Simona Maria Iacob Andrea Maria Chisnoiu; Manuela-Maria Manziuc; Mirela Ioana Fluerașu ...
Romanian Journal of Oral Rehabilitation,
12/2023, Volume:
15, Issue:
4
Journal Article
Peer reviewed
Open access
Aim of the study The aim of this literature review was to assess the difference in muscle activity recorded on electromyography in patients with TMDs before and after receiving different types of ...treatments. Materials and method. The study is the literature review, an electronic search was initiated using PubMed, to identify the relevant literature. The search string comprised a combination of keywords (Medical Subject Headings MeSH) and free-text terms. The inclusion criteria were represented by clinical trial and randomized controlled trial, publications available in English and full text publications. Results. The final electronic search provided 23 articles. After removing the duplicates, 20 articles were selected for eligibility. According to the inclusion criteria, 16 articles were selected for this review. Conclusions. Short term therapeutic effect of the low-level laser therapy improves the pain and sEMG findings in TMD patients, better than soft occlusive splints. Sensorimotor training has a positive effect on pain for patients with myofascial TMD pain and a reduction in muscular activity on sEMG. Splint assisted by transcutaneous electrical nerve stimulation, TENS, had better results than splint alone in EMG recordings.
To evaluate occlusal splint type differences in patients with bruxism.
Seventeen controls and 51 patients were divided into three subgroups, each assigned to use a different occlusal splint (hard, ...soft, or semi-soft) for 3 months and assessed by ultrasonography and electromyography (EMG) before (BT) and 3 months after treatment (AT).
EMG values in all of the occlusal splint groups were significantly lower AT than BT (p < 0.05). BT and AT EMG values in the control group did not differ. Mean muscle thicknesses in bruxism patients was greater than in controls, and the greatest muscle thickness changes occurred with the hard occlusal splint (p < 0.05).
A decrease in EMG activity occurred with all three splint types and was most prominent in the hard occlusal splint group. Ultrasonographic measurements of muscle length and thickness should be used alongside EMG to measure muscle activity in bruxism patients.
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3D printing found its way into various medical applications and could be particularly beneficial for dentistry. Currently, materials for 3D printing of occlusal splints lack mechanical strength ...compared to polymethyl methacrylate (PMMA) used for standard milling of occlusal splints. It is known that print orientation and graphene nanoplatelets (GNP) can increase biaxial strength in a variety of materials. Thus, the aim of this study was to assess if adjustment of print orientation and addition of GNP improve biaxial strength and if they affect cytotoxicity of a 3D printable resin for occlusal splints.
Specimens were printed vertically and horizontally with a stereolithography (SLA) printer and multilayered GNP powder was added to the resin at different concentrations. Printed specimens were characterized by Raman spectroscopy, optical profilometer analysis and scanning electron microscopy. Biaxial strength was evaluated by biaxial flexural testing. Cytotoxicity of specimens on L929 and gingival stromal cells (GSC) was assessed by the toxdent test, the resazurin-based toxicity assay and live-dead staining.
Horizontally printed specimens showed significantly higher biaxial strength and lower deformation. GNP did not improve biaxial strength and material deformation of 3D-printed resins. None of the specimens were cytotoxic to L929 cells or GSC.
Print orientation in SLA printing has a significant impact on biaxial strength and material deformation. 3D printable materials can reach comparable or even improved biaxial strength compared to PMMA when using the optimal print orientation while GNP has no beneficial effects on the biaxial strength of resins for 3D printing of occlusal splints.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
The volume of occlusal adjustment of digital occlusal devices designed with different digital occlusal articulators is unknown.
The purpose of this clinical study was to evaluate and compare the ...clinical efficacy and the volume of occlusal adjustment of digital occlusal devices designed using an average value digital articulator and the jaw movement analyzer (JMA).
Thirty participants were randomly divided into 2 groups, an average value group and a JMA group, with 15 participants in each group. The centric relation position of the participants was determined by an experienced investigator with the aid of a leaf gauge. An intraoral scanner (TRIOS 3) was used to obtain digital scans of the maxillary and mandibular dentition and the maxillomandibular relationship record in the centric relation position. Personalized articulator parameters of participants in the JMA group were obtained by using a JMA (JMAnalyser). Different articulator parameters were used to fabricate an occlusal device in a denture design software program (exocad DentalCAD). The surface of the occlusal device was coated with a dental optical spray and then scanned using a laboratory scanner (Kavo LS3). The process was repeated after the occlusal device was adjusted. The files of the 2 scans were imported into a reverse engineering software program, and the root mean square (RMS) values were obtained by best fit alignment and 3-dimensional comparison. The Shapiro-Wilk normality test and homogeneity of variance test were performed, and t tests were used to evaluate differences in the RMS values between the groups (α=.05).
The experimental data were generally normal distributed (P>.05). No statistically significant difference was found between the RMS values of the Average and the JMA groups (P>.05).
No significant difference in the volume of occlusal adjustment was found when using occlusal devices made using the digital average articulator or the JMA, suggesting that either method can be used to program articulators for the fabrication of occlusal devices.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
The aim of this systematic review with meta-analysis was to evaluate the efficacy of conservative interventions in pain relief in patients with intracapsular temporomandibular disorders (TMD).
...PubMed, Scopus, and Web of Science were systematically searched until January 1
st
, 2022 to identify randomized controlled trials (RCTs) presenting patients with diagnosis of intracapsular TMD according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD), conservative approaches as interventions, and pain intensity as outcome.
Out of 3372 papers, 13 RCTs were included, with 844 study participants. Most of them (n = 7) investigated the efficacy of splint appliance. Meta-analysis revealed that rehabilitative interventions had a significant overall effect size of 0.75 0.17, 1.34, reporting splint appliance and laser therapy as significantly effective treatments.
Findings of this systematic review with network meta-analysis suggested that conservative approaches might be effective in pain relief of intracapsular TMD patients.
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A series of Eu2+ activated BaSi2O2N2 oxynitride cyan phosphors with high crystallinity have been successfully synthesized by a facile deposition-precipitation (DP) method. Under excitation of 375 nm, ...the photoluminescence emission intensity at 495 nm was enhanced by 157% for BaSi2O2N2:Eu2+ prepared by DP method compared to the sample prepared by traditional solid-state reaction (SSR) method due to the uniform distribution of Eu2+ ions. Accordingly, BaSi2O2N2:0.02Eu2+ phosphor prepared by DP method exhibits a longer fluorescence lifetime (553.6 ns) than that (472.8 ns) prepared by SSR method. Interestingly, Eu2+ ions can incorporate in BaSi2O2N2 lattices through DP process even at a lower temperature (1000 °C) compared to the conventional temperature (1450 °C) during SSR process. Finally, the flexible occlusal splints based on BSON:Eu2+/PDMS composite elastomers has been fabricated by the excellent mechanoluminescent (ML) property of BaSi2O2N2:Eu2+ phosphors. The ML signal of BSON:Eu2+/PDMS occlusal splints under mechanical stimulation allows visualization of force magnitude during occlusal examination for the treatment of clinical oral disorders such as temporomandibular disorders.
•The photoluminescence intensity of BaSi2O2N2:Eu2+ at 495 nm is increased by 157%.•The deposition-precipitation method enhances the dispersion of Eu2+ in BaSi2O2N2.•Occlusal splint strategy based on BSON:Eu2+/PDMS composite elastomer is proposed.•The mechanoluminescence of occlusal splint is available for clinical oral diseases.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
AIM AND OBJECTIVEForce platforms are widely used to evaluate the relationship between bodily posture and jaw positions. The aim and objective of this clinical prospective study was to evaluate the ...effect of occlusal splints on bodily posture using force platforms. MATERIALS AND METHODSForty-seven female patients with temporomandibular disorders (TMD) underwent a clinical and postural examination before and during an occlusal treatment with an upper splint. Six postural stabilometric examinations were performed under different visual conditions. Postural stability was assessed using a force platform (SATEL). Subjects were evaluated in static and dynamic conditions, with open and closed eyes, at baseline, at 1 week, and at 3 months. Changes in stabilometric parameters (sway area and sway length) were assessed and compared. RESULTSIn static and dynamic positions, the sway surface area decreased significantly after the occlusal guard placement with closed eyes (p-value, 0.012). Likewise, the sway surface area decreased significantly in the dynamic lateral position with closed eyes (p-value, 0.018) and in anteroposterior dynamic position with open eyes (p-value, 0.031). The mean sway length decreased significantly after the placement of the occlusal guard when participants were in the lateral position with open eyes (p-value, 0.025) and in the anteroposterior position with open eyes (p-value, 0.014). On a 3-month assessment, the mean surface and mean length decreased significantly after the placement of the occlusal guard for practically all the static and dynamic positions. CONCLUSIONThe sway surface area and sway length decreased significantly with the use of occlusal splints Clinical significance: In female patients with TMD, the use of an occlusal splint is associated with a postural improvement evaluated by posturo-stabilometric tests.
Purpose: Whether it is possible to prevent mechanical stress on teeth via an occlusal splint remains to be clarified. This study aimed to assess the same by simultaneously recording the occlusal ...pressure and strain on the teeth in humans.Methods: Eleven participants (five women and six men; mean age 25.7 years) were enrolled in this study. Hard and soft oral appliances were fabricated for the maxillary arch of each participant. The strain on the four target teeth (right maxillary and mandibular first premolars, and first molars) and occlusal pressure were concurrently measured, while the participants performed maximum voluntary teeth clenching under each condition (hard, soft, or no occlusal splint).Results: Compared to the absence of an occlusal splint, hard occlusal splints generated less strain on molar teeth but more strain on premolar teeth, while soft occlusal splints did not lower the strain on all target teeth significantly.Conclusion: Considering the limitations of this study, hard occlusal splints should be used for the protection of molar teeth but for premolar teeth caution is required and depends on the case. On the other hand, soft occlusal splints may not have any benefit for the protection of either type of teeth for patients exhibiting excessive occlusal pressure.
Migraine and tension-type headache often occur comorbid with temporomandibular disorder; occlusal splint therapy is the most common treatment for temporomandibular disorder. The aim of this study was ...to assess the effects of occlusal splint therapy on headache symptoms in patients with migraine and/or tension-type headache comorbid with temporomandibular disorder.
Sixty adult patients with migraine and/or tension-type headache and comorbid temporomandibular disorder were randomly assigned to individualized occlusal splint therapy applied during day- and nighttime plus usual care (n = 30) or usual care alone (n = 30). Primary outcome was the change in current pain intensity on a 100 mm visual analogue scale from week 1 to week 12. Secondary outcomes included changes in headache days and headache hours assessed by headache diaries over a 2-week period, health-related quality of life (SF-36), and adverse events from week 1 to week 12 and (in the occlusal splint plus usual care group only) to week 24.
No group differences in changes in pain intensity from week 1 to week 12 were found. The number needed to treat was 3.8. Physical quality of life reduced stronger in the usual care group than in the occlusal splint plus usual care group. In the occlusal splint plus usual care group, headache intensity significantly decreased and physical quality of life significantly increased from week 1 to week 12 and to week 24 (all P < .001). No adverse events were reported.
A day- and night-time occlusal splint therapy in addition to usual care was not superior to usual care alone in patients with chronic headache and comorbid TMD. Four patients need to be treated to induce a minimal clinically relevant improvement in one patient. The small sample size and lack of power limit these findings.
Introduction: Occlusal splints are usually the first choice in the treatment of bruxism. Splints can also be the only treatment or can be ended with adhesive restoration, orthodontic or prosthetic ...treatment. Methods: This article demonstrates the steps of a digital workflow through the 3Shape Design system - splint studio. The initial units are virtual models, scanned by Trios Color Scanner (3Shape). Results: The digital protocol includes eight steps that allow precise and detailed creation of the searched object. Each step is described from the perspective of a clinician, prosthetist and orthodontist, not a dental technician. Possible complications and ways to management with them are described. Conclusion: Digital protocol of occlusal splint creation gives many opportunities according to design, thickness and occlusion.
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