Home About us Contact
|
Home About us Contact | ||
|
|
||
Splint
Kinds of Splint Terms modified by Splint Selected AbstractsCongenital Left Ventricular Splint in an Adult Patient with Unrepaired Anomalous Left Coronary Artery from the Pulmonary ArteryCONGENITAL HEART DISEASE, Issue 4 2007Adam M. Sabbath MD ABSTRACT A 24-year-old woman presented with a recent increase in dyspnea on exertion and development of presyncope. The patient stated that she has reproducible episodes of dizziness and near fainting when she climbs a flight of stairs and activity is limited to a slow gait. [source] Immediate surgical repositioning following intrusive luxation: a case report and review of the literatureDENTAL TRAUMATOLOGY, Issue 6 2006H. Cem Güngör Abstract,,, This report presents a case of severe intrusive luxation of mature maxillary lateral incisor in a 10-year-old boy. The intruded tooth was immediately repositioned (surgical extrusion) and splinted within 2 h following injury. Tetracycline therapy was initiated at the time of repositioning and maintained for 10 days. Pulp removal and calcium hydroxide treatment of the root canal was carried out after repositioning. Splint was removed 1 month later. Definitive root canal treatment with gutta percha was accomplished at the second month recall. Clinical and radiographic examination 28 months after the surgical extrusion revealed satisfactory apical and periodontal healing. [source] Orthodontics Using an Occlusal Splint: A Clinical ReportJOURNAL OF PROSTHODONTICS, Issue 2 2010Akit Patel BDS, MClinDent (Prostho), MFDS RCS (Eng) Abstract Careful management of the occlusion is necessary for successful prosthodontic treatment. A reorganized occlusal approach requires a more accurate registration of the desired jaw position, and where it is difficult to achieve this, an occlusal splint is indicated. This clinical report documents a 60-year-old man with a Prosthodontic Diagnostic Index Class IV dentition, who prior to a full-mouth reconstruction, underwent occlusal splint therapy with a Michigan-type splint that incorporated z-springs to allow concurrent orthodontic tooth movement of two anterior teeth to positions that would allow favorable restorations by correcting occlusal and esthetic form. [source] Does three months of nightly splinting reduce the extensibility of the flexor pollicis longus muscle in people with tetraplegia?PHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 1 2007Lisa Harvey Abstract Background and Purpose.,The extensibility of the paralysed flexor pollicis longus (FPL) muscle is an important determinant of an effective tenodesis grip in people with C6 and C7 tetraplegia. Therapists believe that splinting can reduce the extensibility of the FPL muscle and thus improve hand function. However, there remains much controversy around the optimal position of splinting and its effectiveness is yet to be verified. The aim of the present study was to determine whether a three-month thumb splinting protocol reduces extensibility of the FPL muscle in people with tetraplegia.,Method.,An assessor-blinded, within-subject, randomized controlled trial was undertaken. Twenty people with tetraplegia and bilateral paralysis of all thumb muscles were recruited from a sample of convenience. One randomly selected hand of each subject was splinted each night for three months. The splint immobilized the FPL muscle in a relatively shortened position by positioning the carpometacarpal and metacarpophalangeal joint of the thumb in flexion. The other hand remained unsplinted for the duration of the study. Carpometacarpal angle was measured with the application of a standardized torque by a blinded assessor at the beginning and end of the three-month study period. A device specifically designed for this purpose that stabilized the wrist and other joints of the thumb in full extension was used.,Results.,No subject withdrew from the study. The three-month splinting protocol had a mean treatment effect on carpometacarpal joint angle of 0° (95% CI, ,6° to 6°).,Conclusion.,Splinting the FPL muscle in a relatively shortened position each night for three months does not reduce its extensibility. Copyright © 2006 John Wiley & Sons, Ltd. [source] Reduction in parafunctional activity: a potential mechanism for the effectiveness of splint therapyJOURNAL OF ORAL REHABILITATION, Issue 2 2007A. G. GLAROS summary, Interocclusal splints may be an effective modality in the management of temporomandibular disorders (TMD), but there is little evidence regarding the mechanism by which splints work. This study tested the hypothesis that pain reduction produced by splints is associated with reduction in parafunctional activity. In a two-group, single-blinded randomized clinical trial, patients diagnosed with myofascial pain received full coverage hard maxillary stabilization splints. Patients were instructed to maintain or avoid contact with the splint for the 6 weeks of active treatment. Patients who decreased the intensity of tooth contact were expected to show the greatest alleviation of pain, and those who maintained or increased contact were expected to report lesser reductions in pain. Experience-sampling methodology was used to collect data on pain and parafunctional behaviours at pre-treatment and during the final week of treatment. Patients were reminded approximately every 2 h by pagers to maintain/avoid contact with the splint. The amount of change in intensity of tooth contact accounted for a significant proportion of the variance in pain change scores. Patients who reduced tooth contact intensity the most reported greater relief from pain. Splints may produce therapeutic effects by reducing parafunctional activities associated with TMD pain. [source] Fate of developing tooth buds located in relation to mandibular fractures in three infancy casesDENTAL TRAUMATOLOGY, Issue 4 2010Kazuhiko Yamamoto Three infants, 2 girls and a boy, aged from 1 year and 5-months old to 2 years and 6-months old, were treated for dislocated mandibular fracture in the symphyseal region by manual reduction and fixation with a thermoforming splint and circumferential wiring under general anesthesia. Fracture healing was uneventful in all cases. A few years later, no obvious deformity of the jaw or malocclusion was observed; however, malformation of the crown was found in one of the permanent teeth on the fracture line in the first case. In the second case, no abnormality was observed in one of the permanent teeth on the fracture line, but the effect on the other tooth could not be evaluated due to abnormality of the tooth probably not related to the injury. In the third case, root formation was arrested in one of the permanent teeth on the fracture line and the tooth was lost early after eruption. The development of tooth buds on the fracture line is not predictable and therefore, should be monitored by regular follow up. [source] Orthodontic rehabilitation for anterior teeth lost due to trauma with crowding malocclusionDENTAL TRAUMATOLOGY, Issue 4 2010Masayoshi Kawakami The central incisors were immediately replaced and fixed with application of a semi-rigid splint for 12 days, then endodontically treated. Severe root resorption and degeneration of periodontal tissue were noted after 4 years and the teeth were extracted, while the patient had also developed maxillary protrusion with severe crowding in the lower arch. The treatment objectives were to close the spaces by mesial movement of the buccal segment in the upper arch and eliminate crowding by extraction of the lower bicuspids. Favorable occlusion was achieved as was substitution with the lateral incisors for the lost central teeth. [source] An evaluation of the Periotest® method as a tool for monitoring tooth mobility in dental traumatologyDENTAL TRAUMATOLOGY, Issue 2 2010Christine Berthold The aims of this study were to determine normal Periotest® values in the vertical and horizontal dimensions of periodontally healthy teeth in individuals aged 20,35 years and investigate the reliability of Periotest® in terms of intra-series and inter-series reproducibility before and after applying a dental trauma splint in vivo. Materials and methods:, Periotest® values were measured in periodontally healthy dental students (n = 33; mean age 24.7 years) at reproducible measuring points in the vertical and horizontal dimensions, before and after splint insertion. Three readings were taken per series to observe the intra-series reproducibility; three series were measured to test inter-series reproducibility (Friedman-test; P , 0.001). Two different wire-composite splints, 0.45 mm Dentaflex and 0.8 × 1.8 Strengtheners, were inserted and the Periotest® values were measured. Results:, The median Periotest® values before splinting were: canines -2.5, lateral incisors -0.9, and central incisors 0.0 for the vertical dimension, and canines 1.1, lateral incisors 3.2, and central incisors 3.6 for the horizontal dimension. The intra-series and inter-series Periotest® values were highly reproducible. Conclusion:, The Periotest® method provides highly reproducible results. Focused on dental trauma, the method can be applied diagnostically during the splint and follow-up period and for evaluating splint rigidity. [source] Rigidity of commonly used dental trauma splintsDENTAL TRAUMATOLOGY, Issue 3 2009Christine Berthold We evaluated the rigidity of various commonly used splints in vitro Material and Methods:, An acrylic resin model was used. The central incisors simulated injured teeth, with increased vertical and horizontal mobility. The lateral incisors and canines stimulated uninjured teeth. Tooth mobility was measured with the Periotest® device. Vertical and horizontal measurements were made before and after splinting, and the difference between values was defined as the splint effect. We evaluated 4 composite splints, 3 wire-composite splints, a titanium trauma splint, a titanium ring splint, a bracket splint, and 2 Schuchardt splints Results:, For all injured teeth and all splints, there was a significant splint effect for the vertical and horizontal dimensions (P < 0.05). For injured teeth, the composite splints produced the largest changes in vertical tooth mobility; wire-composite splints 1 and 2, using orthodontic wires, produced the smallest vertical splint effects. For uninjured teeth, the Schuchardt 1 splint and the bracket splint produced the largest splint effects; wire-composite splints 1 and 2 produced only a slight change in tooth mobility. Composite splints 2 and 3 produced the largest horizontal splint effects for injured teeth, and the 4 composite splints produced the largest horizontal splint effects for uninjured teeth. The most horizontally flexible splints were the titanium trauma splint and wire-composite splints 1 and 2. Conclusions:, According to the current guidelines and within the limits of an in vitro study, it can be stated that flexible or semirigid splints such as the titanium trauma splint and wire-composite splints 1 and 2 are appropriate for splinting teeth with dislocation injuries and root fractures, whereas rigid splints such as wire-composite splint 3 and the titanium ring splint can be used to treat alveolar process fractures. [source] Pulp and periodontal healing of laterally luxated permanent teeth: results after 4 yearsDENTAL TRAUMATOLOGY, Issue 6 2008Elena C. Ferrazzini Pozzi Material and methods:, Patients presenting with lateral luxation of permanent teeth during 2001,2002 were enrolled in this clinical study. Laterally luxated teeth were repositioned and splinted with a TTS/composite resin splint for 4 weeks. Immediate (prophylactic) root-canal treatment was performed in severely luxated teeth with radiographically closed apices. All patients received tetracycline for 10 days. Re-examinations were performed after 1, 2, 3, 6, 12 and 48 months. Results:, All 47 laterally luxated permanent teeth that could be followed over the entire study period survived. In 10 teeth (21.3%), a prophylactic root-canal treatment was performed within 2 weeks following injury. The remaining 37 teeth showed the following characteristics at the 4-year re-examination: 19 teeth (51.4%) had pulp survival (no clinical or radiographic signs or symptoms), nine teeth (24.3%) presented with pulp canal calcification, and pulp necrosis was seen in another nine teeth (24.3%), within the first year after trauma. None of the teeth with a radiographically open apex at the time of lateral luxation showed complications. External root resorption was only seen in one tooth. Conclusions:, Laterally luxated permanent teeth with incomplete root formation have a good prognosis, with all teeth surviving in this study. The most frequent complication was pulp necrosis that was only seen in teeth with closed apices. [source] An evidence-based appraisal of splinting luxated, avulsed and root-fractured teethDENTAL TRAUMATOLOGY, Issue 1 2008Bill Kahler For this systematic review of splinting of teeth that have been luxated, avulsed or root-fractured, the clinical PICO question is (P) what are splinting intervention decisions for luxated, avulsed and root-fractured teeth (I) considering that the splinting intervention choice may include (i) no splinting, (ii) rigid or functional splinting for the different types of trauma and (iii) different durations of the splinting period (C) when comparing these splinting choices for the different types of trauma and their effect on (O) healing outcomes for the teeth. A keyword search of PubMed was used. Reference lists from identified articles and dental traumatology texts were also appraised. The inclusion criterion for this review was either a multivariate analysis or controlled stratified analyses as many variables have the potential to confound the assessment and evaluation of healing outcomes for teeth that have been luxated, avulsed or root-fractured. A positive statistical test is not proof of a causal conclusion, as a positive statistical relationship can arise by chance, and so this review also appraises animal studies that reportedly explain biological mechanisms that relate to healing outcomes of splinted teeth. The clinical studies were ranked using the ,Centre of Evidence-based Medicine' categorization (levels 1,5). All 12 clinical studies selected were ranked as level 4. The studies generally indicate that the prognosis is determined by the type of injury rather than factors associated with splinting. The results indicate that the types of splint and the fixation period are generally not significant variables when related to healing outcomes. This appraisal identified difficulties in the design of animal experimentation to correctly simulate some dental injuries. Some of the studies employed rigid splinting techniques, which are not representative of current recommendations. Recommended splinting treatment protocols for teeth that have been luxated, avulsed or root-fractured teeth are formulated on the strength of research evidence. Despite the ranking of these studies in this appraisal as low levels of evidence, these recommendations should be considered ,best practice', a core philosophy of evidence-based dentistry. [source] Dental trauma that require fixation in a children's hospitalDENTAL TRAUMATOLOGY, Issue 1 2008Timothy Bruns Complex injuries to permanent teeth and their periodontium require immediate repositioning and stabilization. Many of these emergencies are treated by pediatric dental residents at the Women and Children's Hospital of Buffalo, Buffalo, New York. The purpose of this study was to characterize these complex injuries of permanent teeth that require emergency treatment in a Children's Hospital. All of the cases of dental trauma which had involved permanent teeth and which had been treated with a splint in 2001 and 2002 were reviewed. There were 79 patients that were between 5 and 19 years of age with twice as many males (54) as females (25). The number of males increased from childhood (5,10 years) to early adolescence (11,15 years) and then decreased rapidly in late adolescence (16,19 years), whereas the number of females decreased steadily with age. Most of the incidents occurred during the summer months (72%), particularly in June and July (42%), and Fridays and Saturdays were the busiest days of the week. Most of the injuries were caused by organized and recreational sporting activities (39%) and accidental falls (33%), followed by interpersonal violence (15%) and a few motor vehicle accidents (7%). The 173 permanent tooth injuries were mostly luxations (62%) or avulsions (20%), with only a few fractures of the alveolar bone (5%) or tooth root (1%). Most of the displacements were lateral luxations (40%) or extrusions (18%) with only a few intrusions (3%). These injuries most commonly afflicted the maxillary central incisors (54%), followed by the maxillary laterals (18%) and mandibular centrals (17%). The emergency treatment that was provided at the Children's Hospital included replantation and repositioning, and the placement of a semi-rigid or flexible splint. [source] The conservative treatment of pediatric mandibular fracture with prefabricated surgical splint: a case reportDENTAL TRAUMATOLOGY, Issue 4 2007Ceyda Kocabay Abstract,,, The use of rigid fixation in children is controversial and may cause growth retardation along cranial suture lines. Intermaxillary fixation for mandibular fractures should be used cautiously as bony ankylosis in the temporomandibular joint (TMJ) and trismus may develop. The high osteogenic potential of the pediatric mandible allows non-surgical management to be successful in younger patients with conservative approaches. In this case, successful conservative treatment of mandibular fracture of a 3-year-old patient is presented. [source] Healing of 400 intra-alveolar root fractures.DENTAL TRAUMATOLOGY, Issue 4 2004Abstract,,, This is the second part of a retrospective study of 400 root-fractured permanent incisors. In this article, the effect of various treatment procedures is analyzed. Treatment delay, i.e. treatment later than 24 h after injury, did not change the root fracture healing pattern, healing with hard tissue between fragments (HH1), interposition of bone and/or periodontal ligament (PDL) or pulp necrosis (NEC). When initial displacement did not exceed 1 mm, optimal repositioning appeared to significantly enhance both the likelihood of pulpal healing and hard tissue repair (HH1). Significant differences in healing were found among the different splinting techniques. The lowest frequency of healing was found with cap splints and the highest with fiberglass or Kevlar® splints. The latter splinting procedure showed almost the same healing result as non-splinting. Comparison between non-splinting and splinting for non-displaced teeth was found to reveal no benefit from splinting. With respect to root fractures with displacement, too few cases were available for analysis. No beneficial effect of splinting periods greater than 4 weeks could be demonstrated. The administration of antibiotics had the paradoxical effect of promoting both HH1 and NEC. No explanation could be found. It was concluded that, optimal repositioning seems to favor healing. Furthermore, the chosen splinting method appears to be related to healing of root fractures, with a preference to pulp healing and healing fusion of fragments to a certain flexibility of the splint and possibly also non-traumatogenic splint application. Splinting for more than 4 weeks was not found to influence the healing pattern. A certain treatment delay (a few days) appears not to result in inferior healing. The role of antibiotics upon fracture healing is questionable. [source] External skeletal fixation in the management of equine mandibular fractures: 16 cases (1988,1998)EQUINE VETERINARY JOURNAL, Issue 2 2001K. A. BELSITO Summary Fifty-three cases of equine mandibular fractures were managed surgically from 1988,1998, of which 16 (30%) were repaired by external skeletal fixation (ESF). Three surgical methods were utilised: transmandibular 4.76 or 6.35 mm Steinmann pins incorporated into fibreglass casting material or nonsterile dental acrylic (methyl methacrylate - MMA) bars reinforced with steel; transmandibular 9.6 mm self-tapping threaded pins ± 4.76 or 6.35 mm Steinmann pins incorporated into MMA bars reinforced with steel; and 4.5 mm or 5.5 mm ASIF cortical bone screws incorporated into MMA bars reinforced with steel or a ventral MMA splint. Fourteen horses were presented to the hospital for fixator removal at an average of 56.2 days. At removal, fractures were stable and occlusion of incisor and cheek teeth was considered adequate. Complications of the procedure occurred in 3 horses. Two horses with persistent drainage and ring sequestra from pin tracts required curettage 4 or 5 months after ESF removal. A third horse required replacement of the original fibreglass ESF with MMA bars to regain access to open, infected wounds. Another horse required removal of the second premolar at the time of fixator removal because the tooth root had been damaged in the original injury. ESF for the surgical management of mandibular fractures in horses has produced good results, with incisive and cheek tooth alignment reestablished in all horses. Horses that were managed via ESF had a rapid return to full feed and did not require any supplementation via nasogastric tube or oesophagostomy to maintain bodyweight or hydration status. [source] Effects of an occlusal splint compared with cognitive-behavioral treatment on sleep bruxism activityEUROPEAN JOURNAL OF ORAL SCIENCES, Issue 1 2007Michelle A. Ommerborn The impact of an occlusal splint (OS) compared with cognitive-behavioral treatment (CBT) on the management of sleep bruxism (SB) has been poorly investigated. The aim of this study was to evaluate the efficacy of an OS with CBT in SB patients. Following a randomized assignment, the OS group consisted of 29, and the CBT group of 28, SB patients. The CBT comprised problem-solving, progressive muscle relaxation, nocturnal biofeedback, and training of recreation and enjoyment. The treatment took place over a period of 12 wk, and the OS group received an OS over the same time period. Both groups were examined pretreatment, post-treatment, and at 6 months of follow-up for SB activity, self-assessment of SB activity and associated symptoms, psychological impairment, and individual stress-coping strategies. The analyses demonstrated a significant reduction in SB activity, self-assessment of SB activity, and psychological impairment, as well as an increase of positive stress-coping strategies in both groups. However, the effects were small and no group-specific differences were seen in any dependent variable. This is an initial attempt to compare CBT and OS in SB patients, and the data collected substantiate the need for further controlled evaluations, using a three-group randomized design with repeated measures to verify treatment effects. [source] Formable acrylic treatment for ingrowing nail with gutter splint and sculptured nailINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 10 2004Hiroko Arai MD Background, The treatment of choice for an ingrowing nail has been surgical rather than nonsurgical. Yet, surgical treatments are far from successful, cause pain and patient apprehension, and leave disfigurement. Further, there is misunderstanding about the disease pathophysiology. Objective, To demonstrate the benefits of a noninvasive method of treatment for an ingrowing nail using gutter splint and formable acrylics and to present a current understanding of the disease pathophysiology. Methods, From a total of 541 cases of ingrowing nails treated, full follow-up data were obtained between January 1979 and March 2002. Formable acrylic treatments were carried out in 106 cases treated with acrylic-affixed gutter splint, 17 cases with sculptured nails, and 28 cases in which the two treatments were combined. These were then compared with 233 cases treated with adhesive tape-attached gutter splint and the remainder with other conservative modalities. Results, Acrylic treatment with gutter splint and sculptured nail was found to be vastly superior to the other methods described, especially in the ability to firmly affix the gutter splint and sculptured nail for the extended period required for treatment. The treatment leads to a complete remission with almost instant alleviation of pain, with no disfigurement, while allowing for the resumption of daily activities. Conclusion, Conservative methods utilizing formable acrylics are highly beneficial in the treatment of an ingrowing nail and should be viewed as the first treatment option. [source] Intentional replantation of an immature permanent lower incisor because of a refractory peri-apical lesion: case report and 5-year follow-upINTERNATIONAL JOURNAL OF PAEDIATRIC DENTISTRY, Issue 3 2004S. Shintani Summary., We performed an intentional replantation of an immature lower incisor that had a refractory peri-apical lesion. The incisor was extracted and the peri-apical lesion was removed by curettage. The root canal of the tooth was then rapidly irrigated, and filled with a calcium hydroxide and iodoform paste (Vitapex®), after which the tooth was fixed with an arch wire splint. Five years later, no clinical or radiographic abnormalities were found, and the root apex was obturated by an apical bridge formation. A team of two dentists is essential to prevent a prolonged operation time, thus eliminating any of the causes of ankylosis. Furthermore, calcium hydroxide and iodoform paste, along with an arch wire splint retained with composite resin, led to good healing of the periodontal tissue after the intentional replantation. Our results indicate that intentional replantation is a useful method for an immature tooth with refractory peri-apical problems. [source] Diclofenac sodium and occlusal splint therapy in TMJ osteoarthritis: a randomized controlled trialJOURNAL OF ORAL REHABILITATION, Issue 10 2008C. MEJERSJÖ Summary, The aim of the study was to compare treatment with diclofenac sodium (Voltaren 3 × 50 mg) to occlusal splint therapy in a randomized, single-blind controlled trial of patients with a diagnosis of temporomandibular joint (TMJ) osteoarthritis (OA) in accordance with Research Diagnostic Criteria for temporomandibular disorders. Patients with general joint disorders or restrictions against medication with non-steroidal anti-inflammatory drug were not included. Twenty-seven females and two males (aged 36,76 years) included, answered a standardized questionnaire and were clinically examined and they underwent TMJ tomography. The treatment was randomized to either splint (n = 15) or diclofenac (n = 14). The temperatures over the TMJs were determined. The patients were re-examined 1 week, 1 month and 3 months after the start of treatment. A 1-year follow-up was carried out using questionnaires. After 1 week of treatment with diclofenac, significant reductions of pain and discomfort, TMJ tenderness and joint pain on jaw movements were noted. The splint therapy gave a significant reduction of reported symptoms after 1 month of treatment. Both treatments gave few adverse effects and were on an equal level. Estimation of the degree of inflammation by measuring the surface temperature over the TMJ was not reliable. Structural changes of the symptomatic TMJs were radiographically found in 82%, the contralateral, symptom-free TMJ had changes in 36%. There was a discrepancy between the clinical and the radiographical findings. Diclofenac gave a more rapid improvement, but both treatments gave a significant reduction of symptoms of TMJ OA within 3 months which remained at the one-year follow-up. [source] Short-term efficacy of physical therapy compared to splint therapy in treatment of arthrogenous TMDJOURNAL OF ORAL REHABILITATION, Issue 11 2007F. ISMAIL Summary, A prospective randomized study was carried out to evaluate the efficacy of physical therapy in addition to splint therapy on treatment outcome in patients with temporomandibular disorders (TMD) with respect to objective and subjective parameters. Twenty-six patients suffering from an arthrogenic TMD and exhibiting a painfully restricted jaw opening were randomized in two groups. Thirteen patients were treated solely with Michigan splint (group I), 13 patients received supplementary physical therapy (group II). Before treatment a clinical examination and electronic recording of jaw movements were performed and subjective pain level was evaluated by visual analogue scales. After 3 months of therapy maintenance of improvement was evaluated. Within treatment groups comparison of data before and after treatment was analysed using Wilcoxon test. Groups were compared by Mann,Withney- U test. A P -value < 0.05 was considered significant. Compared with the baseline, in both groups mandibular movement capacity increased significantly after treatment, whereas subjective pain decreased significantly (P < 0.05). Active jaw opening increased from 28.6 ± 5.8 to 35.9 ± 4.8 mm in group I and from 30.1 ± 5.4 to 40.8 ± 4.1 mm in group II. After therapy the difference of active jaw opening between groups was significant (P < 0.05). Physical therapy also gave a supplementary improvement of protrusive mandibular movement capacity during electronic registration and subjective pain level. For none of these parameters this difference between groups was significant. Physical therapy seems to have a positive effect on treatment outcome of patients with TMD. [source] Influence of occlusal vertical dimension on the masticatory performance during chewing with maxillary splintsJOURNAL OF ORAL REHABILITATION, Issue 8 2007L. W. OLTHOFF summary, Changing the occlusal vertical dimension is a common procedure in restorative dentistry, during treatment of patients with cranio-mandibular disorders, and during orthodontic and orthognathic treatment. The treatment may alter the length of the main jaw elevator muscles and the position of the mandibular head in the fossa temporalis. These changes may influence the bite forces that are generated during chewing and thus may affect the masticatory function. We measured the objective masticatory function, defined as masticatory performance, by determining an individual's capacity to pulverize a test food. The immediate influence of the increase in the occlusal vertical dimension on the masticatory performance was determined using three anatomical maxillary splints in a group of seven dentate subjects. The splints gave an increase in the occlusal vertical dimension of 2, 4 and 6 mm, respectively. Before we started the experiments the subjects practiced chewing with the splints during about 5 min. No significant differences were observed in masticatory performance among the conditions without and with the three splints. Thus, an increase in the occlusal vertical dimension up to 6 mm did not have a significant effect on the masticatory performance. Maxillary splints may be used to study the effect of occlusal factors on the chewing process by manipulating tooth shape and occlusal area of the splint. [source] Reduction in parafunctional activity: a potential mechanism for the effectiveness of splint therapyJOURNAL OF ORAL REHABILITATION, Issue 2 2007A. G. GLAROS summary, Interocclusal splints may be an effective modality in the management of temporomandibular disorders (TMD), but there is little evidence regarding the mechanism by which splints work. This study tested the hypothesis that pain reduction produced by splints is associated with reduction in parafunctional activity. In a two-group, single-blinded randomized clinical trial, patients diagnosed with myofascial pain received full coverage hard maxillary stabilization splints. Patients were instructed to maintain or avoid contact with the splint for the 6 weeks of active treatment. Patients who decreased the intensity of tooth contact were expected to show the greatest alleviation of pain, and those who maintained or increased contact were expected to report lesser reductions in pain. Experience-sampling methodology was used to collect data on pain and parafunctional behaviours at pre-treatment and during the final week of treatment. Patients were reminded approximately every 2 h by pagers to maintain/avoid contact with the splint. The amount of change in intensity of tooth contact accounted for a significant proportion of the variance in pain change scores. Patients who reduced tooth contact intensity the most reported greater relief from pain. Splints may produce therapeutic effects by reducing parafunctional activities associated with TMD pain. [source] The effect of oral splint devices on sleep bruxism: a 6-week observation with an ambulatory electromyographic recording deviceJOURNAL OF ORAL REHABILITATION, Issue 7 2006T. HARADA summary, This study investigated the effect of stabilization splint (SS) and palatal splint (PS), which had the same design as SS except for the elimination of the occlusal coverage, on sleep bruxism (SB) using a portable electromyographic (EMG) recording system. Sixteen bruxers participated in this study. The EMG activities of the right masseter muscle during sleep were recorded for three nights each in the following five recording periods: before, immediately after, and 2, 4 and 6 weeks after the insertion of the splint. The crossover design, in which each splint was applied to each subject for 6 weeks with an interval of 2 months for a washout period, was employed in this randomized-controlled study. The number of SB events, duration and total activities of SB were analysed. The number of SB events before the insertion of splints (baseline) was 2·98 ± 1·61 times h,1. Both splints significantly reduced SB immediately after the insertion of devices (P < 0·05, one-way repeated-measures anova followed by Dunnett); however, no reduction was observed in 2, 4 or 6 weeks (P > 0·05). There was no statistical difference in the effect on SB between the SS and PS (P > 0·05, two-way repeated-measures anova). Both splints reduced the masseter EMG activities associated with SB; however, the effect was transient. [source] Comparative prospective study on splint therapy of anterior disc displacement without reductionJOURNAL OF ORAL REHABILITATION, Issue 7 2005M. STIESCH-SCHOLZ summary A prospective randomized study was carried out to compare the therapeutic success of two different types of splint in patients with painful anterior disc displacement of the temporomandibular joint. The patients in Group I (n = 20) received stabilization splint therapy and the patients in Group II (n = 20) pivot splint therapy. Clinical investigation of the craniomandibular system was performed before and 1, 2 and 3 months after therapy and this was accompanied by subjective evaluation by the patients of their symptoms, using a validated questionnaire with visual analogue scales (VAS). There was a significant increase in maximum jaw opening and a significant reduction in subjective pain in both groups during the course of therapy (Wilcoxon test, P < 0·05). Active jaw opening increased by a mean of 8·05 mm in the group of patients treated with a stabilization splint (Group I). The comparable figure with pivot splint therapy (Group II) was 8·26 mm. The VAS scale value in Group I was reduced by 30·54 units and in Group II by 39·36 scale units. However, neither of these differences between the groups was statistically significant (Mann,WhitneyU -test, P > 0·05). It can be concluded that both types of splint provided effective therapy in patients with anterior disc displacement. [source] Effects of a functional appliance on masticatory muscles of young adults suffering from muscle-related temporomandibular disordersJOURNAL OF ORAL REHABILITATION, Issue 6 2004T. Castroflorio summary, The aim of this study was to investigate the effects of an original orthodontic functional appliance [function generating bite for deep bite correction (FGB-D)] on masticatory muscle activity in subjects suffering from muscle-related temporomandibular disorders (TMD). Electromyographic (EMG) analysis was performed on 33 young adults (nine men, 24 women) to evaluate the contractile symmetry of the right and left masseter and anterior temporalis muscles. The subjects were divided into three groups: a muscle-related TMD group requiring orthodontic treatment for deep bite correction (three men, eight women) and treated with FGB-D; a muscle-related TMD group not requiring orthodontic treatment (three men, eight women) and treated with a Michigan occlusal splint; and a TMD-free group (three men, eight women) as a control group. Records were made by surface EMG of maximum voluntary teeth clenching, with and without the functional appliance or occlusal splint in place, before and after 12 months of therapy. A torque index was derived from the surface EMG recordings to estimate lateral displacement of the mandible. The results show that the FGB-D corrects the torque index and thus the lateral displacement of the mandible. [source] Effects of interocclusal appliances on EMG activity during parafunctional tooth contactJOURNAL OF ORAL REHABILITATION, Issue 6 2003A. L. Roark summary, To test the hypothesis that a flat plane interocclusal appliance affects the electromyographic (EMG) activity of the temporalis and masseter muscles in pain-free individuals, maxillary splints were fabricated for 20 individuals who reported no history, signs or symptoms of myofascial pain or arthralgia as determined by two trained, independent examiners. Subjects were instructed to establish light tooth contact, maximum clenching, and moderate clenching with/without the splint in place (as determined by random assignment) while EMG data from the left and right temporalis and masseter muscles were recorded. A 5-min biofeedback training session to relax the masticatory muscles was followed by a repetition of the tooth contact/clenching tasks with/without the splint in place. With the splint in place, the activity of the temporalis muscles decreased for all tasks, significantly for the left and right temporalis under maximal clenching and for the right temporalis under moderate clenching. In contrast, the activity of the masseter muscles increased under light and moderate clenching (significantly for the left masseter under moderate clenching) and decreased slightly under maximal clenching. The effectiveness of interocclusal appliances may be due to mechanisms other than redistribution of adverse loading. [source] Is bruxism severity a predictor of oral splint efficacy in patients with myofascial face pain?JOURNAL OF ORAL REHABILITATION, Issue 1 2003K. G. Raphael summary, Both the efficacy and mechanism of any effect of oral splint therapy for patients with temporomandibular disorders (TMDs) are a matter of controversy. To address these issues, this study tested the hypothesis that oral splints produce the most marked pain relief for those TMD patients with myofascial face pain (MFP) who also brux (i.e. grind or clench) more than other MFP patients. In a 6-week randomized controlled clinical trial, 52 women with MFP were randomly assigned to receive either a full-coverage hard acrylic splint or a palatal-only splint. Bruxism was assessed both by self-report and by an objective assessment of molar microwear changes over a 2-week period prior to the start of the trial. Tested across multiple outcome measures, results indicated that those receiving the full-coverage splint had marginally better improvement on some pain-related measures than those receiving the palatal splint, but severity of bruxism did not moderate the therapeutic effect of the full-coverage splint. These findings strongly argue against the belief that oral splints reduce MFP by reducing bruxism and raise questions about the importance of bruxism in the maintenance of MFP. [source] Immediate effect of a stabilization splint on masticatory muscle activity in temporomandibular disorder patientsJOURNAL OF ORAL REHABILITATION, Issue 9 2002V. F. FERRARIO Summary Surface electromyography (EMG) allows the quantification of the occlusal equilibrium in dysfunctional patients, for instance in those with temporomandibular disorders (TMD). Fourteen patients (ten women, four men) with internal derangement type I were selected among the TMD patients referred to a private practice in Milan. A stabilization splint with posterior contacts was made for each patient. To verify the static neuromuscular equilibrium of occlusion, EMG activity of left and right temporal and masseter muscles was recorded in all patients and the activity (ratio between the activities of the temporal and masseter muscles) index was computed over a maximum voluntary clench test of 3 s. Muscular waveforms were also analysed by computing a percentage overlapping coefficient (POC, an index of the symmetric distribution of the muscular activity determined by the occlusion). The total electrical activity was measured by calculating the area under the entire muscular waveforms. In all patients EMG was performed just before and immediately after the insertion of the splint and data were compared by paired Student's t -tests. Overall, the splint reduced the electrical activity of the analysed muscles (P < 0·005) and made it more equilibrated both between the left and right side (larger symmetry in the masseter muscle POC, P < 0·05) and between the temporal and masseter muscles (activity index, P < 0·01). [source] The effects of isometric exercise on maximum voluntary bite forces and jaw muscle strength and enduranceJOURNAL OF ORAL REHABILITATION, Issue 10 2001D. J. Thompson The effects of training and exercise on the strength and endurance of limb muscles has been investigated extensively, but the response of the jaw muscles to exercise remains poorly known. The purpose of this study was to determine whether short-term isometric training increases strength and endurance of the superficial masseter and anterior temporalis muscles. Maximum and submaximum voluntary bite forces and corresponding electromyographic (EMG) activity were measured in 28 young adults, randomly divided into exercise and non-exercise (control) groups. Subjects in the exercise group performed isometric clenches against a soft maxillary splint for five 1-min sessions per day over a 6-week period. After exercise, subjects increased their maximum bite forces by 37%, but control subjects' bite forces also increased by 25%. After exercise, EMG levels per unit of bite force generally decreased, but similar decreases were also seen in the non-exercised controls. Masseter muscle activity levels during standardized 10-kg bites decreased after 6 weeks of exercise. Fatigue resistance increased significantly with exercise but did not differ significantly from control values after 6 weeks of exercise. The results of this study indicate that increases in maximum bite force can be easily produced with training, but that actual strengthening of the jaw muscles is more difficult to achieve. [source] Influence of protrusive tooth contact on tapping point distributionJOURNAL OF ORAL REHABILITATION, Issue 11 2000T. Ueno This study investigated the influence of protrusive tooth contacts (tooth contacts during mandibular protrusion) on the tapping point distribution. Nine healthy subjects volunteered for this study and the protrusive tooth contact pattern, as well as the retrusive tooth contact pattern, was altered on four maxillary occlusal splints. The first splint was adjusted to make the sagittal incisal path of protrusion and retrusion equivalent to that of the natural dentition. The second and third splints had partial and complete elimination of the protrusive tooth contact, respectively. The fourth splint had complete elimination of both protrusive and retrusive tooth contacts. The subjects were asked to use each splint continuously for 1 week. The tapping point distribution was measured on the 7th day after insertion of each splint. The four experimental occlusal conditions were found to have a significant effect on the tapping point distribution. The complete elimination of the protrusive tooth contact caused an anterior tapping point location and an increase in the tapping point area. The former tendency was found to be independent of the presence of the retrusive tooth contact. In conclusion, it was suggested that the protrusive tooth contact plays a significant role in maintaining the consistency and stability of the tapping point. [source] | ||||||||||