily available anterior deprogrammer to determine the centric relation (CR) of cases. This medical device is additively manufactured from a biocompatible material. Size is customizable based on the width of the patient's anterior central incisors. This is a pilot study with two subjects. The task was to develop a complete data protocol for the production process, computer-aided design (CAD), and three-dimensional (3D) printing of the anterior deprogrammers. The research focused on creating simple and practically applicable tools for the dentist's prescription (anterior deprogrammer in three sizes), and secondly for the communication between the dentist and the patient (computer application). The tested hypothesis was whether, according to these novel tools, it is possible to produce functional occlusal splints, which could be manufactured using current technologies. This study compared a traditional splint with a digitally designed and 3D-printed one. The tested hypothesis was whether manufactured occlusal splints differ in patients' subjective perception of comfort. Each conservative treatment was monitored for ten weeks. Initial results are promising; no statistically significant difference was found between the productive technologies.