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Lei Q, Lin D, Lin K, Huang W, Wu D, Liu Y. Clinical and electromyographic signals analysis about the effect of space-adjustment splint on overerupted maxillary molars. BMC Oral Health 2024; 24:296. [PMID: 38431564 PMCID: PMC10909290 DOI: 10.1186/s12903-024-04039-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 02/17/2024] [Indexed: 03/05/2024] Open
Abstract
BACKGROUND Overerupted maxillary molars is common in adults, which can lead to insufficient intermaxillary vertical space ,great difficulty in prosthetic reconstruction ,and cause occlusal interference in movements.To reconstruct occlusal function, it is necessary to prepare enough space for prostheses. The aim of the present study was to evaluate the effect of space-adjustment occlusal splint on overerupted maxillary molars by clinical and electromyographic signals analysis. METHODS Eighteen patients with overerupted maxillary molars were selected to wear space-adjustment occlusal splint suppressing overerupted maxillary molars for three months. Satisfaction was assessed by 5-point Likert; intermaxillary vertical space and the teeth transportation distance were measured in models; clinical periodontal status were evaluated by periodontal probing depth (PPT) and bleeding index (BI); electromyographic recordings of the masseter and anterior temporal muscles were monitored by Cranio-Mandibular K7 Evaluation System. RESULTS All the patients were satisfied with the treatment effect (Likert scale ≧ 4). The intermaxillary space in edentulous areas after treatment showed statistically significant increasing when compared with those before treatment. PPT and BI showed no significant difference. No statistically significant differences were found in electromyographic activity of anterior temporal muscles, while a reduction of muscle activity in masseter in the contralateral side were detected in post-treatment evaluations compared with pre-treatment at mandibular rest position. CONCLUSIONS Space-adjustment occlusal splint is an efficient treatment option on overerupted maxillary molars by intruding the maxillary molar to obtain adequate intermaxillary space for prostheses.
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Affiliation(s)
- Qun Lei
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China.
| | - Dong Lin
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Kaijin Lin
- Fujian Medical University, Fuzhou, China
| | - Wenxiu Huang
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Dong Wu
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Yuyu Liu
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
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Navarro RE, Karadede B, Karadede Ünal B, Salvador DM. Predictive factors of therapeutic response according to craniofacial skeletal biotype in patients with sleep apnea syndrome using mandibular advancement devices: a pilot study. Angle Orthod 2024; 94:216-223. [PMID: 37788163 PMCID: PMC10893917 DOI: 10.2319/092822-670.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 08/01/2023] [Indexed: 10/05/2023] Open
Abstract
OBJECTIVES To evaluate the influence of facial biotype in the therapeutic effect of mandibular advancement devices (MADs) according to polysomnographic records in patients diagnosed with sleep apnea-hypopnea syndrome (SAHS). MATERIALS AND METHODS A total of 46 patients were recruited. Patients were classified according to facial biotype (mesofacial, brachyfacial, or dolichofacial). The quantitative variables were described as the arithmetic mean and standard deviation or the median and interquartile range. Hypothesis tests used were Pearson's chi-square, paired-sample Student's t- test, the Wilcoxon test, one-way analysis of variance, Kruskal-Wallis test, and Mann-Whitney U-test. P < .05 was considered statistically significant. RESULTS A total of 46 patients were categorized into three facial biotype subgroups with no significant differences among them in age, body mass index, neck circumference, and sex. The respiratory disturbance index (RDI) results were as follows: brachyfacial patients had a reduction to 15 events/h (P < .001), the mesofacial patients had a reduction to 14 events/h (P < .001), and the dolichofacial patients did not show a significant reduction. The oxygen desaturation index (ODI) results were as follows: brachyfacial patients had a reduction in ODI episodes to 45 episodes/h (P = .001), mesofacial patients had a reduction to 18 episodes/h (P = .001). In the brachyfacial group, the number of awakenings with MAD therapy was reduced to 23 events/h (P = .003), while, in the mesofacial group, it was reduced to 37 episodes/h (P = .012). CONCLUSIONS The facial biotype influences the effectiveness of MAD therapy and is considered a good predictive factor.
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Al-Moraissi EA, Al-Otaibi K, Almaweri AA, Bastos RM, Haas Junior OL, Amran AG. Treatment of painful temporomandibular joint disc displacement without reduction: network meta-analysis of randomized clinical trials. Int J Oral Maxillofac Surg 2024:S0901-5027(24)00037-7. [PMID: 38395688 DOI: 10.1016/j.ijom.2024.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 02/08/2024] [Accepted: 02/09/2024] [Indexed: 02/25/2024]
Abstract
There is currently no consensus on the best treatment for painful temporomandibular disc displacement without reduction (DDwoR), and no network meta-analysis (NMA) of randomized clinical trials (RCTs) comparing all types of treatments for this condition has been conducted. The objective of this study was to compare and rank all treatments for DDwoR, including conservative treatments, occlusal splints, low-level laser therapy (LLLT), arthrocentesis (Arthro) alone, Arthro plus intra-articular injection (IAI) of platelet-rich plasma (PRP), Arthro plus IAI of hyaluronic acid (HA), Arthro with exercises, Arthro plus occlusal splints, and manipulative therapy. Outcome variables were pain intensity on a visual analogue scale (VAS) and maximum mouth opening (MMO, mm). The mean difference with 95% confidence interval was estimated using Stata software. The GRADE system was used to assess the certainty of the evidence. A total of 742 patients from 16 RCTs were included in the NMA. Both direct meta-analysis and NMA showed that Arthro with IAI of co-adjuvants provided better pain reduction in the short term (≤3 months) than Arthro alone. However, the quality of the evidence was very low. In the intermediate term, Arthro alone or combined with co-adjuvants provided better pain reduction than conservative treatment, but with low-quality evidence. Conservative treatment significantly increased MMO in the short term compared to other treatments. In conclusion, the results of this NMA suggest that arthrocentesis with intra-articular injection of adjuvant medications may be superior to conservative treatments in reducing pain intensity at long-term follow-up, while no significant differences were found for the MMO outcome. However, the quality of evidence was generally low to very low, and further RCTs are needed to confirm these findings.
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Affiliation(s)
- E A Al-Moraissi
- Department of Oral and Maxillofacial Surgery, Thamar University, Thamar, Yemen.
| | - K Al-Otaibi
- Department of Maxillofacial Surgery and Diagnostics Sciences, College of Dentistry, Qassim University, Qassim, Saudi Arabia
| | - A A Almaweri
- Department of Oral Medicine, Thamar University, Thamar, Yemen
| | - R M Bastos
- Department of Oral and Maxillofacial Surgery, Hospital São Lucas of Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - O L Haas Junior
- Department of Oral and Maxillofacial Surgery, Hospital São Lucas of Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - A G Amran
- Department of Periodontolgy, Thamar University, Thamar, Yemen
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Ding WH, Li YF, Liu W, Li W, Wu N, Hu SY, Shi JJ. Effect of occlusal stabilisation splint with or without arthroscopic disc repositioning on condylar bone remodelling in adolescent patients. Int J Oral Maxillofac Surg 2024; 53:156-164. [PMID: 37357072 DOI: 10.1016/j.ijom.2023.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 06/03/2023] [Accepted: 06/06/2023] [Indexed: 06/27/2023]
Abstract
The aim of this study was to investigate the treatment effects of a stabilisation splint (SS) with and without arthroscopic disc repositioning (ADR) on condylar bone remodelling in adolescent patients with anterior disc displacement without reduction (ADDwoR). Cone beam computed tomography and magnetic resonance imaging were used to analyse condylar bone remodelling, condyle position, and disc position. Twenty-two temporomandibular joints of 14 patients who underwent ADR (age range 12-20 years; mean follow-up 12.5 ± 7.8 months) and 21 temporomandibular joints of 14 patients who did not undergo ADR (age range 13-20 years; mean follow-up 11.1 ± 5.1 months) were included. The change in bone volume (P < 0.001), rate of bone volume change (P < 0.001), and change in condyle height (P = 0.031) were significantly greater in patients with ADR than in those without ADR. The changes in posterior joint space (P = 0.013), superior joint space (P = 0.020), and ratio of condyle sagittal position (P = 0.013) were significantly greater in patients with ADR than in those without ADR. All discs in patients who underwent ADR and one disc in those who did not undergo ADR were backward repositioned. In conclusion, in adolescent patients with ADDwoR, ADR with SS therapy achieved better condyle and disc position than SS therapy alone, and also induced bone generation.
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Affiliation(s)
- W H Ding
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Y F Li
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, Zhejiang, China
| | - W Liu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, Zhejiang, China
| | - W Li
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, Zhejiang, China
| | - N Wu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, Zhejiang, China
| | - S Y Hu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, Zhejiang, China
| | - J J Shi
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, Zhejiang, China.
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Kelemen K, König J, Czumbel M, Szabó B, Hegyi P, Gerber G, Borbély J, Mikulás K, Schmidt P, Hermann P. Additional splint therapy has no superiority in myogenic temporomandibular disorders: A systematic review and meta-analysis of randomized controlled trials. J Prosthodont Res 2024; 68:12-19. [PMID: 37286515 DOI: 10.2186/jpr.jpr_d_22_00264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Purpose Temporomandibular disorders (TMDs) are frequent stomatological disorders. However, their treatment is controversial. Therefore, we compared the efficacy of combination therapy (splint therapy along with physiotherapy, manual therapy, and counseling) with physiotherapy, manual therapy, and counseling alone. The extent of mouth opening and pain perception were the outcomes.Study selection Systematic searches for English publications were performed using four major literature databases (Cochrane Library, EMBASE, PubMed, and Web of Science). We included randomized controlled trials. We calculated mean differences with 95% confidence interval (CI) for pain perception and maximum mouth opening (MMO) for the two groups. The Hartung-Knapp adjustment was used for cases comprising at least five studies.Results Six articles were included in the pain perception category, and four were reviewed for MMO at baseline. Four articles assessed pain perception, and two assessed MMO at 1 month. Five articles were analyzed upon comparing pain perception at baseline and 1-month follow-up. The mean difference was -2.54 [95% CI: -3.38; to -1.70] in the intervention group and -2.33 [95% CI: -4.06; to -0.61] in the control group. Two articles were analyzed upon comparing MMO at baseline and 1-month follow-up. The mean difference in the intervention group was 3.69 [95% CI: -0.34; 7.72], whereas that in the control group was 3.62 [95% CI: -3.43; 10.67].Conclusions Both therapies can be used in the management of myogenic TMD. Due to the marginal differences between the baseline and 1-month values, our results could not confirm the efficacy of combination therapy.
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Affiliation(s)
- Kata Kelemen
- Department of Prosthodontics, Semmelweis University, Budapest, Hungary
| | - János König
- Department of Prosthodontics, Semmelweis University, Budapest, Hungary
| | - Márk Czumbel
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Bence Szabó
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
| | - Péter Hegyi
- Centre for Translational Medicine, Semmelweis University, Budapest, Hungary
- Division of Pancreatic Diseases, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Gábor Gerber
- Department of Prosthodontics, Semmelweis University, Budapest, Hungary
| | - Judit Borbély
- Department of Prosthodontics, Semmelweis University, Budapest, Hungary
| | - Krisztina Mikulás
- Department of Prosthodontics, Semmelweis University, Budapest, Hungary
| | - Péter Schmidt
- Department of Prosthodontics, Semmelweis University, Budapest, Hungary
| | - Péter Hermann
- Department of Prosthodontics, Semmelweis University, Budapest, Hungary
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Al-Moraissi EA, Almaweri AA, Al-Tairi NH, Alkhutari AS, Grillo R, Christidis N. Treatments for painful temporomandibular disc displacement with reduction: a network meta-analysis of randomized clinical trials. Int J Oral Maxillofac Surg 2024; 53:45-56. [PMID: 37802670 DOI: 10.1016/j.ijom.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 09/15/2023] [Accepted: 09/20/2023] [Indexed: 10/08/2023]
Abstract
There is currently no consensus on the best treatment for painful temporomandibular disc displacement with reduction (DDwR), and no network meta-analysis of randomized clinical trials (RCTs) comparing all types of treatment for this condition has been conducted. The objective of this study was to compare and rank all treatments for DDwR, including conservative treatments, occlusal splints, low-level laser therapy (LLLT), manual therapy, no treatment (control), arthrocentesis (Arthro) alone, Arthro plus intra-articular injection of platelet-rich plasma (Arthro-PRP) or hyaluronic acid (Arthro-HA), and Arthro plus occlusal splint. Predictor variables were pain intensity and maximum mouth opening (MMO). The mean difference with 95% confidence interval was estimated using Stata software. The GRADE system was used to assess the certainty of the evidence. Twenty RCTs reporting 1107 patients were identified in the literature search; 980 of these patients were included in the network meta-analysis. Direct meta-analysis showed that Arthro-PRP significantly reduced pain intensity compared to Arthro alone, while occlusal splint and manual therapy were superior to conservative treatment (all very low quality evidence). Arthro with intra-articular injection of PRP/HA ranked as the most effective treatment in terms of pain reduction, whereas LLLT ranked the best choice for increasing MMO for patients with DDwR. However, it is important to note that the evidence for the superiority of these treatments is generally of very low quality. Therefore, further high-quality research is needed to confirm these findings and provide more reliable recommendations for the treatment of DDwR.
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Affiliation(s)
- E A Al-Moraissi
- Department of Oral and Maxillofacial Surgery, Thamar University, Thamar, Yemen.
| | - A A Almaweri
- Department of Oral Medicine, Thamar University, Thamar, Yemen
| | - N H Al-Tairi
- Department of Oral and Maxillofacial Surgery, Thamar University, Thamar, Yemen
| | - A S Alkhutari
- Department of Oral and Maxillofacial Surgery, Thamar University, Thamar, Yemen
| | - R Grillo
- Department of Oral and Maxillofacial Surgery, Faculdade Patos de Minas, Brasília, Brazil; Department of Oral and Maxillofacial Surgery, Faculdade São Leopoldo Mandic, Campinas, Brazil
| | - N Christidis
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, Huddinge, Sweden
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Therchilsen JH, Kirketerp P, Homoe P. Effectiveness of Narval CC™ device in the treatment of obstructive sleep apnea. Sleep Med X 2023; 6:100076. [PMID: 38162591 PMCID: PMC10757193 DOI: 10.1016/j.sleepx.2023.100076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/24/2023] [Accepted: 06/10/2023] [Indexed: 01/03/2024] Open
Abstract
Mandibular advancement devices (MAD) are used in sleep apnea with varying results. We aimed to examine whether or not a MAD should be an integral treatment modality in the care of our patients with obstructive sleep apnea. We designed a feasibility study and included 32 patients after meeting inclusion criteria. Only 3 patients did not finish the second sleep study exam. The intervention was an individually designed MAD and a sleep study exam was performed prior and post treatment. The outcome objective was an apnea-hypopnea index of under 10 and with a 50% reduction. Patient population had a baseline AHI of 19.0 and mean reduction of AHI with MAD treatment to 13.3 yielding a MAD efficacy rate of 31% when outcome objectives were applied. The average reduction in AHI was 24.8% with 9 of the 29 patients actually experiencing an increase in AHI with MAD treatment. When there was a reduction in AHI using the MAD device the AHI reduction rate was 49.1% and there was a tendency for better treatment outcome when apnea-hypopnea was predominantly supine. A mandibular advancement device serves as an important treatment modality in the care of patients with obstructive sleep apnea due to patient satisfaction and compliance. The broad range of treatment response to our MAD device highlights the importance of performing a sleep study exam after initiation of treatment with a MAD but also illustrates the complexity and need for individually tailored treatment for patients with obstructive sleep apnea.
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Affiliation(s)
- Johan H. Therchilsen
- Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Køge, Denmark
| | | | - Preben Homoe
- Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Køge, Denmark
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Raffaini JC, Soares EJ, Oliveira RFDL, Vivanco RG, Amorim AA, Pereira ALC, Pires-de-Souza FCP. Effect of artificial aging on mechanical and physical properties of CAD-CAM PMMA resins for occlusal splints. J Adv Prosthodont 2023; 15:227-237. [PMID: 37936836 PMCID: PMC10625884 DOI: 10.4047/jap.2023.15.5.227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 10/11/2023] [Accepted: 10/25/2023] [Indexed: 11/09/2023] Open
Abstract
PURPOSE This study aimed to assess and compare the color stability, flexural strength (FS), and surface roughness of occlusal splints fabricated from heat-cured acrylic resin, milled polymethyl methacrylate (PMMA)-based resin, and 3D-printed (PMMA) based-resin. MATERIALS AND METHODS Samples of each type of resin were obtained, and baseline measurements of color and surface roughness were recorded. The specimens were divided into three groups (n = 10) and subjected to distinct aging protocols: thermomechanical cycling (TMC), simulated brushing (SB), and control (without aging). Final assessments of color and surface roughness and three-point bending test (ODM100; Odeme) were conducted, and data were statistically analyzed (2-way ANOVA, Tukey, P <.05). RESULTS Across all resin types, the most significant increase in surface roughness (Ra) was observed after TMC (P < .05), with the 3D-printed resin exhibiting the lowest Ra (P < .05). After brushing, milled resin displayed the highest Ra (P < .05) and greater color alteration (ΔE00) compared to 3D-printed resin. The most substantial ΔE00 was recorded after brushing for all resins, except for heat-cured resin subjected to TMC. Regardless of aging, milled resin exhibited the highest FS (P < .05), except when compared to 3D-printed resin subjected to TMC. Heat-cured resin exposed to TMC demonstrated the lowest FS, different (P < .05) from the control. Under control conditions, milled resin exhibited the highest FS, different (P < .05) from the brushed group. 3D-printed resin subjected to TMC displayed the highest FS (P < .05). CONCLUSION Among the tested resins, 3D-printed resin demonstrated superior longevity, characterized by minimal surface roughness and color alterations. Aging had a negligible impact on its mechanical properties.
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Affiliation(s)
- Júlia Correa Raffaini
- Department of Dental Materials and Prosthodontics, Ribeirão Preto School of Dentistry - University of Sao Paulo, Ribeirão Preto, SP, Brazil
| | - Eduardo Jose Soares
- Department of Pediatric Dentistry, Ribeirão Preto School of Dentistry - University of Sao Paulo, Ribeirão Preto, SP, Brazil
| | - Rebeca Franco de Lima Oliveira
- Department of Dental Materials and Prosthodontics, Ribeirão Preto School of Dentistry - University of Sao Paulo, Ribeirão Preto, SP, Brazil
| | - Rocio Geng Vivanco
- Department of Dental Materials and Prosthodontics, Ribeirão Preto School of Dentistry - University of Sao Paulo, Ribeirão Preto, SP, Brazil
| | - Ayodele Alves Amorim
- Department of Dental Materials and Prosthodontics, Ribeirão Preto School of Dentistry - University of Sao Paulo, Ribeirão Preto, SP, Brazil
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Sun J, Zhu H, Lu C, Zhao J, Nie X, Yang Z, He D. Temporomandibular joint disc repositioning and occlusal splint for adolescents with skeletal class II malocclusion: a single-center, randomized, open-label trial. BMC Oral Health 2023; 23:694. [PMID: 37759222 PMCID: PMC10537145 DOI: 10.1186/s12903-023-03402-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND Temporomandibular joint (TMJ) disc repositioning through open suturing (OSu) is a new disc repositioning method. Its result for adolescents with condylar resorption and dentofacial deformities combined with and without postoperative occlusal splints (POS) has not been well studied. OBJECTIVE This study was to evaluate and compare the effects of OSu with and without POS in the treatment of TMJ anterior disc displacement without reduction (ADDwoR) in adolescent skeletal Class II malocclusion. METHODS A total of 60 adolescents with bilateral ADDwoR were enrolled in this study. They were randomly allocated into two groups: OSu with and without POS. Magnetic resonance imaging (MRI) and lateral cephalometric radiographs were used to measure changes in condylar height and the degree of skeletal Class II malocclusion from before operation and at 12 months postoperatively. Changes in these indicators were compared within and between the two groups. RESULTS After OSu, both groups exhibited significant improvements in condylar height and occlusion at the end of 12 months follow-up (P < 0.05). The group of OSu with POS had significantly more new bone formation (2.83 ± 0.75 mm vs. 1.42 ± 0.81 mm, P < 0.001) and improvement in dentofacial deformity than the group of OSu only (P < 0.05). The new bone height was significantly correlated with POS (P < 0.001), the changes of SNB (P = 0.018), overjet (P = 0.012), and Wits appraisal (P < 0.001). CONCLUSION These findings indicated that OSu can effectively stimulate condylar regeneration and improve skeletal Class II malocclusion in adolescents with bilateral ADDwoR. The results are better when combined with POS. TRIAL REGISTRATION This trial was prospectively registered on the chictr.org.cn registry with ID: ChiCTR1900021821 on 11/03/2019.
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Affiliation(s)
- Jiali Sun
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Huimin Zhu
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Chuan Lu
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Jieyun Zhao
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Xin Nie
- Biostatistics Office of Clinical Research Unit, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China
| | - Zhi Yang
- Department of Oral and Cranio-maxillofacial Surgery, Shanghai Ninth People's Hospital, College of Stomatology, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University School of Medicine, 639 Zhi Zao Ju Road, Shanghai, 200011, China.
| | - Dongmei He
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China.
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Benli M, Özcan M. Short-term effect of material type and thickness of occlusal splints on maximum bite force and sleep quality in patients with sleep bruxism: a randomized controlled clinical trial. Clin Oral Investig 2023; 27:4313-4322. [PMID: 37127807 DOI: 10.1007/s00784-023-05049-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 04/26/2023] [Indexed: 05/03/2023]
Abstract
OBJECTIVE To evaluate the short-term effects of hard and soft splints of different thicknesses on maximum bite force (MBF) and sleep quality (SQ) in participants with sleep bruxism (SB). METHODS One-hundred-fifteen patients were randomly allocated to five groups: Groups H2(Hard splint-2 mm), H3(Hard splint-3 mm), S2(Soft splint-2 mm), S3(Soft splint-3 mm), and C (control). Outcomes were MBF (assessed with a digital gnathodynamometer) and SQ (assessed with the Pittsburgh Sleep Quality Index). Measurements were performed at T0 (before the splints), T1 (1-month follow-up), and T2 (2-months follow-up). Data were analyzed using one-way analysis of variance(ANOVA), Tukey's HSD, and chi-square tests (alpha = 0.05). RESULTS At T1, the highest MBF values were observed in group H3 (658.01 ± 22.6 N), while the lowest in group S2 (585.45 ± 8.68 N). For T2, the highest values were obtained in H3 group (676.85 ± 21.9 N), and the lowest in group S2 (565.65 ± 10.9 N) (p < 0.05).For SQ, groups S2 and S3 revealed the lowest PSQI values at T1 (9.1; 9.6) and T2 (9; 9.5) (p < 0.001). CONCLUSIONS The short-term use of both 2 and 3-mm thick soft splints resulted in a decrease in MBF. Improvement in SQ in patients using soft splints was observed in the 1st month and was maintained in the 2nd month. CLINICAL RELEVANCE This study provides insights on short-term clinical effects as regards to increased sleep quality and regulated maximum bite force as a function of splint material type and the thickness of the splint.
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Affiliation(s)
- Merve Benli
- Department of Oral Biology, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
- Department of Prosthodontics, Faculty of Dentistry, Istanbul University, Istanbul, Turkey.
| | - Mutlu Özcan
- Division of Dental Biomaterials, Center for Dental Medicine, Clinic for Reconstructive Dentistry, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
- Clinic for Chewing Function Disturbances, Center for Dental Medicine, Clinic for Reconstructive Dentistry, University of Zurich, Plattenstrasse 11, 8032, Zurich, Switzerland
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11
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Wuersching SN, Westphal D, Stawarczyk B, Edelhoff D, Kollmuss M. Surface properties and initial bacterial biofilm growth on 3D-printed oral appliances: a comparative in vitro study. Clin Oral Investig 2023; 27:2667-2677. [PMID: 36576565 PMCID: PMC10264496 DOI: 10.1007/s00784-022-04838-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 12/21/2022] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To investigate the initial bacterial adhesion on 3D-printed splint materials in relation to their surface properties. MATERIALS AND METHODS Specimens of five printable splint resins (SHERAprint-ortho plus UV, NextDent Ortho Rigid, LuxaPrint Ortho Plus, V-Print Splint, KeySplint Soft), one polymethylmethacrylate (PMMA) block for subtractive manufacturing (Astron CLEARsplint Disc), two conventional powder/liquid PMMA materials (FuturaGen, Astron CLEARsplint), and one polyethylene terephthalate glycol (PETG) thermoplastic sheet for vacuum forming (Erkodur Thermoforming Foil) were produced and finished. Surface roughness Ra was determined via contact profilometry. Surface morphology was examined under a scanning electron microscope. Multi-species bacterial biofilms were grown on entire splints. Total biofilm mass and viable bacterial counts (CFU/ml) within the biofilms were determined. Statistical analyses were performed with a one-way ANOVA, Tukey's post hoc test, and Pearson's test (p < 0.05). RESULTS Astron CLEARsplint and KeySplint Soft specimens showed the highest surface roughness. The mean total biofilm mass on KeySplint Soft splints was higher compared to all other materials (p < 0.05). Colony-forming unit per milliliter on FuturaGen, Astron CLEARsplint, and KeySplint Soft splints was one log scale higher compared to all other materials. The other four printable resins displayed overall lower Ra, biofilm mass, and CFU/ml. A positive correlation was found between Ra and CFU/ml (r = 0.69, p = 0.04). CONCLUSIONS The 3D-printed splints showed overall favorable results regarding surface roughness and bacterial adhesion. Thermoplastic materials seem to display a higher surface roughness, making them more susceptible to microbial adhesion. CLINICAL RELEVANCE The development of caries and gingivitis in patients with oral appliances may be affected by the type of material.
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Affiliation(s)
- Sabina Noreen Wuersching
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Goethestrasse 70, 80336, Munich, Germany.
| | - David Westphal
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Goethestrasse 70, 80336, Munich, Germany
| | - Bogna Stawarczyk
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Goethestrasse 70, 80336, Munich, Germany
| | - Daniel Edelhoff
- Department of Prosthetic Dentistry, University Hospital, LMU Munich, Goethestrasse 70, 80336, Munich, Germany
| | - Maximilian Kollmuss
- Department of Conservative Dentistry and Periodontology, University Hospital, LMU Munich, Goethestrasse 70, 80336, Munich, Germany
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12
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Thorpe ARDS, Haddad Y, Hsu J. A systematic review and meta-analysis of randomized controlled trials comparing arthrocentesis with conservative management for painful temporomandibular joint disorder. Int J Oral Maxillofac Surg 2023:S0901-5027(22)00488-X. [PMID: 36732095 DOI: 10.1016/j.ijom.2022.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 12/06/2022] [Accepted: 12/09/2022] [Indexed: 02/01/2023]
Abstract
The aim of this study was to determine whether arthrocentesis is superior to conservative treatment in the management of painful temporomandibular joint disorders with restricted opening. A systematic review was undertaken of prospective randomized controlled trials (RCT) comparing arthrocentesis to conservative management, identified in the MEDLINE and PubMed databases. Inclusion criteria included a 6-month follow-up, with clinical assessment of the patients and painful restricted mouth opening. Data extracted included pain measured on a visual analogue scale and maximum mouth opening measured in millimetres. Risk of bias was assessed using the Cochrane Risk of Bias Tool 2 for RCTs, and a meta-analysis with the random-effects model was undertaken. Of 879 records retrieved, seven met the inclusion criteria; these RCTs reported the results at 6 months for 448 patients. One study had a low risk of bias, four studies had an uncertain risk, and two had a high risk of bias. In the meta-analysis, arthrocentesis was statistically superior to conservative management at 6 months for an increase in maximum mouth opening (1.12 mm, 95% confidence interval 0.45-1.78 mm; P = 0.001; I2 = 87%) and borderline superior for pain reduction (-1.09 cm, 95% confidence interval -2.19 to 0.01 cm; P = 0.05; I2 = 100%). However, these differences are unlikely to be clinically relevant.
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Affiliation(s)
- A R D S Thorpe
- Department of Oral Surgery, Faculty of Medicine and Health, The University of Sydney, Kingswood, Australia.
| | - Y Haddad
- Dentist in Private Practice, Welland, Ontario, Canada
| | - J Hsu
- Dentist in Private Practice, McMahons Point, New South Wales, Australia
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Gurgel M, Cevidanes L, Pereira R, Costa F, Ruellas A, Bianchi J, Cunali P, Bittencourt L, Chaves Junior C. Three-dimensional craniofacial characteristics associated with obstructive sleep apnea severity and treatment outcomes. Clin Oral Investig 2022; 26:875-887. [PMID: 34273012 PMCID: PMC8761785 DOI: 10.1007/s00784-021-04066-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 06/29/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVES This study aims to assess craniofacial dimensions in obstructive sleep apnea (OSA) patients treated with a mandibular advancement device (MAD) and to identify anatomic influences on OSA severity and MAD therapy outcomes. MATERIALS AND METHODS Twenty patients with OSA were prospectively treated with MAD. Clinical, cone-beam computed tomography, and polysomnography exams were performed before treatment and 4-6 months after achieving the MAD therapeutic position. Polysomnographic exams and three-dimensional maxillary, mandibular, and upper airway (UA) measurements were evaluated. Pearson's correlation and t-tests were applied. RESULTS Before MAD treatment, the transverse width measured at the frontomaxillary suture and the angle between the mandibular ramus and Frankfurt horizontal were statistically correlated with apnea and the hypopnea index (AHI), while the gonial angle was correlated with therapeutic protrusion. After MAD treatment, all patients showed a significant AHI reduction and an improvement in minimum oxyhemoglobin saturation. The UA total volume, superior and inferior oropharynx volume, and area were statistically correlated with MAD therapeutic protrusion. The UA total area showed a statistical correlation with the improvement in AHI, and the superior oropharynx volume and area increased significantly. CONCLUSIONS The transversal frontomaxillary suture width and the mandibular ramus facial angle may influence OSA severity. The gonial angle, volume, and area of all UA regions may indicate the amount of protrusion needed for successful MAD treatment. CLINICAL RELEVANCE The craniofacial characteristics reported as important factors for OSA severity and MAD treatment outcomes impact therapy planning for OSA patients, considering individual anatomic characteristics, prognosis, and cost benefits.
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Affiliation(s)
- Marcela Gurgel
- Department of Dental Clinic, School of Dentistry, Federal University of Ceara, Fortaleza, Brazil
| | - Lucia Cevidanes
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, United States of America
| | - Rowdley Pereira
- Department of Pneumology, Division of Sleep Medicine and Biology, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Fabio Costa
- Department of Dental Clinic, School of Dentistry, Federal University of Ceara, Fortaleza, Brazil
| | - Antonio Ruellas
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, United States of America.,Department of Orthodontics and Pediatric Dentistry, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Jonas Bianchi
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, United States of America.,Department of Orthodontics, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA, United States of America
| | - Paulo Cunali
- Department of Pneumology, Division of Sleep Medicine and Biology, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Lia Bittencourt
- Department of Pneumology, Division of Sleep Medicine and Biology, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Cauby Chaves Junior
- Department of Dental Clinic, School of Dentistry, Federal University of Ceara, Fortaleza, Brazil
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Al-Moraissi EA, Conti PCR, Alyahya A, Alkebsi K, Elsharkawy A, Christidis N. The hierarchy of different treatments for myogenous temporomandibular disorders: a systematic review and network meta-analysis of randomized clinical trials. Oral Maxillofac Surg 2021; 26:519-533. [PMID: 34674093 DOI: 10.1007/s10006-021-01009-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 09/23/2021] [Indexed: 02/08/2023]
Abstract
The best treatment modality for the management of painful temporomandibular disorders of muscular origin (M-TMD) with predictable outcomes based on solid evidence is still not well defined. Thus, the aim of this network meta-analysis (NMA) was to identify the best treatment for adult patients with M-TMD. An electronic search was undertaken from the inception of each database to August 2018, to identify randomized clinical trials (RCTs), which are comparing two or more of the following treatment modalities in patients with M-TMD: counseling therapy; occlusal appliances; manual therapy; laser therapy; dry needling; intramuscular injection of local anesthesia (LA) or botulinum toxin-A (BTX-A); muscle relaxants; hypnosis/relaxation therapy; oxidative ozone therapy; and placebo or no treatment. Primary outcome variables were the reduction of pain and mechanical sensitivity. The secondary outcome was the maximal mouth opening (MMO). The quality of evidence was rated according to Cochrane's tool for assessing risk of bias. Standardized mean difference was used to analyze via frequentist network meta-analysis (NMA), using STATA software. 52 RCTs were included in this NMA. At the most follow up moments, manual therapy, counseling therapy, occlusal splints therapy, and needling using BTX-A or LA as well as dry needling significantly decreased post-treatment pain intensity in M-TMDs, when compared to placebo. At short term (≤5 months), the four highest-ranked treatments for post-treatment pain reduction were manual therapy (83.5%, low quality evidence), ozone therapy (75.7%, very low quality evidence),counseling therapy (71.2%, moderate quality), and occlusal appliances (71.7%,moderate quality evidence). When intermediate term (≥6 months)was considered, BTX-A (85.8%, very low quality evidence) , counseling therapy(80%, low quality evidence), occlusal appliances (62.8%, low quality evidence) and hypnosis (50.6%, very low quality evidence) were the four highest-ranked treatments. This NMA reveals that manual therapy can be considered the most effective treatment for M-TMD, followed by counseling treatment, intramuscular injection of LA, and occlusal appliances . However, considering the limitations of the studies included, and the scarce of strong evidence, the present findings should be interpreted cautiously.
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Affiliation(s)
- Essam Ahmed Al-Moraissi
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Thamar University, Thamar, Yemen.
| | | | - Abdulmalik Alyahya
- Oral and Maxillofacial Surgery Department, King Abdulaziz Medical City - National Guard, Riyadh, Saudi Arabia
| | - Khaled Alkebsi
- Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Ahmed Elsharkawy
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Nikolaos Christidis
- Division of Oral Diagnostics and Rehabilitation, Department of Dental Medicine, Karolinska Institutet, and Scandinavian Center for Orofacial Neurosciences, SE-141 04, Huddinge, Sweden
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15
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Nilius M, Nilius MH. How precise are oral splints for frameless stereotaxy in guided ear, nose, throat, and maxillofacial surgery: a cadaver study. Eur Radiol Exp 2021; 5:27. [PMID: 34195878 PMCID: PMC8245614 DOI: 10.1186/s41747-021-00223-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 05/18/2021] [Indexed: 11/12/2022] Open
Abstract
Background Computer-assisted surgery optimises accuracy and serves to improve precise surgical procedures. We validated oral splints with fiducial markers by testing them against rigid bone markers. Methods We screwed twenty bone anchors as fiducial markers into different regions of a dried skull and measured the distances. After computed tomography (CT) scanning, the accuracy was evaluated by determining the markers’ position using frameless stereotaxy on a dry cadaver and indicated on the CT scan. We compared the accuracy of chairside fabricated oral splints to standard registration with bone markers immediately after fabrication and after a ten-time use. Accuracy was calculated as deviation (mean ± standard deviation). For statistical analysis, t test, Kruskal-Wallis, Tukey's, and various linear regression models, such as the Pearson's product–moment correlation coefficient, were used. Results Oral splints showed an accuracy of 0.90 mm ± 0.27 for viscerocranium, 1.10 mm ± 0.39 for skull base, and 1.45 mm ± 0.59 for neurocranium. We found an accuracy of less than 2 mm for both splints for a distance of up to 152 mm. The accuracy persisted even after ten times removing and reattaching the splints. Conclusions Oral splints offer a non-invasive indicator to improve the accuracy of image-guided surgery. The precision is dependent on the distance to the target. Up to 150-mm distance, a precision of fewer than 2 mm is possible. Dental splints provide sufficient accuracy than bone markers and may opt for higher precision combined with other non-invasive registration methods.
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Affiliation(s)
- Manfred Nilius
- NILIUSKLINIK Dortmund, Londoner Bogen 6, D-44269, Dortmund, Germany. .,Technische Universität Dresden, Dresden, Germany.
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Lo LJ, Niu LS, Liao CH, Lin HH. A novel CAD/CAM composite occlusal splint for intraoperative verification in single-splint two-jaw orthognathic surgery. Biomed J 2021; 44:353-362. [PMID: 34144940 PMCID: PMC8358214 DOI: 10.1016/j.bj.2020.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Revised: 06/22/2019] [Accepted: 03/02/2020] [Indexed: 11/08/2022] Open
Abstract
Background Previous computer-generated splints were designed and produced without modification than the traditional occlusal splints, which did not facilitate surgeon's intraoperative judgment in the single-splint two-jaw orthognathic surgery. Modifications of the digital occlusal splint can be achieved using computer-aided design and computer-aided manufacturing (CAD/CAM) software. This study reported the design, clinical application and validation of a novel CAD/CAM occlusal splint. Methods The maxillary and mandibular segments were fixed into the final occlusal splint and moved to the planned position according to the 3-dimensional simulation. The composite occlusal splint has 4 orthogonal bars to facilitate intraoperative assessment of the dental and skeletal midline, facial soft tissue midline, occlusal plane, upper tooth show, facial symmetry and facial bone position. To validate the surgical outcome, 5 parameters including pitch, roll and yaw rotations, midline deviation and chin position were measured on the virtual plan and the postoperative cone-beam computed tomography images to quantify the difference. Results The results showed no significant differences in the 5 parameters between the simulation and postoperative images. The root-mean-square difference between the conventional splints and CAD/CAM surgical splint ranged from 0.18 to 0.31 mm by superimposition of the two image models. All patients were satisfied with the treatment outcomes. Overall, this novel occlusal splint is ideal for verification of the maxillomandibular position during surgery. Conclusion The novel composite occlusal splint provided useful and informative check to verify the maxillomandibular complex (MMC) position and facial appearance in single-splint two-jaw orthognathic surgery.
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Affiliation(s)
- Lun-Jou Lo
- Department of Plastic and Reconstructive Surgery, and Craniofacial Research Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Lien-Shin Niu
- Craniofacial Research Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chun-Hao Liao
- Craniofacial Research Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Hsiu-Hsia Lin
- Craniofacial Research Center, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
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房 硕, 杨 广, 康 艳, 孙 玉, 谢 秋. [Method and accuracy of determining the jaw position of repositioning splint with the aid of digital technique]. Beijing Da Xue Xue Bao Yi Xue Ban 2020; 53:76-82. [PMID: 33550339 PMCID: PMC7867963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Indexed: 11/11/2023]
Abstract
OBJECTIVE To establish the workflow of determining the jaw position of repositioning splint with the aid of digital technique, and to evaluate the accuracy of this workflow and compare the accuracy of raising different vertical dimensions in vitro. METHODS A volunteer was recruited. The data of full-arch scans, cone beam computed tomography (CBCT) image and ultrasonic jaw motion tracking of the volunteer were acquired. The full-arch scans were merged with the CBCT image, which were then matched to the jaw motion tracking reference system. The jaw position of repositioning splint was determined when the anterior teeth opening was 3 mm and the condyle was in centric relation of the fossa in the sagittal plane. A digital repositioning splint was designed in the software based on virtual articulator and fabricated with additive manufacturing technique. After the splint was tried in, another CBCT image was taken and a qualitative analysis was conducted to compare the position of condyle between these two CBCT images. In the in vitro study, standard dental plaster casts with resin ball markers attached to the base were mounted onto a fully adjustable articulator in the intercuspal position. The dental casts were scanned by an extraoral scanner to establish digital models. The ultrasonic jaw motion tracking device was used to obtain simulated jaw movements on the articulator, which was repeated for three times. The digital models and data of jaw movements were merged in one coordination with the aid of bite forks. The jaw position of repositioning splint was determined by adjusting data of jaw movements, each of which was used to determine three vertical jaw positions 4 mm, 5 mm, and 6 mm with the horizontal jaw position of protrusion 2 mm. The virtual articulators with differently adjusted jaw movements were applied in designing repositioning splints, and the final repositioning splints and virtual jaw relationships were exported in STL format. Then the repositioning splints were fabricated with additive manufacturing technique and tried in plaster casts on the mechanical articulator, which were scanned and the jaw relationships on the mechanical articulator were exported later. The virtual jaw relationships and scanned jaw relationships were registered according to lower models and displacement of upper models was calculated. Ball markers were fit to acquire the coordinates of centers and absolute difference values of centers along three coordinating axes X, Y, and Z were calculated. One-way analysis of variance was conducted using SPSS 18.0 software to compare deviations of the three different vertical jaw relationships in two-side test and the significance level was 0.05. RESULTS With the aid of multi-source data fusion and individualized jaw motion, the clinical workflow of determining jaw position of repositioning splint was preliminarily established. The designed jaw position was realized on the right and the condyle was more inferior than the designed position on the left. Both displacement of the upper models and absolute difference values of centers showed no significant differences (P>0.05) in different vertical jaw dimensions. The displacement of the upper models was (0.25±0.04) mm. The absolute difference values of centers along the three coordinating axes X, Y, and Z were respectively (0.08±0.01) mm, (0.30±0.02) mm, and (0.21±0.04) mm. CONCLUSION A novel method of determining the jaw position of repositioning splint with the aid of digital technique is established. It is proved to be feasible by try-in after multi-data fusion, computer-aided design and computer-aided manufacturing. As is shown in vitro, it is accurate to apply this method in adjusting jaw position. Further clinical trial will be designed to evaluate its clinical effect.
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Affiliation(s)
- 硕博 房
- 北京大学口腔医学院·口腔医院,修复科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department 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 100081, China
- 北京大学口腔医学院·口腔医院,口颌功能诊疗研究中心 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Center for Oral and Jaw Functional Diagnosis, 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 100081, China
| | - 广聚 杨
- 北京大学口腔医学院·口腔医院,修复科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department 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 100081, China
- 北京大学口腔医学院·口腔医院,口颌功能诊疗研究中心 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Center for Oral and Jaw Functional Diagnosis, 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 100081, China
| | - 艳凤 康
- 北京大学口腔医学院·口腔医院,修复科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department 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 100081, China
- 北京大学口腔医学院·口腔医院,口颌功能诊疗研究中心 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Center for Oral and Jaw Functional Diagnosis, 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 100081, China
| | - 玉春 孙
- 北京大学口腔医学院·口腔医院,修复科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department 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 100081, China
| | - 秋菲 谢
- 北京大学口腔医学院·口腔医院,修复科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department 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 100081, China
- 北京大学口腔医学院·口腔医院,口颌功能诊疗研究中心 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Center for Oral and Jaw Functional Diagnosis, 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 100081, China
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房 硕, 杨 广, 康 艳, 孙 玉, 谢 秋. [Method and accuracy of determining the jaw position of repositioning splint with the aid of digital technique]. Beijing Da Xue Xue Bao Yi Xue Ban 2020; 53:76-82. [PMID: 33550339 PMCID: PMC7867963 DOI: 10.19723/j.issn.1671-167x.2021.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To establish the workflow of determining the jaw position of repositioning splint with the aid of digital technique, and to evaluate the accuracy of this workflow and compare the accuracy of raising different vertical dimensions in vitro. METHODS A volunteer was recruited. The data of full-arch scans, cone beam computed tomography (CBCT) image and ultrasonic jaw motion tracking of the volunteer were acquired. The full-arch scans were merged with the CBCT image, which were then matched to the jaw motion tracking reference system. The jaw position of repositioning splint was determined when the anterior teeth opening was 3 mm and the condyle was in centric relation of the fossa in the sagittal plane. A digital repositioning splint was designed in the software based on virtual articulator and fabricated with additive manufacturing technique. After the splint was tried in, another CBCT image was taken and a qualitative analysis was conducted to compare the position of condyle between these two CBCT images. In the in vitro study, standard dental plaster casts with resin ball markers attached to the base were mounted onto a fully adjustable articulator in the intercuspal position. The dental casts were scanned by an extraoral scanner to establish digital models. The ultrasonic jaw motion tracking device was used to obtain simulated jaw movements on the articulator, which was repeated for three times. The digital models and data of jaw movements were merged in one coordination with the aid of bite forks. The jaw position of repositioning splint was determined by adjusting data of jaw movements, each of which was used to determine three vertical jaw positions 4 mm, 5 mm, and 6 mm with the horizontal jaw position of protrusion 2 mm. The virtual articulators with differently adjusted jaw movements were applied in designing repositioning splints, and the final repositioning splints and virtual jaw relationships were exported in STL format. Then the repositioning splints were fabricated with additive manufacturing technique and tried in plaster casts on the mechanical articulator, which were scanned and the jaw relationships on the mechanical articulator were exported later. The virtual jaw relationships and scanned jaw relationships were registered according to lower models and displacement of upper models was calculated. Ball markers were fit to acquire the coordinates of centers and absolute difference values of centers along three coordinating axes X, Y, and Z were calculated. One-way analysis of variance was conducted using SPSS 18.0 software to compare deviations of the three different vertical jaw relationships in two-side test and the significance level was 0.05. RESULTS With the aid of multi-source data fusion and individualized jaw motion, the clinical workflow of determining jaw position of repositioning splint was preliminarily established. The designed jaw position was realized on the right and the condyle was more inferior than the designed position on the left. Both displacement of the upper models and absolute difference values of centers showed no significant differences (P>0.05) in different vertical jaw dimensions. The displacement of the upper models was (0.25±0.04) mm. The absolute difference values of centers along the three coordinating axes X, Y, and Z were respectively (0.08±0.01) mm, (0.30±0.02) mm, and (0.21±0.04) mm. CONCLUSION A novel method of determining the jaw position of repositioning splint with the aid of digital technique is established. It is proved to be feasible by try-in after multi-data fusion, computer-aided design and computer-aided manufacturing. As is shown in vitro, it is accurate to apply this method in adjusting jaw position. Further clinical trial will be designed to evaluate its clinical effect.
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Affiliation(s)
- 硕博 房
- 北京大学口腔医学院·口腔医院,修复科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department 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 100081, China
- 北京大学口腔医学院·口腔医院,口颌功能诊疗研究中心 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Center for Oral and Jaw Functional Diagnosis, 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 100081, China
| | - 广聚 杨
- 北京大学口腔医学院·口腔医院,修复科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department 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 100081, China
- 北京大学口腔医学院·口腔医院,口颌功能诊疗研究中心 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Center for Oral and Jaw Functional Diagnosis, 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 100081, China
| | - 艳凤 康
- 北京大学口腔医学院·口腔医院,修复科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department 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 100081, China
- 北京大学口腔医学院·口腔医院,口颌功能诊疗研究中心 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Center for Oral and Jaw Functional Diagnosis, 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 100081, China
| | - 玉春 孙
- 北京大学口腔医学院·口腔医院,修复科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department 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 100081, China
| | - 秋菲 谢
- 北京大学口腔医学院·口腔医院,修复科 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Department 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 100081, China
- 北京大学口腔医学院·口腔医院,口颌功能诊疗研究中心 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室,北京 100081Center for Oral and Jaw Functional Diagnosis, 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 100081, China
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Lin R, Yu CH, Sun J. [Construction and preliminary clinical evaluation of digital stabilization occlusal splint system]. Zhonghua Kou Qiang Yi Xue Za Zhi 2020; 55:983-6. [PMID: 33280364 DOI: 10.3760/cma.j.cn112144-20200629-00381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
To established a digital workflow for stabilization occlusal splint with computer-aided design and computer-aided manufacturing (CAD/CAM) methods. Two subjects were enrolled from April 2019 to May 2019 from Department of Prosthodontics, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine (one male, 25 years old; one female, 24 years old). The working models of the participants' dentition were made. Two stabilization occlusal splints were manufactured for each participant using digital workflow and conventional workflow. With the digital workflow, the three-dimensional (3D) scanning of the cast, recording of the digital personalized mandibular movements and condyle trajectory, and the design and the 3D printing for the fabrication of the final appliance using CAD/CAM technologies were performed. With conventional workflow, conventional technologies were adopted based on requirements and experiment of designing and manufacturing of stabilization splint. During try-in, a checklist was built to compare the clinical performance of the two workflows. The digital workflow of the stabilization occlusal splint was built successfully. The total score of clinical primary evaluation by the two subjects were 26 and 26 for digital workflow splints, and 25 and 23 for conventional workflow splints. Digital stabilization occlusal splint workflow is feasible.
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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: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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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Yildiz Domanic K, Aslan YU, Ozkan Y. Two-body wear of occlusal splint materials against different antagonists. BMC Oral Health 2020; 20:174. [PMID: 32571384 PMCID: PMC7310217 DOI: 10.1186/s12903-020-01165-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 06/15/2020] [Indexed: 11/30/2022] Open
Abstract
Background This study aimed to demonstrate that the material of the occlusal splint can be chosen according to the needs of individual patients and contribute to the knowledge of the wear rate of these materials. Methods In this study, four occlusal splint materials (Sr Ivocap Heat Cured, Valplast, SR Ivocap Elastomer and Eclipse) and three antagonists (natural tooth enamel, inCoris TZI and IPS e.max Press ceramic materials) were used. Each wear test was performed using a chewing simulator (n = 16; test load: 50 N; number of cycles: 10,000, 20,000 and 30,000; continuous rinsing with water at 30 °C for the wet condition). The Shapiro Wilk test was used for normal distribution suitability. Antagonist on average wear quantities both main effects and interactions of material, cycle and condition factors were investigated by Univariate variance analysis. Multiple comparisons were examined using the Games-Howell test. Results There was a statistically significant effect of the difference in materials on the amount of wear (p < 0.001). Furthermore, there was a statistically significant difference among the mean values of all materials (p > 0.001). The highest mean value was obtained with Eclipse (0,318 μm3), and the lowest mean value was obtained with Valplast (0,134 μm3). Conclusion Our study found differences in the in vitro wear rate among various occlusal splint materials.
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Affiliation(s)
- Kubra Yildiz Domanic
- Department of Prosthodontics, Dentistry Faculty, University of Marmara, Basibuyuk, Maltepe, Istanbul, Turkey.
| | - Yilmaz Umut Aslan
- Department of Prosthodontics, Dentistry Faculty, University of Marmara, Basibuyuk, Maltepe, Istanbul, Turkey
| | - Yasemin Ozkan
- Department of Prosthodontics, Dentistry Faculty, University of Marmara, Basibuyuk, Maltepe, Istanbul, Turkey
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Fouda AAH. No evidence on the effectiveness of oral splints for the management of temporomandibular joint dysfunction pain in both short and long-term follow-up systematic reviews and meta-analysis studies. J Korean Assoc Oral Maxillofac Surg 2020; 46:87-98. [PMID: 32364348 PMCID: PMC7222619 DOI: 10.5125/jkaoms.2020.46.2.87] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2019] [Revised: 11/30/2019] [Accepted: 12/17/2019] [Indexed: 11/26/2022] Open
Abstract
The aim of this study was to determine the efficacy of oral splints in reducing the intensity of pain in patients with temporomandibular joint dysfunction in both short and long-term treatment durations. Electronic databases, Cochrane Library, MEDLINE via PubMed, Web of Science, Egyptian Knowledge Bank, and EMBASE were searched for randomized controlled trials comparing different types of splints to non-occluding splints, behavioral therapy, pharmacotherapy, counseling, and no treatment. The risk of bias was assessed by using Cochrane risk of bias recommendations. Fixed and random effects were used to summarize the outcomes. The effect estimates were expressed as standardized mean differences (SMD) or risk ratios with a 95% confidence interval (CI). Subgroup analyses were carried out according to the treatment duration. Twenty-two studies met the inclusion criteria. A meta-analysis of short-term studies up to three months revealed no significant difference between the study groups. However, long-term studies exhibited a significant difference in pain reduction in favor of the control group. Total analysis revealed that the control group resulted in significant pain reduction (SMD 0.14, 95% CI 0.05-0.23, P=0.002, I2=0%). Oral splints are not effective in reducing pain intensity or improving function in patients with temporomandibular joint dysfunction.
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Abstract
Occlusal splint is a removable device for the treatment of oral and maxillary diseases with reversible occlusal treatment property. When patients wear the occlusal splint, the occlusal contact state can be changed and the position of the lower jaw may be adjusted, with the improvement of functions of temporomandibular joints and masticatory muscles. There are various types of occlusal splints, among which stabilization splint, soft occlusal splint and repositioning splint are widely used in the treatment of temporomandibular disorders and night bruxism. For the patients requiring occlusal reconstruction, occlusal splint can be used as an important means to adjust and verify the therapeutic jaw position. As a major trend of research in future, the digital design and production of occlusal splint are still in the initial stage and need to be further improved.
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Affiliation(s)
- Q F Xie
- 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, Beiijng 100081, China
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Abstract
Temporomandibular disorders (TMD) is a common clinical disease with complex etiology and diverse treatment. There are many studies on the treatment of TMD. Occlusal splint therapy is the most commonly used TMD treatment solution, but its effectiveness remains unclear. A review of the latest literature is therefore conducted to evaluate the effectiveness of splint therapy for TMD.
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Demjaha G, Kapusevska B, Pejkovska-Shahpaska B. Bruxism Unconscious Oral Habit in Everyday Life. Open Access Maced J Med Sci 2019; 7:876-881. [PMID: 30962854 PMCID: PMC6447347 DOI: 10.3889/oamjms.2019.196] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 02/21/2019] [Accepted: 02/22/2019] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND: Bruxism is defined as an unconscious oral habit of rhythmical, unfunctional clenching, grinding and making chewy sounds with the teeth while making movements that are not part of the masticatory function and that lead to occlusal trauma. AIM: The purpose of this article is to show the habit bruxism, in everyday life, reviewing literature data. METHODS: Data was researched by using information on the internet on Researchgate, Pubmed, ScienceDirect, by analysing written articles and books and student books. From 200 articles that were analysed, 45 articles and two textbooks were involved in writing of this review article. RESULTS: Results derived from the analyzed literature, classify the main consequences of bruxism, from fatigue, pain, wasting of the incisal edges and occlusal surfaces of the teeth to loss of teeth, dental implants, headaches, periodontal lesions and TMD (dysfunctions of the masticatory muscles and temporomandibular joint (TMJ)) in severe cases. All these problems negatively affect the quality of everyday life of the patient. CONCLUSION: Bruxism as a parafunctional habit is present in everyday life needing a multidisciplinary approach for prevention of the teeth, bone and prosthetic restorations. The prevalence of bruxism is growing related to stress, drugs, changes in lifestyle, bad nutrition and sleep problems. The therapist should follow signs and symptoms to ensure the best treatment plan of the patient.
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Affiliation(s)
| | - Biljana Kapusevska
- Faculty of Dentistry, Ss Cyril and Methodius University of Skopje, Skopje, Republic of Macedonia
| | - Budima Pejkovska-Shahpaska
- University Dental Clinic St. Pantelejmon, Departement for Removable Prosthetics, Skopje, Republic of Macedonia
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He HJ, Zheng LL, Yu JF, Zhou JP, Chen J. [Bone remodeling in patients with juvenile condylar resorption after stabilization splint treatment]. Zhonghua Kou Qiang Yi Xue Za Zhi 2018; 53:832-837. [PMID: 30522207 DOI: 10.3760/cma.j.issn.1002-0098.2018.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate bone remodeling in patients with different types of juvenile condylar resorption after stabilization splint treatment using cone-beam CT (CBCT). Methods: Fifty-nine juvenile condylar resorption patients (114 sides of condyle) treated with stabilization splint from January 2012 to May 2018 in Department of Temporomandibular Joint, Stomatological Hospital of Chongqing Medical University were selected as splint group, while twenty-four patients (48 sides of condyle) who underwent natural remodeling without stabilization splint treatment after 6-12 months were severed as control group. Pre-and post-treatment CBCT was taken for all patients. There were three types of condyles (including type Ⅰ, type Ⅱ and type Ⅲ) before treatment and four types of condyles (including progression, no changes, stable without new bone and remodeled with new bone) after treatment. Progression and no change were considered as poor curative effect, and stable without new bone and remodeled with new bone were considered to be effective. The vertical distance of the condylar height was measured and compared before and after treatment in the two groups. Results: Significant difference in treatment outcome was found in types Ⅰ and Ⅱ between the splint group and the control group (Z=-2.874, P=0.004; Z=-3.874, P=0.000), and no significant difference was found in type Ⅲ between the two groups (Z=-0.617, P=0.537). The difference of condylar progression percentage [splint group: 43% (15/35), control group: 80% (16/20)] was statistically significant between the two groups in type Ⅱ (χ(2)=7.139, P=0.011), and no significant difference was found in types Ⅰ and Ⅲ between the two groups (χ(2)=0.103, P=0.748; χ(2)=1.249, P=0.540). In two groups, the condylar height difference before and after treatment in type Ⅱ condylar resorption was statistically significant (P<0.05). Conclusions: Stabilization splint treatment was effective in patients with different types of juvenile condylar resorption, especially in type Ⅰ. However, it was difficult to reverse the height reduction of the condylar bone regardless of treatment.
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Affiliation(s)
- H J He
- Department of Orthodontics, Stomatological Hospital of Chongqing Medical University & Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences & Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing 401147, China
| | - L L Zheng
- Department of Orthodontics, Stomatological Hospital of Chongqing Medical University & Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences & Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing 401147, China
| | - J F Yu
- Department of Orthodontics, Stomatological Hospital of Chongqing Medical University & Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences & Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing 401147, China
| | - J P Zhou
- Department of Temporomandibular Joint, Stomatological Hospital of Chongqing Medical University & Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences & Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing 401147, China
| | - J Chen
- Department of Orthodontics, Stomatological Hospital of Chongqing Medical University & Chongqing Key Laboratory of Oral Diseases and Biomedical Sciences & Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing 401147, China
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Michiels S, van der Wal AC, Nieste E, Van de Heyning P, Braem M, Visscher C, Topsakal V, Gilles A, Jacquemin L, Hesters M, De Hertogh W. Conservative therapy for the treatment of patients with somatic tinnitus attributed to temporomandibular dysfunction: study protocol of a randomised controlled trial. Trials 2018; 19:554. [PMID: 30314506 PMCID: PMC6186065 DOI: 10.1186/s13063-018-2903-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 09/04/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Tinnitus is a highly prevalent symptom affecting 10-15% of the adult population. It often affects patient quality of life and frequently causes distress. When subjective tinnitus can be elicited by the somatosensory system of the cervical spine or temporomandibular area it is termed somatic tinnitus. The first aim of the current study is to investigate the effect of the best evidence conservative temporomandibular disorder (TMD) treatment on tinnitus in patients with co-existence of tinnitus and TMD or oral parafunctions compared to no treatment. The second aim is to identify a subgroup of patients with tinnitus that benefits from the conservative temporomandibular joint treatment. METHODS AND DESIGN This study is a randomised controlled trial with a delayed treatment design. Patients with a TMD (TMD pain screener ≥ 3 points) or oral parafunctions (such as clenching and bruxism), who are suffering from moderate to severe subjective tinnitus (Tinnitus Functional Index (TFI) between 25 and 90 points), will be recruited from the tertiary tinnitus clinic of the University Hospital of Antwerp, Edegem, Belgium. Patients will be excluded in case of clear otological or neurological causes of the tinnitus, progressive middle ear pathology, intracranial pathology, traumatic cervical spine or temporomandibular injury in the past 6 months, severe depression as diagnosed by a psychologist, tumours, previous surgery in the orofacial area, substance abuse that may affect the outcome measures, any contra-indication for physical therapy treatment directed to the orofacial area or when they received TMD treatment in the past 2 months. After screening for eligibility, baseline data among which scores on the TFI, tinnitus questionnaire (TQ), mean tinnitus loudness as measured with visual analogue scale (VAS), TMD pain screener, and a set of temporomandibular joint tests will be collected. Patients will be randomised in an early-start group and in a delayed-start group of therapy by 9 weeks. Patients will receive conservative TMD treatment with a maximum of 18 sessions within 9 weeks. At baseline (week 0), at the start of therapy (weeks 0 or 9), 9 weeks after therapy (weeks 9 or 18), and at follow-up (weeks 18 or 27) data from the TFI, TQ, VAS mean tinnitus loudness and the TMD pain screener will be collected. DISCUSSION Herein, we aim to improve the quality of care for patients with tinnitus attributed to TMD or oral parafunctions. By evaluating the effect of state-of-the-art TMD treatment on tinnitus complaints, we can investigate the usefulness of TMD treatment in patients with somatic tinnitus. TRIAL REGISTRATION 3 July 2017, version 1 of the protocol, ClinicalTrials.gov NCT03209297 .
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Affiliation(s)
- Sarah Michiels
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium. .,Department of Otorhinolaryngology, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium. .,Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium. .,Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.
| | - Annemarie Christien van der Wal
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Department of Otorhinolaryngology, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium.,Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Evelien Nieste
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Department of Otorhinolaryngology, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium.,Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Paul Van de Heyning
- Department of Otorhinolaryngology, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium.,Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Multidisciplinary Motor Centre Antwerp, University of Antwerp, Antwerp, Belgium.,Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Marc Braem
- Lab Dental Materials, University of Antwerp, 2610, Antwerp, Belgium.,Department of Special Care Dentistry, University Hospital Antwerp, 2650, Edegem, Belgium.,Faculty of Medicine and Health Sciences, University of Antwerp, 2610, Antwerp, Belgium
| | - Corine Visscher
- Department of Oral Health Sciences, Academic Centre for Dentistry Amsterdam, University of Amsterdam and VU University Amsterdam, Research Institute MOVE Amsterdam, Amsterdam, Netherlands
| | - Vedat Topsakal
- Department of Otorhinolaryngology, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium.,Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Annick Gilles
- Department of Otorhinolaryngology, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium.,Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Department of Human and Social Welfare, University College Ghent, Ghent, Belgium
| | - Laure Jacquemin
- Department of Otorhinolaryngology, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium.,Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Department of Translational Neurosciences, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Marianne Hesters
- Department of Special Care Dentistry, University Hospital Antwerp, 2650, Edegem, Belgium
| | - Willem De Hertogh
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
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Hasegawa Y, Kakimoto N, Tomita S, Fujiwara M, Ishikura R, Kishimoto H, Honda K. Clinical study of splint therapeutic efficacy for the relief of temporomandibular joint discomfort. J Craniomaxillofac Surg 2017; 45:1772-7. [PMID: 28943181 DOI: 10.1016/j.jcms.2017.08.019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 07/17/2017] [Accepted: 08/15/2017] [Indexed: 11/21/2022] Open
Abstract
PURPOSE This study aimed to evaluate the relationship between displacement of the mandibular condyle/disc due to occlusal splint insertion with splint therapy and changes in discomfort of the temporomandibular joint (TMJ), and to clarify the relationships between the outcomes over time of temporomandibular discomfort and TMJ magnetic resonance imaging (MRI) findings at the initiation of splint therapy. MATERIALS AND METHODS A total of 75 patients admitted to hospital with discomfort around the TMJ were evaluated. A visual analogue scale for TMJ discomfort was administered during visits for approximately 3 months following the initiation of splint therapy. At the start of splint therapy, magnetic resonance imaging (MRI) was performed with and without splint insertion, and condyle and disc movements were evaluated. Disc balance, disc position and function, disc configuration, joint effusion, osteoarthritis, and bone marrow were evaluated. Linear regression and multiple regression analyses were used to clarify relationships between changes in discomfort and the factors evaluated. RESULTS There was no significant correlation between TMJ discomfort and condyle/disc movement with splint insertion. TMJ discomfort was significantly relieved by splint therapy regardless of temporomandibular MRI findings. Unilateral anterior disc displacement and marked or extensive joint effusion fluid were significantly improved with splint therapy. CONCLUSION Discomfort tended to remit with splint therapy regardless of temporomandibular MRI findings. Improvement of TMJ discomfort appears more likely to occur in patients with unilateral anterior disc displacement and with an apparent organic disorder, such as a joint effusion.
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Salgueiro MDCC, Bortoletto CC, Horliana ACR, Mota ACC, Motta LJ, Motta PDB, MesquitaFerrari RA, Fernandes KPS, Bussadori SK. Evaluation of muscle activity, bite force and salivary cortisol in children with bruxism before and after low level laser applied to acupoints: study protocol for a randomised controlled trial. Altern Ther Health Med 2017; 17:391. [PMID: 28789647 PMCID: PMC5549372 DOI: 10.1186/s12906-017-1905-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2017] [Accepted: 08/02/2017] [Indexed: 12/02/2022]
Abstract
Background Bruxism is a repetitive activity that causes tooth wear, audible sounds, and discomfort. Preventive measures have been studied for conditions that can exert a negative influence on physiological development in children. Low-level laser therapy administered over acupoints is an effective, painless, low-cost treatment option that has achieved good results. Thus, the aim of the proposed study is to evaluate changes in muscle activity, bite force and salivary cortisol in children with bruxism after the application of low-level laser to accupoints. Methods The children will be randomly allocated to four groups of 19 individuals: G1 - low-level laser; G2 - occlusal splint; G3 - placebo laser; and G4 - control (without bruxism). The BTS TMJOINT electromyography will be used to determine muscle activity and a digital gnathodynamometer will be used to measure bite force. Salivary cortisol will be analysed at baseline as well as one and six months after treatment. Two-way ANOVA will be employed and complemented by Tukey’s test. Discussion Bruxism is a repetitive activity of the masticatory muscles that can have negative consequences if not treated, such as tooth wear, noises, discomfort and anxiety. Thus, control and treatment measures should be taken. Although low-level laser therapy over acupoints has been indicated for children, the effects of this treatment modality have not yet been studied. Trial registration NCT02757261 on 8 April 2016. This study protocol received a grant from the Brazilian fostering agency São Paulo Research Foundation (FAPESP: #2015/24731-0). Electronic supplementary material The online version of this article (doi:10.1186/s12906-017-1905-y) contains supplementary material, which is available to authorized users.
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Goiato MC, Zuim PRJ, Moreno A, Dos Santos DM, da Silva EVF, de Caxias FP, Turcio KHL. Does pain in the masseter and anterior temporal muscles influence maximal bite force? Arch Oral Biol 2017; 83:1-6. [PMID: 28688272 DOI: 10.1016/j.archoralbio.2017.06.029] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 06/20/2017] [Accepted: 06/22/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate changes in pain and muscle force, and the relationship between them, in patients with muscle pain and bruxism, prior to and after treatment. METHODS Thirty women with bruxism and myofascial pain (Ia) were included in this study. Sleep bruxism diagnosis was made based on clinical diagnostic criteria, and awake bruxism diagnosis was made by patient questionnaires and the presence of tooth wear. The diagnosis of myofascial pain was established according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC-TMD). Dentulous or partially edentulous patients (rehabilitated with conventional fixed prostheses) were included in the study according to the inclusion and exclusion criteria. The pain treatment protocol included occlusal splints, patient education, and physiotherapy for 30days. Bite force was measured using a dynamometer at the central incisor and the first molar regions on both sides. The exams were performed at baseline, after 7days, and 30days after treatment. The Wilcoxon test was used to compare patient pain level response among the periods analyzed in the study. Bite force data were submitted to two-way repeated-measures ANOVA, followed by the Tukey HSD test (p<0.05). A simple regression analysis was performed to verify the relation between pain level and bite force. RESULTS Results revealed that there was a statistical difference in pain level over time for both muscles and sides (p<0.01). In the molar region, the bite force exhibited significantly higher values after 30days of treatment, when compared with the baseline (p<0.001). There was a correlation between pain level and bite force only for the temporal muscle in all periods analyzed (p<0.05). There was no strong correlation in the response level points to support the association of pain and bite force. CONCLUSIONS Pain level decreased and bite force increased in the molar region after treatment. No strong correlation or dispersion in the relationship between pain levels and bite force was seen in women with myofascial pain and bruxism.
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Affiliation(s)
- Marcelo Coelho Goiato
- Department of Dental Materials and Prosthodontics, Aracatuba Dental School, Sao Paulo State University (UNESP), Brazil
| | - Paulo Renato Junqueira Zuim
- Department of Dental Materials and Prosthodontics, Aracatuba Dental School, Sao Paulo State University (UNESP), Brazil
| | - Amália Moreno
- Department of Oral Surgery, Pathology and Dental Clinical, School of Dentistry, Federal University of Minas Gerais (UFMG), Brazil
| | - Daniela Micheline Dos Santos
- Department of Dental Materials and Prosthodontics, Aracatuba Dental School, Sao Paulo State University (UNESP), Brazil
| | | | - Fernanda Pereira de Caxias
- Department of Dental Materials and Prosthodontics, Aracatuba Dental School, Sao Paulo State University (UNESP), Brazil
| | - Karina Helga Leal Turcio
- Department of Dental Materials and Prosthodontics, Aracatuba Dental School, Sao Paulo State University (UNESP), Brazil.
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Abstract
AIM The purpose of this intervention was to treat the patient, a 51-year-old woman, who was wearing a maxillary denture and a mandibular bilateral distal-extension partial denture (both unfit) and was suffering from temporomandibular disorder (TMD). METHODOLOGY The treatment suggested was to construct a superior repositioning splint (SRS), and after remission of the symptomatology, fabricate new dentures. RESULTS The occlusal splint was effective and the symptomatology ceased after about five months of treatment. The new dental prostheses were made and followed up for 10 years with no return of the pain. CONCLUSIONS SRS and subsequent construction of new dentures after remission of the symptomatology was an effective treatment for TMD in the case described.
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Affiliation(s)
- Mariana Marquezan
- a Department of Pediatric Dentistry and Orthodontics , Universidade Federal do Rio de Janeiro (UFRJ) , Rio de Janeiro , Brazil.,b Department of Restorative Dentistry , Universidade Federal de Santa Maria (UFSM) , Santa Maria , Rio Grande do Sul , Brazil
| | - Cláudio Figueiró
- b Department of Restorative Dentistry , Universidade Federal de Santa Maria (UFSM) , Santa Maria , Rio Grande do Sul , Brazil
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Bortoletto CC, Cordeiro da Silva F, Silva PFDC, Leal de Godoy CH, Albertini R, Motta LJ, Mesquita-Ferrari RA, Fernandes KPS, Romano R, Bussadori SK. Evaluation of Cranio-cervical Posture in Children with Bruxism Before and After Bite Plate Therapy: A Pilot Project. J Phys Ther Sci 2014; 26:1125-8. [PMID: 25140110 PMCID: PMC4135211 DOI: 10.1589/jpts.26.1125] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2013] [Accepted: 02/07/2014] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The aim of the present study was to evaluate the effect of a biteplate on the
cranio-cervical posture of children with bruxism. [Subjects and Methods] Twelve male and
female children aged six to 10 years with a diagnosis of bruxism participated in this
study. The children used a biteplate during sleep for 30 days and were submitted to three
postural evaluations: initial, immediately following placement of the biteplate, and at
the end of treatment. Posture analysis was performed with the aid of the
Alcimagem® 2.1 program. Data analysis (IBM SPSS Statistics 2.0) involved
descriptive statistics and the Student’s t-test. [Results] A statistically significant
difference was found between the initial cranio-cervical angle and the angle immediately
following placement of the biteplate. However, no statistically significant difference was
found between the initial angle and the angle after one month of biteplate usage.
[Conclusion] No significant change in the cranio-cervical posture of the children was
found one month of biteplate usage. However, a reduction occurred in the cranio-cervical
angle when the biteplate was in position.
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Affiliation(s)
| | | | | | | | - Regiane Albertini
- Master's Course in Rehabilitation Sciences, Nove de Julho University (UNINOVE), 235, Brazil
| | - Lara J Motta
- Master's Program Management Healthcare System, Nove de Julho University (UNINOVE), Brazil
| | | | | | - Renata Romano
- Rehabilitation Sciences, Nove de Julho University (UNINOVE), Brazil
| | - Sandra Kalil Bussadori
- Master's Course in Rehabilitation Sciences, Nove de Julho University (UNINOVE), 235, Brazil
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Gümüş HÖ, Kılınç Hİ, Tuna SH, Ozcan N. Computerized analysis of occlusal contacts in bruxism patients treated with occlusal splint therapy. J Adv Prosthodont 2013; 5:256-61. [PMID: 24049566 PMCID: PMC3774939 DOI: 10.4047/jap.2013.5.3.256] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Revised: 06/21/2013] [Accepted: 06/28/2013] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Occlusal splints are commonly used to prevent tooth wear caused by bruxism. However, the effects of splints on occlusion are still unclear. Although it is rarely alluded in literature, splints can provoke severe occlusal alterations and other complications. This study was aimed to identify differences in the responses of individuals with bruxism and healthy individuals to a full-arch maxillary stabilization splint in terms of occlusal changes. MATERIALS AND METHODS Occlusal contacts in 20 (5 male, 15 female) bruxism patients and 20 (5 male, 15 female) controls with normal occlusion were evaluated before and after occlusal splint therapy. T-Scan III, a computerized occlusal analysis system, was used to simultaneously measure occlusion and disclusion times as well as left-right and anterior-posterior contact distributions before splint therapy and 3 months after therapy. Wilcoxon and Mann-Whitney U tests were used for statistical analyses (α=.05). RESULTS No differences were found in the posterior contact of bruxism patients before and after stabilization splint treatment. However, differences in posterior contact were observed between bruxists and normal individuals prior to treatment, and this difference disappeared following treatment. CONCLUSION The results of this study showed the use of a stabilization splint may not have an effect on occlusion. However, the area of posterior occlusal contact among bruxists was found to be greater than that of normal individuals. According to this study, the clinical use of splints may be harmless.
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Affiliation(s)
- Hasan Önder Gümüş
- Department of Prosthodontics, Faculty of Dentistry, Erciyes University, Kayseri, Turkey
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