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1
Chairunnisa, Ricca, and Erna Kurnikasari. "Tinjauan tentang splin oklusal untuk terapi gangguan sendi temporomandibula A review about occlusal splint as a therapy for temporomandibular disorders." Journal of Dentomaxillofacial Science 12, no. 1 (February 28, 2013): 38. http://dx.doi.org/10.15562/jdmfs.v12i1.347.
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An occlusal splint is a removable appliance usually made of acrylic, that fits over the occlusal and incisal surfaces ofthe teeth in one arch, creating precise occlusal contact with the teeth of the opposing arch. Occlusal splint has severalfunctions, one of which is to temporarily provide an temporary occlusion that allows the temporomandibular joints(TMJ) to make the most othopedically stable joint position. Occlusal splint is also used to protect the teeth and itssupportive structure from abnormal forces that may create breakdown and/or tooth wear. Occlusal splint is reversibleand noninvasive treatment, which is most important in treating temporomandibular disorders (TMD) with manycausative factors involved. Many types of splints have been suggested for the treatment of TMD, but the most frequentlyused are the stabilization splint and the anterior positioning splint. The purpose of this paper is to describe the types ofocclusal splints and indication used for the treatment of TMD.
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Ettlin, D. A., H. Mang, V. Colombo, S. Palla, and L. M. Gallo. "Stereometric Assessment of TMJ Space Variation by Occlusal Splints." Journal of Dental Research 87, no. 9 (September 2008): 877–81. http://dx.doi.org/10.1177/154405910808700903.
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Occlusal splints are used for the management of temporomandibular disorders, although their mechanism of action remains controversial. This study investigated whether insertion of an occlusal splint leads to condyle-fossa distance changes, and to mandibular rotation and/or translation. By combining magnetic resonance images with jaw tracking (dynamic stereometry), we analyzed the intra-articular distances of 20 human temporomandibular joints (TMJs) before and after insertion of occlusal splints of 3 mm thickness in the first molar region. For habitual closure, protrusion, and laterotrusion in the contralateral joint, occlusal splints led to minor—yet statistically significant—increases of global TMJ space and to larger increases at defined condylar areas. Condylar end rotation and translation in habitual closure were reduced. Hence, the insertion of a 3-mm-thick occlusal splint led to a change in the topographical condyle-fossa relationship, and therefore to a new distribution of contact areas between joint surfaces.
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Kui, Andreea, Silvia Pop, Smaranda Buduru, and Marius Negucioiu. "The use of occlusal splints in temporomandibular disorders - an overview." Acta Stomatologica Marisiensis Journal 3, no. 2 (December 1, 2020): 3–8. http://dx.doi.org/10.2478/asmj-2020-0008.
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AbstractTemporomandibular disorders (TMD) affect the temporomandibular joints, the masticatory muscles, and surrounding tissues. Among symptoms such as jumps, joint noises, reduced mouth opening (closed lock), difficulties in closing the mouth (subluxation or open lock), pain is the most common symptom encountered among patients diagnosed with temporomandibular disorders. As literature on this topic is abundant and sometimes controversial, the authors focus on reviewing the state of art of occlusal splints indications. Therefore, the most common occlusal splints, like Lucia jig, nociceptive trigeminal inhibition (NTI), directive splints, etc., are being described, based on their design and therapeutic indications. Cases of malocclusions associated or not with parafunctions are usually manageable using the splints mentioned in this article. In case of disc displacements, occlusal appliances can be used, but as the etiology is multifactorial, there are some limitations, depending on the complexity of each clinical situation.
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Ferreira, Fabiane Maria, Paulo Cézar Simamoto-Júnior, Carlos José Soares, António Manuel de Amaral Monteiro Ramos, and Alfredo Júlio Fernandes-Neto. "Effect of Occlusal Splints on the Stress Distribution on the Temporomandibular Joint Disc." Brazilian Dental Journal 28, no. 3 (June 2017): 324–29. http://dx.doi.org/10.1590/0103-6440201601459.
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Abstract Conservative approach, including occlusal splint therapy, is the first option to treat temporomandibular disorders (TMD), because of its reversibility. The present study analyzed the effect of the articular disc position and occlusal splints use on the stress distribution on this disc. A two-dimensional (2D) finite element (FE) model of the temporomandibular joint with the articular disc at its physiologic position was constructed based on cone-beam computed tomography. Three other FE models were created changing the disc position, according to occlusal splint use and anterior disc displacement condition. Structural stress distribution analysis was performed using Marc-Mentat package. The equivalent von Mises stress was used to compare the study factor. Higher stress concentration was observed on the intermediate to anterior zone of the disc, with maximum values over 2MPa. No relevant difference was verified on the stress distribution and magnitude comparing disc positions and occlusal splint use. However, there was stress reduction arising from the use of the occlusal splints in cases of anterior disc displacement. In conclusion, based on the generated FE models and established boundary conditions, the stress increased at the intermediate zone of the TMJ disc during physiological mandible closure. The stress magnitude was similar in all tested situations
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Tanaka, Elisa Emi, Emiko Saito Arita, and Bunji Shibayama. "Occlusal stabilization appliance: evaluation of its efficacy in the treatment of temporomandibular disorders." Journal of Applied Oral Science 12, no. 3 (September 2004): 238–43. http://dx.doi.org/10.1590/s1678-77572004000300015.
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Occlusal stabilization appliances or splints are the most widely employed method for treatment of temporomandibular disorders (TMD). Magnetic Resonance Imaging (MRI) is the most indicated imaging modality to evaluate the components of the temporomandibular joint (TMJ). Forty patients with signs and symptoms of temporomandibular disorders were treated with splints for a mean period of 12 months, comprising regular semimonthly follow-ups. After stabilization of the clinical status, occlusal adjustments and MRI evaluation were performed. It was concluded that the success of this kind of treatment are related to the total (70%) or partial improvement (22.5%) of painful symptomatology and to the functional reestablishment of the craniomandibular complex. The MRI allowed evaluation and also the conclusion that the splints provide conditions for the organism to develop means to resist to the temporomandibular disorders by means of elimination of several etiologic factors. Moreover, after treatment the patients are able to cope with disc displacements with larger or smaller tolerance.
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Chaudhary, Poorna, Amit Khera, Shalu Jain, and Pradeep Raghav. "Role of occlusal splints in temporomandibular joint disorder." International Journal of Applied Dental Sciences 7, no. 2 (April 1, 2021): 18–21. http://dx.doi.org/10.22271/oral.2021.v7.i2a.1184.
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Awan, Uzma, and Nadeem Tariq. "TEMPOROMANDIBULAR JOINT PAIN SYNDROME." Professional Medical Journal 23, no. 01 (January 10, 2016): 081–84. http://dx.doi.org/10.29309/tpmj/2016.23.01.801.
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Introduction: The temporomandibular joint disorders TMD and theirmanagement is a problem in dentistry and complaints associated to this problem are painin the area of joint and associated muscles along with limitations and clicking sounds duringmandibular opening and closing. One of the popular method of treatment is splint therapy.Study design: It was longitudinal intervention study. Objectives: The purpose of this study is toassess about oral splint as an effective treatment for TMD patients. Period: Total study time forthis study was about two years. Setting: Study was carried out in prosthodontics department ofSharif medical and dental college Lahore. Methodology: In the present study 40 patients wereincluded the study. All patients were suffering from some psycho-social issue. Their maximummouth opening MMO was measured and all of them were treated with occlusal splints. Results:There was significant improvement in MMO and reduction in pain.75% patients responded totreatment very well, however, 22.5% responded moderately and 2.5% patients did not respondto treatment. Conclusion: Splint therapy is an effective way to treat TMD. Splint therapy alongwith some psychological rehabilitation of patients which may produce better results.
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Lazic, Vojkan, Igor Djordjevic, and Ana Todorovic. "Occlusal splints in reversible occlusal therapy of craniomandibular dysfunction." Serbian Dental Journal 58, no. 3 (2011): 156–62. http://dx.doi.org/10.2298/sgs1103156l.
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Craniomandibular dysfunction (CMD) is a set of structural and functional disorders of different etiology that affects temporomandibular joint (TMJ) and orofacial muscles. The most common etiologic factors are psychogenic, occlusal, trauma and congenital anomalies of craniofacial structures. About 75% of the examined population have mild symptoms of CMD while 3-4% have more severe symptoms which require medical attention. The main symptoms why people seek for medical attention are: facial pain which increases with chewing and irradiates in surrounding areas and pain in TMJ which irradiates in the ear canal, temporal area or neck. Painful restriction of mandible during mouth opening and eccentric movements is frequent as well as mandible deviation or deflection. Sound effects in TMJ such as popping or clicking during mouth opening are common. Initial and least invasive therapeutic procedure is reversible occlusal therapy using splints. There are two main types of occlusal splints: stabilization and relaxation. First type of splints works on condyle stabilization in orthopedically stable position; it is superoanterior condylar position in articular fossa with position of intercondylar discs between condyle and articular fossa when working cusps of the antagonists are in maximal contact with the splint. Another type of splint causes disocclussion of posterior teeth and eliminates negative effects of occlusal interference in the intercuspal position or during eccentric mandibular movements. During therapy, occlusal splint temporarily changes occlusal relationships as well as relations within TMJ, causing reduction of CMD symptoms. The best therapeutic effect for reduction of CMD symptoms is achieved by combination of physical therapy and medication.
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Mazzeto, Marcelo Oliveira, Takami Hirono Hotta, and Rafaela Galli Mazzetto. "Analysis of TMJ vibration sounds before and after use of two types of occlusal splints." Brazilian Dental Journal 20, no. 4 (2009): 325–30. http://dx.doi.org/10.1590/s0103-64402009000400011.
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Temporomandibular joint (TMJ) sounds are important and common physical signs of temporomandibular disorders (TMD). The aim of this study was to evaluate the influence of the effect of the use of occlusal bite splints (stabilizing and repositioning) on the sounds produced in the TMJ, by means of the electrovibratography (EVG). Thirty-one patients with TMD from the Dental School of Ribeirão Preto, University of São Paulo, Brazil were selected for this study. Group 1 (n=23) wore stabilizing bite splints and Group 2 (n=8) used anterior repositioning splints. Before and after treatment with occlusal splints both groups were analyzed using the SonoPAK Q/S recording system (BioResearch System, Inc.). The treatments with stabilizing bite splints were satisfactory, since they reduced the total amount of the sound energies (p<0.05), but the use of anterior repositioning splints for no more than 4 weeks produced significantly better results (p<0.01). The total amount of vibration energy involved in the vibrating movements of the TMJ showed significant improvement using anterior repositioning splints.
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Makeev, V. F., Yu O. Rybert, V. Ya Shybinskyy, N. R. Kliuchkovska, and O. S. Kyrmanov. "FEATURES OF OCCLUSAL THERAPY IN FUNCTIONAL DISORDERS OF TEMPOROMANDIBULAR JOINTS." Актуальні проблеми сучасної медицини: Вісник Української медичної стоматологічної академії 20, no. 3 (November 12, 2020): 249–57. http://dx.doi.org/10.31718/2077-1096.20.3.249.
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Temporomandibular joint (TMJ) dysfunctions are known as being highly prevalent, having multifactorial etiology, progressive course, and high recurrence rate. This combination of features typical of this pathology places it among pressing medical issues nowadays. The variety of concepts and approaches to the analysis of the etiopathogenesis of TMJ dysfunction causes a particular interest in both highly informative diagnostic techniques and functional methods of treatment. A complex pathological morphofunctional syndrome involving parafunctions of masticatory muscles, dysfunctional TMJ states and occlusal disorders ultimately leads to deformation and a low functional disproportion in the TMJ kinetics. The work analyzes the reports on the research of various occlusal splints, and in particular, the mechanism of their action, classification of their effectiveness in various types of TMJ disorders, advantages, and disadvantages of splints, as well as materials used for their manufacturing. It is important to emphasize that the choice of the optimal therapeutic approach to internal TMJ disorders should be chosen taking into account the position of the mandibular condyle, the nature of the articular disk displacement, the presence or absence of pain, its possible causes, and concomitant local and general aggravating factors. The study was performed as a part of the research project of the Department of Orthopaedic Dentistry, Danylo Halytskyi Lviv National Medical University.
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Singh, Dr Cheena, and Dr Parvathi Devi M. "Effectiveness of Soft Occlusal Splint Therapy in Patients With Temporomandibular Joint Disorders: A Crossectional Study." International Journal of Scientific Research 3, no. 8 (June 1, 2012): 323–30. http://dx.doi.org/10.15373/22778179/august2014/98.
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Garrocho-Rangel, Arturo, Andrea Gómez-González, Adriana Torre-Delgadillo, Socorro Ruiz-Rodríguez, and Amaury Pozos-Guillén. "Pain Management Associated with Posttraumatic Unilateral Temporomandibular Joint Anterior Disc Displacement: A Case Report and Literature Review." Case Reports in Dentistry 2018 (2018): 1–7. http://dx.doi.org/10.1155/2018/8206381.
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The aim of the present article is to review the etiological risk factors and the general and oral management of anterior disc displacement with reduction caused by a chin trauma, and to describe the diagnostic process and the treatment provided to an affected 7-year-old girl. The patient also experienced frequent and severe cephaleas, which may be related to cervical vertebrae deviation. The patient was successfully treated with an intraoral occlusal splint and analgesics. Pediatric dentists must always be aware of the early signs and symptoms of temporomandibular joint disorders in their patients, especially in cases of orofacial trauma history, with the aim of providing an opportune resolution and preventing its progression later in life. Occlusal splints are strongly recommended for the treatment of anterior disc displacement with reduction in children and adolescents.
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Ahmed, Mohammed Ayaz, Quazi Billur Rahman, Md Wares Uddin, and Md Asaduzzaman. "Efficacy of Acrylic Splint in Management of Internal Derangement of Temperomandibular Joint." Bangladesh Medical Research Council Bulletin 42, no. 2 (April 2, 2017): 72–77. http://dx.doi.org/10.3329/bmrcb.v42i2.32040.
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Occlusal splint plays a great role in the treatment of internal derangement of temporomandibular joint. Temporomandibular disorders affect 25 % of the population of the world. The purpose of the study was to elucidate the effectiveness of occlusal splint in reduction of pain, increase mouth opening, elimination of clicking sound. This randomized controlled clinical trial was done on 26 patients in two groups. Group A received occlusal splint and Group B received medications with supportive care. Monthly follow-up was done for a period of four months. In Group A and Group B, preoperative mean of mouth opening were 36.31 mm; and 39.77 mm. pain score 4.54 cm, clicking in 76.9% and 84.6% patients respectively. After 4 months of follow- up mouth opening 50.69 mm and 43.15 mm, pain score 0.154 cm and 0.69 cm, clicking 30.8% and 76.9% patients in both groups respectively. It may be conclude that the occlusal splint is highly efficient than medication and supportive care for managing of internal derangement of temporomandibular joint.
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Pichugina, Ekaterina, Valery Konnov, Alexey Bizyaev, Angelica Khodorich, Ekaterina Smolyaninova, Viktor Koshkin, Anush Arushanyan, and Taisiya Kochkonyan. "CLINICALEFFECTIVENESS OF OCCLUSALSPLINTS IN PATIENTS WITH FUNCTIONAL OCCLUSAL PROBLEMS." Archiv Euromedica 11, no. 1 (March 27, 2021): 127–30. http://dx.doi.org/10.35630/2199-885x/2021/11/1.28.
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Occlusal disorders caused by missing teeth and without timely and proper treatment, lead to poorly diagnosed pathology of the masticatory muscles and the temporomandibular joint. Our study included 31 patients with dental defects, impaired canine guidance, and TMJ pathology. With a specifically developed computer program we accomplished the differentiation of various degrees of muscle and joint dysfunction in the temporomandibular joint. The results obtained by examining the patients prior to, and after the treatment, provide evidence to the effect that the modified occlusal splint has on the upper jaw.
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Okeson, J. P. "Long-term treatment of disk-interference disorders of the temporomandibular joint with anterior repositioning occlusal splints." Journal of Prosthetic Dentistry 60, no. 5 (November 1988): 611–16. http://dx.doi.org/10.1016/0022-3913(88)90224-7.
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Mańka-Malara, Katarzyna, Joanna Łuniewska, Magdalena Łuniewska, Anahit Hovhannisyan, Elżbieta Mierzwińska-Nastalska, and Dominika Gawlak. "Analysis of factors determining athletes’ choice of the type of mouthguard." Prosthodontics 68, no. 1 (March 15, 2018): 16–31. http://dx.doi.org/10.5604/01.3001.0011.6804.
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Introduction. The application of flexible occlusal splints in therapy of the stomatognatic system is recommended for short-term use only because of the risk of muscle overloading or occlusal plane disorders. Mouthguards used in prevention of head and mouth injuries are a modification of occlusal splints. They are made of flexible material with properties enabling absorption of impact energy. Due to regular use during trainings and competitions they may have an impact on the incidence of stomatognatic system ailments. Aim of the study. To assess the factors determining the choice of a mouthguard type and its influence on the stomatognatic system. Material and methods. A survey was conducted among 1279 mouthguard users to collect demographic data and information concerning mouthguards on the occurrence of problems arising from their use including pain in the area of the stomatognatic system. Statistical analysis of the results was also performed. Results. 36% athletes with standard mouthguards, 37% with “boil and bite” and 44% with custom-made ones have a tendency towards strong clenching of dental arches. Participants using a custom-made mouthguard reported chewing muscle fatigue more often than the users of the standard and “boil and bite” type, but they did not report any pain located in the area of temporomandibular joint. People experiencing fatigue and with a strong clenching of dental arches tendency significantly more often choose a type considering its retention ability, whereas pain in the temporomandibular joint area does not influence their preferences. Athletes, who declare teeth clenching, more frequently indicate the retention factor as important. Conclusion. It is necessary to conduct further research on the use of mouthguards considering their impact on the stomatognatic system.
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Korkmaz, YT, C. Candirli, M. Celikoglu, SH Altintas, U. Coskun, and S. Memis. "Dentists' knowledge of occlusal splint therapy for bruxism and temporomandibular joint disorders." Nigerian Journal of Clinical Practice 19, no. 4 (2016): 496. http://dx.doi.org/10.4103/1119-3077.183310.
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EMSHOFF, R. "Clinical factors affecting the outcome of occlusal splint therapy of temporomandibular joint disorders." Journal of Oral Rehabilitation 33, no. 6 (June 2006): 393–401. http://dx.doi.org/10.1111/j.1365-2842.2005.01584.x.
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Lyashev, Ilya N., Andrey M. Dybov, and Polina V. Kholmogorova. "The effectiveness of the surgical correction of the temporomandibular joint intracapsular disorders." Journal of Clinical Practice 10, no. 2 (August 17, 2019): 6–13. http://dx.doi.org/10.17816/clinpract1026-13.
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Background. The prevalence of temporomandibular joint diseases covers about 40% of the population. The main place (from 70 to 82%) among these diseases is occupied by the so-called intracapsular disorders of the temporomandibular joint (TMJ). The lack of consensus on the use of treatment methods and clear protocols for the rehabilitation of patients with intracapsular TMJ disorders was the basis for the conduct of this study.
Objective. The purpose of the study was to analyze the treatment effectiveness in patients with intracapsular disorders of the temporomandibular joint using the complex of pathogenetically substantiated conservative and surgical methods. Methods. The research included 43 patients with complaints to pains and dysfunction of TMJ. Everything fulfilled the uniform protocol of inspection. Depending on disease degree to patients were assigned or a course of conservative treatment with use splint therapy, or surgical correction of defect.
Results. After analyzing the dynamics of patient treatment in the framework of this study, it was found that surgical correction of intracapsular disorders of the temporomandibular joint was effective in all patients examined by us.
Conclusion. To maintain a long-term stable result, this group of patients is shown orthodontic-orthopedic rehabilitation, with the goal of creating and maintaining correct occlusal relationships.
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Özçelik, Tuncer Burak, and Ahmet Ersan Ersoy. "Temporomandibular Joint Clicking Noises Caused by a Multilocular Bone Cyst: A Case Report." Journal of Contemporary Dental Practice 7, no. 3 (2006): 99–105. http://dx.doi.org/10.5005/jcdp-7-3-99.
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Abstract When diagnosing patients with temporomandibular disorder (TMD) symptoms, the possibility of unusual causes must be considered, including neoplastic disorders, as well as infections and inflammatory disease. Therefore, radiologic examination may prove to be invaluable in the differential diagnosis of TMDs. This article describes a patient whose temporomandibular joint (TMJ) noise was initially diagnosed by another dental clinic as a TMJ anterior disc displacement with reciprocal clicking. Occlusal splint therapy was used for nearly three to four months but did not improve the TMJ noise condition. When the patient was examined clinically and imaged with magnetic resonance imaging (MRI) and computed tomography (CT), a multilocular bone cyst (MBC) was suspected. The cyst could cause surface irregularities in the posterior part of the left eminence of the temporal bone, which could be the source of the clicking noise. Citation Özçelik TB, Ersoy AE. Temporomandibular Joint Clicking Noises Caused by a Multilocular Bone Cyst: A Case Report. J Contemp Dent Pract 2006 July;(7)3:099-105.
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Hobeiche, Joseph, Amine el Zoghbi, Mohamad Halimi, and Camille Haddad. "Effect of Occlusal Splints on Posture Balance in Patients with Temporomandibular Joint Disorder: A Prospective Study." Journal of Contemporary Dental Practice 22, no. 6 (2021): 615–19. http://dx.doi.org/10.5005/jp-journals-10024-3094.
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Konnov, V. V., T. S. Kochkonyan, D. A. Domenyuk, E. N. Pichugina, S. V. Konnov, A. S. Khodorich, A. A. Bizyaev, and A. R. Arushanyan. "Differentiated approach to the development of methods of pathogenetic therapy of pain dysfunction of the temporomandinary joint." Medical alphabet, no. 2 (March 30, 2021): 38–46. http://dx.doi.org/10.33667/2078-5631-2021-2-38-46.
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The issues of structural organization, function and diagnosis of diseases of the temporomandibular joint have long attracted the attention of not only morphologists, dentists, maxillofacial surgeons, but also doctors of related specialties. Temporomandibular disorders are among the most common non-odontogenic pain syndromes in the maxillofacial region and are considered a variant of musculoskeletal pain syndrome. Based on the analysis of the results of clinical and functional studies, an algorithm for the management of patients with terminal dentition defects complicated by signs of painful dysfunction of the temporomandibular joint was proposed. Therapeutic measures, depending on the degree of painful dysfunction of the temporomandibular joint, included the following stages: occlusive splint therapy; physiotherapy treatment with dynamic electroneurostimulation; prosthetic treatment of end defects of the dentition; stabilization of the spatial relationship of the jaws. Complex therapeutic measures are aimed at normalizing the functional activity of the dentoalveolar apparatus by restoring the uniform distribution of the occlusal load.
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Medlicott, Marega S., and Susan R. Harris. "A Systematic Review of the Effectiveness of Exercise, Manual Therapy, Electrotherapy, Relaxation Training, and Biofeedback in the Management of Temporomandibular Disorder." Physical Therapy 86, no. 7 (July 1, 2006): 955–73. http://dx.doi.org/10.1093/ptj/86.7.955.
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Abstract Background and Purpose. This systematic review analyzed studies examining the effectiveness of various physical therapy interventions for temporomandibular disorder. Methods. Studies met 4 criteria: (1) subjects were from 1 of 3 groups identified in the first axis of the Research Diagnostic Criteria for Temporomandibular Disorders, (2) the intervention was within the realm of physical therapist practice, (3) an experimental design was used, and (4) outcome measures assessed one or more primary presenting symptoms. Thirty studies were evaluated using Sackett’s rules of evidence and 10 scientific rigor criteria. Four randomly selected articles were classified independently by 2 raters (interrater agreement of 100% for levels of evidence and 73.5% for methodological rigor). Results. The following recommendations arose from the 30 studies: (1) active exercises and manual mobilizations may be effective; (2) postural training may be used in combination with other interventions, as independent effects of postural training are unknown; (3) mid-laser therapy may be more effective than other electrotherapy modalities; (4) programs involving relaxation techniques and biofeedback, electromyography training, and proprioceptive re-education may be more effective than placebo treatment or occlusal splints; and (5) combinations of active exercises, manual therapy, postural correction, and relaxation techniques may be effective. Discussion and Conclusion. These recommendations should be viewed cautiously. Consensus on defining temporomandibular joint disorder, inclusion and exclusion criteria, and use of reliable and valid outcome measures would yield more rigorous research. [Medlicott MS, Harris SR. A systematic review of the effectiveness of exercise, manual therapy, electrotherapy, relaxation training, and biofeedback in the management of temporomandibular disorder. Phys Ther. 2006;86:955–973.]
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Arioğlu, Ender Ege, and Rory Molloy. "A comparative approach to treatment methods for myofacial pain and internal derangement of the temporomandibular joint." Morecambe Bay Medical Journal 8, no. 1 (August 1, 2018): 16–23. http://dx.doi.org/10.48037/mbmj.v8i1.52.
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The temporomandibular joint (TMJ) is the site of articulation between the mandibular fossa of the temporal bone and condylar head of the mandible. The TMJ is a synovial joint that has a cartilaginous disc between two articular surfaces. It can perform rotation and translation. A group of muscles (primarily masseter, temporalis and pterygoids) and ligaments are involved in jaw movement. The group of disorders that encompasses dysfunction of these structures is called “temporomandibular disorders (TMD)”. This research primarily focuses on myofacial pain, dysfunction and internal derangement of the TMJ (anterior disc displacement (ADD) with and without reduction). Treatments include conservative and invasive interventions. Conservative treatment consists of behavioural/psychosocial therapy, physiotherapy, pain management, occlusal splint therapy, low-level laser therapy and transcutaneous electric nerve stimulation therapy. Conservative treatment provides very effective results for pain relief and signifi cant improvement of jaw function, however follow-up periods in studies were short-term (not more than three months). Continuous improvement was observed in occlusal splint therapy as it leads to sustained behavioural change, helpful in alleviating pain by reducing stress put on the masticatory muscles and correcting jaw function. Exercise and physiotherapy have also resulted in considerable pain reduction and restoration of jaw function. Evidence showed that botulinum-toxin type A provided an immediate alleviation of pain effective for 3 months, however decreased maximal incisal opening as its mechanism of action is inhibiting muscle activity.
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Fernández-González, Felipe J., Jorge Cabero-López, Aritza Brizuela, Ivan Suazo, Esteban Pérez-Pevida, Teresa Cobo, Oier Montalban, et al. "Efficacy of Selective Grinding Guided by an Occlusal Splint in Management of Myofascial Pain: A Prospective Clinical Trial." Open Dentistry Journal 11, no. 1 (June 30, 2017): 301–11. http://dx.doi.org/10.2174/1874210601711010301.
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Background:For patients whose centric relation (CR) has not been considered at the start and during treatment, the task of achieving an occlusal scheme that works together with the temporomandibular joint, the muscles, and the structures of the stomatognathic apparatus becomes a major concern.Objective:This study aims to describe a reproducible, predictable and to date unreported procedure of selective grinding guided by an occlusal splint and to analyze condylar position (CP) based on the skeletal pattern.Methods:A total of 72 symptomatic patients (38 females and 34 males) were classified into three groups: hyperdivergent, intermediate and hypodivergent. CP was quantified by mounted casts on a measures condyle displacement (MCD) device. Helkimo index was also performed in order to assess the severity of the temporomandibular joint (TMJ) disorders attending to clinical dysfunction, occlusal state and anamnestic dysfunction. Once the stability had been obtained, the splint was progressively reduced until the maximum intercuspation (MIC) was achieved.Results:The vertical displacement was found to be significantly different between the hyperdivergent and other two groups (p<0.01). Comparisons of MCD analysis before and after the selective grinding procedure identified a statistically significant difference in the horizontal and vertical CP (p<0.01) between the different groups whereas the Helkimo Index showed a clear improvement of TMJ disorders.Conclusion:All facial types, specially the hyperdivergent face type, showed a reduction in condylar displacement (CD) and less craniomandibular symptoms using this procedure, making it an excellent technique for clinicians.
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Cho, Il-San, Jung Hwan Jo, and Ji Woon Park. "Complications Following Masseteric Nerve Neurectomy with Radiofrequency for the Treatment of Temporomandibular Disorders—A Case Series and Literature Review." Applied Sciences 11, no. 13 (June 23, 2021): 5824. http://dx.doi.org/10.3390/app11135824.
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This article describes two cases of masseteric nerve neurectomy with radiofrequency done with the intention to treat temporomandibular disorders and related symptoms; the patients then visited our clinic complaining of side-effects after the procedure. A literature review was conducted to find scientific evidence relevant to masseteric nerve neurectomy with radiofrequency. A 21-year-old male patient visited with the chief complaint of swelling of both cheeks, dizziness, and generalized lethargy occurring after masseteric nerve neurectomy using radiofrequency. His mouth opening range was restricted. Magnetic resonance imaging indicated post-procedural inflammation with hemorrhage within both masseter muscles. A 28-year-old male patient visited with the chief complaint of occlusal discomfort and disocclusion after masseteric nerve neurectomy using radiofrequency. His occlusion was abnormal with only both second molars occluding. Overbite was −1 mm. Cone-beam computed tomography indicated degenerative joint disease of both condyles. In case 1, pharmacotherapy and physical therapy relieved overall symptoms. In case 2, although exacerbation of symptoms repeatedly occurred, long-term stabilization splint and physical therapy alleviated the temporomandibular disorders symptoms. However, the occlusion remained unstable. Scientific evidence of masseteric nerve neurectomy using radiofrequency for the treatment of temporomandibular disorders is still lacking. Therefore, conservative treatment should remain as the first line approach for temporomandibular disorders.
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Cruz, José Henrique de Araújo, Lindoaldo Xavier Sousa, Bruno Firmino de Oliveira, Francisco Patrício de Andrade Júnior, Maria Angélica Satyro Gomes Alves, and Abrahão Alves de Oliveira Filho. "Disfunção temporomandibular: revisão sistematizada." ARCHIVES OF HEALTH INVESTIGATION 9, no. 6 (October 10, 2020): 570–75. http://dx.doi.org/10.21270/archi.v9i6.3011.
Full textAbstract:
Introdução: Disfunção Temporomandibular (DTM) é o termo para designar um quadro de desorganização neuromuscular identificada pela presença de cefaleias crônicas, sons na articulação temporomandibular, restrições dos movimentos mandibulares, hiperestesia e dor nos músculos da mastigação, da cabeça e do pescoço. Objetivo: realizar uma revisão de literatura sobre a DTM. Material e Método: foi feita uma seleção de artigos científicos a partir das bases de dados LILACS e SCIELO utilizando os descritores “Articulação Temporomandibular”, “Transtornos da Articulação Temporomandibular” e “Dor Facial”, usando como critérios de inclusão trabalhos brasileiros e inglês publicados em português e inglês no período de 2000 a 2018. Dos 798 artigos encontrados e delimitados pelos critérios inclusivos, foram selecionados 56 artigos como amostra, que apresentaram a temática elencada para a pesquisa e que foram discutidos nas seguintes sessões: a) Conceitos e epidemiologia; b) Etiologia; c) Sintomatologia; d) Diagnóstico; e) Tratamento. Conclusão: as causas da DTM são multifatoriais e seu diagnóstico deve ser minucioso. Observa-se a importância da anamnese para coleta de dados sintomatológicos da doença e o estudo de cada caso para melhor adequar a técnica de tratamento a ser utilizada. Há a necessidade de avaliações clínicas multidisciplinares nos indivíduos identificados com DTM para que o tratamento seja otimizado, minimizando a morbidade e diminuindo os custos do tratamento.
Descritores: Articulação Temporomandibular; Transtornos da Articulação Temporomandibular; Dor Facial.
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MARTINS, Ana Paula Varela Brown, Luana Maria Martins de AQUINO, Carolina Beraldo MELOTO, and Célia Marisa Rizzatti BARBOSA. "Counseling and oral splint for conservative treatment of temporomandibular dysfunction: preliminary study." Revista de Odontologia da UNESP 45, no. 4 (August 4, 2016): 207–13. http://dx.doi.org/10.1590/1807-2577.28515.
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Abstract Introduction Temporoamndiular Disorders (TMD) involve the masticatory muscles, temporomandibular joint (TMJ) or both. The most common symptom is pain, which is usually located in the muscles of mastication, pre-auricular region, and / or ATM, especially during mandibular function. The main treatment for TMD is related to pain relief. Objective The purpose of this case report was to evaluate the reduction of pain symptoms using Visual Analogue Scale (VAS) of patients with TMD treated with counseling and use of occlusal splint (OS). Material and method 16 subjects had participated in this study, that was composed by 4 appointment with 7-day interval between each (CEP FOP / Unicamp – 137/2009). In the first, an examiner used the Research Diagnostic Criteria for Temporomandibular Disorders (RDC / TMD) to diagnose each patient and delivered a VAS to register the intensity of daily pain. In the second, counseling, molding of both dental arcs to fabricate the OS and the delivery of new VAS were performed. In the third, there was the installation and adjustment of the OS and the delivery of another scale, and in the last, possible adjustments on the OS were done. Data were analyzed by ANOVA two way and Tukey post-test at 5% significance level. Result There was significant difference when comparing the intensity of pain of individuals after installation of splint with the baseline data and after counseling (p = 0.05). Conclusion According to the result of this study, the treatment of TMD associating counseling occlusal splint is effective in reducing pain intensity.
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Shopova, Dobromira, Tanya Bozhkova, Svetlana Yordanova, and Miroslava Yordanova. "Case Report: Digital analysis of occlusion with T-Scan Novus in occlusal splint treatment for a patient with bruxism." F1000Research 10 (September 13, 2021): 915. http://dx.doi.org/10.12688/f1000research.72951.1.
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Bruxism is a disease with a multifactorial etiology. Its clinical manifestations are most often an unaesthetic smile with abraded tooth surfaces, temporomandibular disorders and muscle hyperactivity. Here we present a case of bruxism where proper articulation of the occlusal splint was performed using the T-scan Novus system. A patient with bruxism underwent treatment with stabilization splint made by 3D printer technology. Intraoral scanning was performed using Trios Color (3Shape), and the digital design was achieved using the 3Shape Dental system design - splint studio. Formlabs Form 2 printer with biocompatible resin Dental LT Clear Resin was used for printing. The T-Scan Novus system with software attached to it, version 9.1, was used for digital examination of the occlusion. A 2.7 mm thick occlusal splint was developed, and the software adapted the occlusion with antagonists. After adjustment with T-Scan Novus, a reduction in disocclusion time of the patient was achieved, which is a desired result in the treatment of bruxism. The position of the joint components was proven radiologically. The treatment of bruxism with splint therapy continues to be the main method of treatment. Using digital technology allows for more accurate constructions and precise balancing of occlusal relationships.
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Novikov, V. M., M. A. Korostashova, V. I. Dodatko, O. S. Svyryda, and Ya O. Yushchenko. "THE ROLE OF MAGNETIC RESONANCE RESEARCH IN THE TREATMENT OF DYSFUNCTION OF THE TEMPOROMANDIBULAR JOINT." Ukrainian Dental Almanac, no. 2 (June 29, 2021): 59–63. http://dx.doi.org/10.31718/2409-0255.2.2021.11.
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The main criterion for diagnosis of dysfunctional conditions of the temporomandibular joint is the visualization of the intra-articular cartilaginous disc. The method of diagnosis, that the most perfectly determines the disorders in the temporomandibular joint, particular the displacement of the menisci, is magnetic resonance imaging. So, the aim of the work was to determine the amplitude of anterior displacements of the menisci in patients suffering from dysfunction of the temporomandibular joint using magnetic resonance imaging.
In 20 patients, who underwent magnetic resonance imaging, different amplitudes of the anterior displacements of the meniscus were determined. Patients were divided into groups. The first group included 6 patients who were diagnosed by MRI the anterior displacement of the disc to the center of the articular head. The second group included 4 patients who had anterior displacement of the disc to the center of the articular head by 2/3 of its own length. Ten patients of the third group had a displacement of the meniscus to the center of the articular head by 1/2 of its own length. For the future treatment of TMJ dysfunction, the distance of the pathological displacement of the meniscus determines the degree of occlusion. All patients were prescribed a Michigan-splint occlusal splint in combination with a sling-like head cap at night. The results of the selected treatment were interpreted after 3-6 months.
A series of magnetic resonance imaging has described the articular fissures of the temporomandibular joint, articular discs (their shape in frontal projection and on parasagittal sections), posterior ligaments, and lateral pterygoid muscles. Each of the joints was carefully examined in the case when the mouth is closed and open. During the MRI description, the shape of the joint heads and their possible pathological changes were determined. In the position of the closed or open mouth, the positions of each of the discs and their poles relatively to the articular head in centimeters were compared, and the movement of the menisci was described. The sizes of disks of the closed and open mouth were defined. The study protocol also reported the shape and amplitude of the movements of the articular heads.
Treatment was planned according to the selected protocol. For the first group of patients diagnosed with anterior meniscus dislocation, treatment was planned by separating the occlusion to the relatively physiological rest of the mandible (2 - 4 mm). The patients of the second group, in which anterior displacements of the disc relatively to the articular head by 2/3, were treated with detachment of the occlusion to contact with the cutting edge of the teeth of the upper and lower jaws. For the third patients’ group with diagnosed anterior displacement of the meniscus by 1/2, treatment was performed with a separation of the bite on 2 - 4 mm above the contact with the cutting edges of the front teeth. The main criterion for recovery is the complete disappearance of symptoms of dysfunction, even without the use of a splint.
At the first stage of treatment the task was the following: reconstruction of a myotatic reflex by means of the medical and diagnostic occlusal splint "Michigan-splint" completed with the main slingshot cap. Patients were monitored monthly. The main problems were the following: after a week of using the structure the patients complained of increased salivation, muscle pain and burning, headache, which disappeared after approximately 3 weeks. The main cause of such phenomena is the physiological rearrangement of the muscular reflex, which involves a certain tension in the muscles and irritation of the nerve endings in the muscles due to changes in the usual occlusion. During planned examination, the patients demonstrated supercontacts followed by cap correction. In 3 or 6 months of using the Michigan-splint occlusal splint, patients noted a significant improvement and they didn’t have any complaints. The main criterion for recovery is the complete disappearance of symptoms of dysfunction, even without the use of a splint. Therefore, the next stage of treatment depended on the anatomical and functional changes of TMJ and consolidation of therapeutic effect was been necessary.
Therefore, the use of magnetic resonance imaging of the temporomandibular joint to determine the amplitude of the displacements of the discs, ensures the effectiveness of the selected treatment.
Prospects for further research include improvement of the MRI protocol and its correlation with definite symptoms, the distance of the vertical separation of occlusal surfaces, and the introduction of the protocol into practical health care.
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Incorvati, Cristina, Antonio Romeo, Adele Fabrizi, Luca Defila, Carla Vanti, Maria Rosaria Antonella Gatto, Claudio Marchetti, and Paolo Pillastrini. "Effectiveness of physical therapy in addition to occlusal splint in myogenic temporomandibular disorders: protocol of a randomised controlled trial." BMJ Open 10, no. 8 (August 2020): e038438. http://dx.doi.org/10.1136/bmjopen-2020-038438.
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IntroductionTemporomandibular disorders (TMDs) are considered a collection of musculoskeletal conditions involving the masticatory muscles, the temporomandibular joint and associated structures. The myogenous group appears to represent the most frequently diagnosed category. In the context of a multimodal approach, splint therapy and musculoskeletal physiotherapy are often considered as a preferred therapy. The purpose of this study will be to investigate the effects of musculoskeletal physiotherapy combined with occlusal splint and education versus occlusal splint and education alone in the treatment of chronic myogenous TMD on pain and mandibular range of motion.Methods and analysisAll consecutive adults complaining of TMDs presented to the Department of Biomedical and Neuromotor Sciences of the University of Bologna will be considered eligible. Inclusion criteria shall be based on the presence of myogenous TMDs, as diagnosed through clinical examination in reference to the international diagnostic criteria of TMDs. Randomisation, concealed allocation, blinded assessment and intention-to-treat analysis will be employed. The splint therapy will consist of the use of the splint every night and concurrent delivery of an educational programme; the protocol shall have a duration of three consecutive months. The combined musculoskeletal physiotherapy, splint therapy and education will additionally consist of manual therapy techniques and exercise; such protocol shall consist of a duration of three consecutive months, inclusive of 10 sessions for the enhanced elements. All outcome measures will be collected at baseline, after treatment and at a 6 months follow-up.Ethics and disseminationEthical approval has been obtained from the Independent Ethic Committee in Clinical Research of AUSL Bologna-Italy (47/2018/SPER/AUSLBO). Pursuant to applicable rules,we will obtain informed consent from each participant and collect data anonymously to maintain privacy. Results will be disseminated to clinicians and researchers through peer-reviewed publications and conferences.Trial registration numberNCT03726060
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NEGUCIOIU, Marius, Andreea KUI, Mihai MITARIU, Manuela MANZIUC, Daniela CONDOR, Loredana MITARIU, and Smaranda BUDURU. "The outcomes of ultrasonic and laser therapy in case of temporomandibular disorders – an evidence based update." Balneo and PRM Research Journal 12, no. 3 (September 1, 2021): 210–17. http://dx.doi.org/10.12680/balneo.2021.440.
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Introduction. Temporomandibular disorders (TMDs) are considered multifactorial conditions, thereby with different therapy options, from occlusal equilibration, splint therapy, pharmacotherapy or physical therapy. Among the physical therapies, over the last years, laser therapy and ultrasound therapy have gained attention, as different experimental or clinical studies suggest their efficacy in case of TMDs. The aim of our literature review is to evaluate the available evidence on the effectiveness of laser and ultrasound therapy in the treatment of temporomandibular disorders. Material and method. A research of literature has been performed - articles published over the last 5 years (January 2016 until June 2021) were searched by introducing a combination of different terms, using the Pubmed, Scopus and Google Scholar databases. Results and discussions. A total number of 332 articles was found. For multiple publications regarding the same group of patients, the most recent studies were included. Initial analysis of titles and abstracts eliminated 232 articles, leaving 35 articles whose full text was examined. 20 articles met the inclusion criteria Conclusions. According to the findings of this literature update we can conclude that low level laser therapy, ultrasound therapy, and photobiomodulation may effectively reduce pain for patients suffering of muscular and joint TMDs. However, their effects appear to be only shortly maintained, and only for less complex cases. In addition, it was difficult to compare the studies included, as they do not offer an optimal usage (program, duration of sessions, or number of sessions) of each technique. In this context, we consider that further randomized clinical studies are necessarily to compare each physical technique as well as their synergic effect on the symptoms in case of temporomandibular disorders. Keywords: temporomandibular disorders, low level laser therapy, ultrasound therapy, photobiomodulation, TMD, LLLT
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Lickteig, Rita, Martin Lotze, and Bernd Kordass. "Successful therapy for temporomandibular pain alters anterior insula and cerebellar representations of occlusion." Cephalalgia 33, no. 15 (June 14, 2013): 1248–57. http://dx.doi.org/10.1177/0333102413491028.
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Aim Craniomandibular disorders (CMD) are widespread, but we know little about the cerebral representations associated with this pain syndrome and nothing about changes in cerebral representations of occlusion induced by common therapy approaches. Methods In a longitudinal therapy study, we applied functional magnetic resonance imaging (fMRI) in 14 patients with mild CMD during occlusal movements. fMRI, pain scoring, kinematic investigations of occlusal movements, and jaw muscle electromyography (EMG) were measured before and after two weeks of therapy with an individually optimized Michigan splint. Results The patients’ subjective pain ratings decreased, and the symmetry of condylar movements increased over the period of therapy. After therapy, EMG of the jaw muscles demonstrated more relaxed resting conditions and increased activity during maximal occlusion. fMRI during occlusion showed an activation decrease in the right anterior insula and right cerebellum over the course of therapy. Correlation analysis between pain score and fMRI activation decreases identified right anterior insula, left posterior insula and left cerebellar hemisphere. Left cerebellar and right primary motor activation magnitude was negatively associated with symmetry of the condylar movements. Conclusions Our findings highlight the impact of the anterior insula for the internal monitoring and the anticipation of temporomandibular joint (TMJ) pain. In addition, an increase of symmetry of condylar movements after therapy has been associated with a decrease of activation magnitude in primary motor and cerebellar regions.
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Ahmad, Nafis. "18. Selection of a precise occlusal splint (directive or permissive) for the treatment of temporomandibular joint disorders: a clinical report." Journal of Indian Prosthodontic Society 18, no. 6 (2018): 100. http://dx.doi.org/10.4103/0972-4052.246592.
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Pihut, M., M. Górnicki, M. Orczykowska, E. Zarzecka, W. Ryniewicz, and A. Gala. "The Application of Radiofrequency Waves in Supportive Treatment of Temporomandibular Disorders." Pain Research and Management 2020 (May 6, 2020): 1–6. http://dx.doi.org/10.1155/2020/6195601.
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In recent years, the number of patients applying for prosthetic treatment due to temporomandibular joint disorders (TMD) has been increasing. The main methods for treating disorders are the use of occlusal splints and physiotherapeutic rehabilitation as supportive treatment. Radio waves are electromagnetic waves with radiation frequency between 3 Hz and 3 THz, used for physiotherapeutic treatment of skeletal muscle relaxation in the range of 3 to 6 MHz. The rehabilitation effect of these waves is based on diathermy by means of high-voltage quick alternating current. Aim. The aim of the study was to evaluate the influence of radiofrequency waves on the pain of the masticatory muscles in the course of TMD and the usefulness of these procedures in the supporting treatment of these disorders. Materials and Methods. Patients aged 19 to 45 years, of both sexes, reported to the Consulting Room of TMD at the Institute of Dentistry in Krakow to undertake prosthetic treatment of TMD (I a—according to RDC/TMD). Study group (SG) consists of 20 patients who had 10 supportive treatments with radiofrequency currents. In the case of application of radiation to the muscle area, the energy was 20 J to the area of the masticatory muscles, the frequency was 3 MHz, bipolar technique, the duration of the procedure was 10 minutes, and the coupling substance was a gel for ultrasound examinations. The control group (CG) consisted of 20 patients who had 10 supportive treatments with sonophoresis procedures. For the area of masticatory muscles, 0.9 W/cm2 treatments were applied, the duty factor was 80%, the treatment time was 10 minutes, and the medical substance was 25% Voltaren gel. Results. Analysis of the results of the first clinical examinations (axis I) conducted in both groups shows a homogeneous clinical material and similar results. The second clinical examination revealed improved clinical parameters, but it showed a greater improvement in the SG. In the SG, the mean level of VAS was 6.25, and the extreme values were 5.9–0.14, the median was 2.15, and the standard deviation was 1.54. In the CG, the average value of VAS was 6.20 (peak of 5.2–0.7), the median was 2.4, and the standard deviation was 1.87. Summary. The search for new methods of supportive treatment of TMD is an important research direction due to the complex etiology of this disease and the lack of an explicit treatment algorithm. Conclusion. The results of our own research clearly indicate that the use of the radiofrequency waves brings pain relief and improvement of clinical parameters to a greater extent than in sonophoresis. It can be a very important new method in supportive treatment of TMD. Research needs to be continued.
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Clemente, Miguel, Joaquim Mendes, André Moreira, Ricardo Vardasca, Afonso Ferreira, and José Amarante. "Wind Instrumentalists and Temporomandibular Disorder: From Diagnosis to Treatment." Dentistry Journal 6, no. 3 (August 23, 2018): 41. http://dx.doi.org/10.3390/dj6030041.
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Introduction: Temporomandibular disorders (TMD) involve the presence of pain or dysfunction on certain areas of the Cranio-Cervico-Mandibular Complex (CCMC), such as the masticatory muscles, the temporomandibular joint (TMJ) and associated structures like the postural muscles of the cervical region, can be considered as a sub-group of musculoskeletal disorders. Wind instrument players, as a consequence of their musical performance and its relation with the CCMC, can develop a TMD associated to muscle hyperactivity of certain elevator muscles, or even an increase of the intra-articular pressure in the functioning of the TMJ throughout musical activity. Aim: The objective of this paper is to describe the necessary and elementary steps in the diagnoses and treatment of a wind instrumentalist with a temporomandibular disorder, with the introduction of infrared thermography during this procedure. This case study also has the purpose of presenting the usefulness of piezoresistive sensors in the analysis of the clarinettists’ embouchure. Methodology: A Caucasian, 30-year-old female clarinettist was assessed through a clinical examination following the Diagnostic Criteria for TMD (RDC/TMD), as a complementary tool of diagnosis, a thermal imaging infrared camera, Flir E60 (Wilsonville, OR, USA), was used in order to analyse the above referred articular and muscular regions. The complementary examination protocol implemented with this clarinet player also involved the analyses of the embouchure with the support of piezoresistive sensors. Results: The clinical outcomes resulting from this work were based on the RDC/TMD diagnoses indicated that the clarinet player had an internal derangement on both TMJ, with an osteoarthritis on the left TMJ and an anterior disc displacement with reduction on the right TMJ. The infrared thermograms that were analysed, verified the existence of a temperature differential of the anterior temporal muscle (0.1 °C), the TMJ (0.1 °C) and the masseter muscle (0.7 °C), and after the occlusal splint therapy the asymmetry related to the master muscle reduced to 0.3 °C. The high pitches can reach values of 379 g of force induced to the tooth 21 comparing to the 88 g of force applied on tooth 11. The embouchure force measurements consistently presented greater forces during the higher notes, followed by the medium notes and finally the low notes and this happened with higher pressures being transmitted always to tooth 21. Conclusion: Performing arts medicine should understand the major importance of the dentistry field in the daily life of a professional musician, and the significance of implementing routine screening procedures of dental examinations, with infrared thermograms examination of distinct areas of the CCMC, as well as the use of sensors on the analyses of an eventual asymmetrical embouchure. Employing these techniques in dentistry will create the chance of preventing the overuse of some anatomical structures, with an early diagnosis and the correct monitoring of these areas.
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Tanne, Kazuo, Yuki Okamoto, Shao-Ching Su, Tomomi Mitsuyoshi, Yuki Asakawa-Tanne, and Kotaro Tanimoto. "Current status of temporomandibular joint disorders and the therapeutic system derived from a series of biomechanical, histological, and biochemical studies." APOS Trends in Orthodontics 5 (December 29, 2014): 4–21. http://dx.doi.org/10.4103/2321-1407.148014.
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This article was designed to report the current status of temporomandibular joint disorders (TMDs) and the therapeutic system on the basis of a series of clinical, biomechanical, histological and biochemical studies in our research groups. In particular, we have focused on the association of degenerative changes of articular cartilage in the mandibular condyle and the resultant progressive condylar resorption with mechanical stimuli acting on the condyle during the stomatognathic function. In a clinical aspect, the nature and prevalence of TMDs, association of malocclusion with TMDs, association of condylar position with TMDs, association of craniofacial morphology with TMDs, and influences of TMDs, TMJ-osteoarthritis (TMJ-OA) in particular, were examined. In a biomechanical aspect, the nature of stress distribution in the TMJ from maximum clenching was analyzed with finite element method. In addition, the pattern of stress distribution was examined in association with varying vertical discrepancies of the craniofacial skeleton and friction between the articular disk and condyle. The results demonstrated an induction of large compressive stresses in the anterior and lateral areas on the condyle by the maximum clenching and the subsequent prominent increases in the same areas of the mandibular condyle as the vertical skeletal discrepancy became more prominent. Increase of friction at the articular surface was also indicated as a cause of larger stresses and the relevant disk displacement, which further induced an increase in stresses in the tissues posterior to the disks, indicating an important role of TMJ disks as a stress absorber. In a histological or biological aspect, increase in TMJ loading simulated by vertical skeletal discrepancy, which has already been revealed by the preceding finite element analysis or represented by excessive mouth opening, produced a decrease in the thickness of cartilage layers, an increase in the numbers of chondroblasts and osteoclasts and the subsequent degenerative changes in the condylar cartilage associated with the expression of bone resorption-related factors. In a biochemical or molecular and cellular aspect, excessive mechanical stimuli, irrespective of compressive or tensile stress, induced HA fragmentation, expression of proinflammatory cytokines, an imbalance between matrix metalloproteinases and the tissue inhibitors, all of which are assumed to induce lower resistance to external stimuli and degenerative changes leading to bone and cartilage resorption. Excessive mechanical stimuli also reduced the synthesis of superficial zone protein in chondrocytes, which exerts an important role in the protection of cartilage and bone layers from the degenerative changes. It is also revealed that various cytoskeletal changes induced by mechanical stimuli are transmitted through a stretch-activated or Ca2+ channel. Finally, on the basis of the results from a series of studies, it is demonstrated that optimal intra-articular environment can be achieved by splint therapy, if indicated, followed by occlusal reconstruction with orthodontic approach in patients with myalgia of the masticatory muscles, and TMJ internal derangement or anterior disk displacement with or without reduction. It is thus shown that orthodontic treatment is available for the treatment of TMDs and the long-term stability after treatment.
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Saranya, S. K., Chandrashekar Janakiram, Anil Mathew, Pramod Subash, and Priya K. Nair. "Efficacy of Occlusal Splints in Managing Temporomandibular Disorders." Indian Journal of Public Health Research & Development 10, no. 12 (December 1, 2019): 464. http://dx.doi.org/10.37506/v10/i12/2019/ijphrd/191997.
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Gray, R. J. M., and S. J. Davies. "Occlusal Splints and Temporomandibular Disorders: Why, When, How?" Dental Update 28, no. 4 (May 2, 2001): 194–99. http://dx.doi.org/10.12968/denu.2001.28.4.194.
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Saakyan, Mikhail, Ol'ga Uspenskaya, Sergey Ryabov, and Aleksey Aleksandrov. "DETERMINATION OF ERRORS IN THE MANUFACTURING TECHNOLOGY OF OCCLUSIVE SPLINTS FOR THE TREATMENT OF TMJ DISEASES." Actual problems in dentistry 16, no. 2 (August 12, 2020): 129–33. http://dx.doi.org/10.18481/2077-7566-20-16-2-129-133.
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Subject. For the treatment of diseases of the temporomandibular joint, occlusal splints are used, in the manufacture of which different methods are used, which have their negative and positive properties. 3D printing technology allows the manufacture of occlusal splints with high precision fit to the dentition and with uniform occlusal contacts with respect to antagonist teeth.
The goal is to study errors in the technology of manufacturing occlusal splints for the treatment of patients with diseases of the temporomandibular joint.
Methodology. Thirty patients with distal displacement of the heads of the temporomandibular joint in the range of 1-1.5 mm were examined. Patients were diagnosed with Angle Grade 2. The methods used were tele-radiography, 3D computed tomography, and laboratory scanning of jaw models.
Results. Errors were revealed in the manufacture of occlusal tires using digital scanning in the EXO-CAD program, various features of adaptation to occlusal tires obtained using 3D printing and cad-cam milling.
Findings. 3D printing technology allows the manufacture of occlusal splints with high precision fit to the dentition with uniform occlusal contacts with respect to antagonist teeth. The technology for milling occlusal tires gives an advantage in their strength compared to 3D printing technology. However, the mouthguards made by technology are inferior to mouthguards made on a 3D printer in terms of elasticity of fit to the dentition, which can cause discomfort and pain during the use of milled mouthguards. Occlusal tires made by cold polymerization have lower accuracy of fit to the dentition and require correction when fitting and checking the occlusal relationship of the dentition.
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Turcio, Karina Helga Leal, Alício Rosalino Garcia, Paulo Renato Junqueira Zuim, Marcelo Coelho Goiato, Daniela Micheline dos Santos, and Maria Lucia Marçal Mazza Sundefeld. "Temporomandibular Joint Vibration Before and After Exercises and Occlusal Splints." Journal of Craniofacial Surgery 22, no. 6 (November 2011): e14-e16. http://dx.doi.org/10.1097/scs.0b013e31822ec7e8.
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Guguvcevski, Ljuben, Nikola Gigovski, Aneta Mijoska, Katerina Zlatanovska, and Ana Arsova Gigovska. "Temporomandibular Disorders Treatment with Correction of Decreased Occlusal Vertical Dimension." Open Access Macedonian Journal of Medical Sciences 5, no. 7 (October 25, 2017): 983–86. http://dx.doi.org/10.3889/oamjms.2017.201.
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BACKGROUND: The term decreased occlusal vertical dimension refers to the reduced distance between two anatomical points while the teeth are in a state of occlusion. The development of this situation is about some parafunctional activities of the masticatory system.AIM: To evaluate the value of decreased occlusal vertical dimension in cases with temporomandibular disorder and to follow up the influence of corrective treatment with occlusal splints and definitive prosthetic construction upon the elimination of clinical symptoms.MATERIAL AND METHODS: Eight cases with decreased occlusal vertical dimension accompanied with temporomandibular disorders were treated with an occlusal splint, as part of reversible occlusal treatment. After reducing, or complete elimination of the symptoms related to problems of decreased occlusal vertical dimension, the definitive prosthetic therapy was performed.RESULTS: The mean value of decreased occlusal vertical dimension in our patients is 8.5 mm, and the mean value of therapy time with an occlusal splint in these patients was 3.5 months.CONCLUSION: Occlusal splint is a part of reversible occlusal therapy in cases with decreased occlusal vertical dimension. After reducing the symptoms related to decreased occlusal vertical dimension definitive prosthetic therapy can be done.
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Lozano, Paulina. "Use of Occlusal Splints in Patients with Deep Bite and Bruxism." International Journal of Medical and Surgical Sciences 2, no. 1 (October 26, 2018): 427–31. http://dx.doi.org/10.32457/ijmss.2015.009.
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The occlusal splints are most commonly used devices for the treatment of temporomandibular disorders and bruxism. A case report of a male patient with deep bite and bruxism, indicating two flat occlusal splints presents full coverage made up of rigid acrylic and permanent use for five months is described. Using both intraoral devices allowed restoring lost vertical dimension and protect teeth attrition, deprogram the musculature and establish a new mandibular positioning prior to treatment of oral rehabilitation.
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Kui, Andreea, Smaranda Buduru, Simona Iacob, Manuela Manziuc, Loredana Mitariu, and Marius Negucioiu. "The use of occlusal splints in the management of temporomandibular disorders." Health, Sports & Rehabilitation Medicine 21, no. 2 (June 29, 2020): 82–87. http://dx.doi.org/10.26659/pm3.2020.21.2.82.
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Çifter, Ebru Demet, Gülümser Evlioğlu, and Haluk Keskin. "Occlusal Evaluation and Effect of Occlusal Disorders on Temporomandibular Joint." Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi 56, supp 1 (April 18, 2010): 25–28. http://dx.doi.org/10.4274/tftr.56.25.
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Strini, Paulinne Junqueira Silva Andresen, Naila Aparecida de Godoi Machado, Marília Cavalheri Gorreri, Amanda de Freitas Ferreira, Gilmar da Cunha Sousa, and Alfredo Júlio Fernandes Neto. "Postural evaluation of patients with temporomandibular disorders under use of occlusal splints." Journal of Applied Oral Science 17, no. 5 (October 2009): 539–43. http://dx.doi.org/10.1590/s1678-77572009000500033.
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Telkar, Swaroop, Mubeen K. Khan, Anil Kumar Shukla, Arun Dodamani, Shilpa Yalsangi, and Deepti Telkar. "Evaluation of occlusal splint therapy in temporomandibular joint disorder patients using real-time ultrasonography." Journal of Investigative and Clinical Dentistry 1, no. 2 (November 2010): 96–100. http://dx.doi.org/10.1111/j.2041-1626.2010.00018.x.
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Zuim, Paulo Renato Junqueira, Alicio Rosalino Garcia, Karina Helga Leal Turcio, and Marcelo Matida Hamata. "Evaluation of microcurrent electrical nerve stimulation (MENS) effectiveness on muscle pain in temporomandibular disorders patients." Journal of Applied Oral Science 14, no. 1 (January 2006): 61–66. http://dx.doi.org/10.1590/s1678-77572006000100012.
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The effect of Microcurrent Electrical Nerve Stimulation (MENS) was evaluated and compared with occlusal splint therapy in temporomandibular disorders (TMD) patients with muscle pain. Twenty TMD patients were divided into four groups. One received occlusal splint therapy and MENS (I); other received splints and placebo MENS (II); the third, only MENS (III) and the last group, placebo MENS (IV). Sensitivity derived from muscle palpation was evaluated using a visual analogue scale. Results were submitted to analysis of variance (p<0.05). There was reduction of pain level in all groups: group I (occlusal splint and MENS) had a 47.7% reduction rate; group II (occlusal splint and placebo MENS), 66.7%; group III (MENS), 49.7% and group IV (placebo MENS), 16.5%. In spite of that, there was no statistical difference (analysis of variance / p<0.05) between MENS and occlusal splint therapy regarding muscle pain reduction in TMD patients after four weeks.
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Myagkova, Natalia, and Nikolay Styazhkin. "RESULTS OF THE USE OF OCCLUSAL SPLINTS IN PATIENTS WITH TMJ PAIN DYSFUNCTION SYNDROME ACCORDING TO KINESIOGRAPHY DATA." Actual problems in dentistry 16, no. 1 (May 14, 2020): 114–20. http://dx.doi.org/10.18481/2077-7566-20-16-1-114-120.
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Subject. Syndrome of pain dysfunction of the temporomandibular joint is one of the common pathologies of TMJ. Patients with this diagnosis complain of a violation of the movements of the lower jaw, discomfort and pain in the joint. The writings of many authors contain a deep and comprehensive discussion of various aspects of this problem, and scientific justification is given that TMJ dysfunction is almost always accompanied by muscle symptoms. One method of treatment is the use of occlusal splints. In this regard, the task of determining the effectiveness of eliminating muscular-articular dysfunction using individual occlusal splints is relevant.
The aim of the study was to determine the effectiveness of treatment of TMJ dysfunction with occlusal splints according to kinesiography.
Methodology. The kinesiographic study on the Myotronics K7 apparatus consisted of sequentially performing functional tests (opening and closing the mouth, lower jaw movements to the side) and using the method of percutaneous electroneurostimulation. In the treatment of all patients, an occlusal positioner splint was used, which was made individually in an articulator using an interocclusal register in the neuromuscular position of the lower jaw. The average treatment period was 4.5 months with monthly adjustments to the occlusal splint.
Results. As a result of treatment with the use of the occlusal splint, disturbances in the trajectory in the transverse (in 70 % of cases) and sagittal (in 65 % of cases) planes were eliminated, the position of the lower jaw in the neuromuscular position (in 100 % of cases) was normalized.
Conclusions. Treatment of patients with TMJ dysfunction using individual occlusal splints is one of the most effective ways to treat this pathology.
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MINENO, Yasuhisa, Takayuki YAMAUCHI, Kohji SATOH, Takeshi MURAI, Kinko KAKEHI, Miyoko KUWAHARA, Goroh HIBI, and Tohru OKA. "Effects of occlusal splints and intra-articular injection therapy in temporomandibular joint arthrosis." Japanese Journal of Oral & Maxillofacial Surgery 33, no. 12 (1987): 2512–17. http://dx.doi.org/10.5794/jjoms.33.2512.
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