INTRODUCTION: The restoration of function after surgery with mandibular reconstruction is of utmost importance. Mastication and deglutition are compromised if pre-operative dental occlusion is not reestablished. For this purpose, occlusal splints are fabricated pre-operatively. Various methods of occlusal splint fabrication are at hand. DESIGN: Surgical Instrumentation SETTING: Tertiary Academic Hospital OBJECTIVE: This paper presents a simple, quick and inexpensive way of fabricating an occlusal splint with the use of dental modeling compound. MATERIALS AND METHODS: The dental modeling compound is used pre-operatively to make an occlusal appliance. Occlusal splint fabricated with this method was used in 6 patients who underwent segmental mandibular resection with reconstruction for various pathologies. Post-operatively, patients were assessed in terms of occlusion, type of diet and pain on mastication. RESULTS: Out of the 6 patients, only 5 patients were available for evaluation. One patient suffered a myocardial infarction 3 days post-operation and subsequently died. The five patients had good mandibular-maxillary relation post-surgery. They were able to tolerate regular diet with no pain on mastication. CONCLUSION: In conclusion, we have discussed a simple, quick and cost-effective way of fabricating an occlusal splint for use in mandibular reconstruction. (Author)
OCCLUSAL SPLINTS

No abstract available.
Occlusal Splints* ; Temporomandibular Joint*

PURPOSE: Occlusal splints are commonly used to prevent tooth wear caused by bruxism. However, the effects of splints on occlusion are still unclear. Although it is rarely alluded in literature, splints can provoke severe occlusal alterations and other complications. This study was aimed to identify differences in the responses of individuals with bruxism and healthy individuals to a full-arch maxillary stabilization splint in terms of occlusal changes. MATERIALS AND METHODS: Occlusal contacts in 20 (5 male, 15 female) bruxism patients and 20 (5 male, 15 female) controls with normal occlusion were evaluated before and after occlusal splint therapy. T-Scan III, a computerized occlusal analysis system, was used to simultaneously measure occlusion and disclusion times as well as left-right and anterior-posterior contact distributions before splint therapy and 3 months after therapy. Wilcoxon and Mann-Whitney U tests were used for statistical analyses (alpha=.05). RESULTS: No differences were found in the posterior contact of bruxism patients before and after stabilization splint treatment. However, differences in posterior contact were observed between bruxists and normal individuals prior to treatment, and this difference disappeared following treatment. CONCLUSION: The results of this study showed the use of a stabilization splint may not have an effect on occlusion. However, the area of posterior occlusal contact among bruxists was found to be greater than that of normal individuals. According to this study, the clinical use of splints may be harmless.
Bruxism ; Humans ; Male ; Occlusal Splints ; Splints ; Tooth Wear

OBJECTIVETo study the short-term effects of nociceptive trigeminal inhibitory tension suppression system (NTI-tss) and occlusal stabilization splint (OS) on sleep bruxism patients.

METHODSTen patients received the two splint treatments in a randomized cross-over fashion: An NTI-tss and an OS for a 1-week period, respectively. Record the bruxism episodes per hour, micro-arousals per hour of the patients before wearing the splints (baseline), the first night and 1 week after wearing the splints with polysomnography. Statistical analysis was performed with SAS 9.1 by means of mixed effect model analysis.

RESULTSThere were no differences among the micro-arousal index of the baseline, the first night and 1 week later with both types of the splints (P>0.05). The NTI-tss was associated with a significant reduction in bruxism index compared with baseline. The bruxism index of baseline, the first night and 1 week later were 7.50 +/- 1.11, 3.45 +/- 1.22, and 3.51 +/- 1.03 per hour(the first night vs baseline, t=26.52, P<0.01; 1 week vs baseline, t=26.12, P<0.01). There were also significant differences in the bruxism index after wearing the OS. The bruxism index of baseline, the first night and 1 week later were 7.44 +/- 1.23, 2.97 +/- 0.91 and 6.43 +/- 1.02 per hour(the first night vs baseline, t=16.79, P<0.01; 1 week vs baseline, t=3.79, P<0.01). Compared with the NTI-tss group, the reduction was much less, especially 1 week later.

CONCLUSIONBoth the NTI-tss and the OS splints can reduce the bruxism index, and have no affect the incidence of micro-arousal. In this short term study, the NTI-tss was more effective than the OS for the treatment of sleep bruxism.

In mandibular fractures basic principle of treatment for rapid healing are accurate reduction and secure immobilization. Till now many kinds of operative techniques have been mentioned. But each method has several disadvantages such as inaccurate reduction, immature operative technique and long operative time. To overcome these disadvantages, tension wire band secured to monocortical screws for open reduction and internal fixation of mandibular fractures were applied. From March, 2000 to August, 2002 tension wire band and intermaxillary fixation with occlusal splint for 1-2 weeks had been applied in total 63 patients. The operative technique is as follows. The first, two pieces of monocortical screws, which have 1.5-2.0 mm diameter and 5-7 mm length is fixed on each fracture site through outer cortex. Second, tension wire is twisted appropriately between two screws to reduction of fracture site. No cases of infection, malunion, or malocclusion occurred. Compaired with other operative techniques, this technique is more useful because of short operative time, accurate reduction and secure immobilization.
Humans ; Immobilization ; Malocclusion ; Mandibular Fractures* ; Occlusal Splints ; Operative Time

OBJECTIVE: To establish a complete workflow of digital design and manufacturing occlusal splint for sleep bruxism, which can be preliminarily applied in clinical use, thus observe the clinical efficacy. METHODS: Twenty-four patients with sleep bruxism were recruited in the study and randomly divided into two groups by using random number tables. Digital-occlusal-splint (experimental group) treatment plan and traditional-occlusal-splint (control-group) treatment plan were carried out for each group, respectively. For experimental group, digital models of patients' both dental arches and the occlusion relationship after elevation were captured using an intraoral scanner. The occlusal splint was carried out by computer aided design/computer aided manufacturing (CAD/CAM), including splint designing and milling. For control group, the traditional soft occlusal splint was fabricated by vacuum laminator. The two kinds of occlusal splints were tried in the patients from each group, and the occlusal contacts were tested respectively by T-scan analysis system, which recorded the changes of occlusal indicators in the two groups. The retention, appearance and occlusal comfort degree were evaluated by the two groups of patients. Mann-Whitney test was performed with IBM SPSS 20.0 software, and bilateral test was performed. P<0.05 was considered to be statistically significant. RESULTS: The complete workflow of digital design and manufacturing occlusal splint was successfully established. During the clinical use, there was no statistical difference in the retention evaluation of two kinds of occlusal splints between the two groups of patients (Z=-0.538, P=0.590). The appearance score (Z=2.038, P=0.042) and the occlusal comfort score (Z=-2.579, P=0.010) of the experimental group were higher than those of the control group, with statistically significant differences. The T-scan analysis results showed that only the second molar on both sides of the traditional occlusal splint had occlusal contact in intercupsal position, while the digital occlusal splint had stable and bilaterally balanced contact between the maxillary and mandibular teeth. Furthermore, the occlusal force was uniformly distributed in the experimental group. CONCLUSION The complete workflow of digital occlusal splint improves the occlusal design, greatly simplifies and optimizes the traditional process of making occlusal splint. This new method is resource-saving and environmental-friendly, and it is able to serve patients more conveniently and efficiently.
Dental Arch ; Dental Occlusion ; Humans ; Occlusal Splints ; Sleep Bruxism ; Workflow

Dental Occlusion ; Dental Occlusion, Traumatic ; therapy ; Dental Prosthesis ; Humans ; Occlusal Adjustment ; Occlusal Splints

PURPOSE: The occlusal splint has been used for many years as an effective treatment of sleep bruxism. Several methods have been used to evaluate efficiency of the occlusal splints. However, the effect of the occlusal splints on occlusal force has not been clarified sufficiently. The purpose of this study was to evaluate the effect of occlusal splints on maximum occlusal force in patients with sleep bruxism and compare two type of splints that are Bruxogard-soft splint and canine protected hard stabilization splint. MATERIALS AND METHODS: Twelve students with sleep bruxism were participated in the present study. All participants used two different occlusal splints during sleep for 6 weeks. Maximum occlusal force was measured with two miniature strain-gage transducers before, 3 and 6 weeks after insertion of occlusal splints. Clinical examination of temporomandibular disorders was performed for all individuals according to the Craniomandibular Index (CMI) before and 6 weeks after the insertion of splints. The changes in mean occlusal force before, 3 and 6 weeks after insertion of both splints were analysed with paired sample t-test. The Wilcoxon test was used for the comparison of the CMI values before and 6 weeks after the insertion of splints. RESULTS: Participants using stabilization splints showed no statistically significant changes in occlusal force before, 3, and 6 weeks after insertion of splint (P>.05) and participants using Bruxogard-soft splint had statistically significant decreased occlusal force 6 weeks after insertion of splint (P<.05). There was statistically significant improvement in the CMI value of the participants in both of the splint groups (P<.05). CONCLUSION: Participants who used Bruxogard-soft splint showed decreases in occlusal force 6 weeks after insertion of splint. The use of both splints led to a significant reduction in the clinical symptoms.
Bite Force* ; Humans ; Occlusal Splints* ; Pilot Projects* ; Sleep Bruxism* ; Splints ; Temporomandibular Joint Disorders ; Transducers

OBJECTIVES: Stress may have an impact on treatment types that patients receive for temporomandibular disorders (TMDs). This study sought to investigate the relationship between the stress index and type of treatments in patients with TMD. MATERIALS AND METHODS: The psychosocial well-being index-short form (PWI-SF) was used to evaluate stress levels in ninety-two patients with TMD. Treatment types were classified into two groups: one group received counseling, physical therapy or medication, while the second group received splint therapy or surgical intervention. RESULTS: The high-risk group (PWI-SF> or =27, the higher the points, the more severe the stress level) was more frequently treated by splint therapy than the low-risk group (PWI-SF<27). Female TMD patients reported higher PWI-SF scores than male TMD patients. CONCLUSION: This study suggests a relationship between stress levels and treatment types for patients with TMD. Thus, the appropriate evaluation and management of stress could be an important factor in treating TMD.
Counseling ; Female ; Humans ; Male ; Occlusal Splints ; Splints ; Stress, Psychological ; Temporomandibular Joint Disorders

The surgical reconstruction of complex facial injuries have focused on the following; early one-stage repair, exposure of all fracture fragments, precise anatomic rigid fixation, immediate bone grafting, and definite soft tissue management were the main surgical procedures, as in other facial bone injuries. Complex facial bone fractures involving dentition should be managed by the same principles. However, conventional methods can not achieve accurate preinjury occlusion when there are unstable fracture segments, edentulous state, or complex palatal/maxillary and mandibular fractures. Seventeen patients were surgically reconstructed in conjunction with dental impression, model surgery, and fabrication of dental splints to establish better occlusion. Among the facial fractures that had the occlusal problem, maxillary/palatal fractures and complex mandibular fractures, were the major indications for fabrication of acrylic splints. During operation, fracture segments were reduced and repositioned according to dental wear facets of the prefabricated occlusal splint and then temporary intermaxillary fixations were performed. This allowed us to accomplish precise anatomical reduction and rigid intrenal fixations. The postoperative occlusions were acceptible and no complication occurred as direct effects of dental splint. We suggest that fabrication of an acrylic occlusal splint is necessary for the management of complex facial injuries involving dentition.
Bone Transplantation ; Dentition ; Facial Bones ; Facial Injuries* ; Humans ; Mandibular Fractures ; Occlusal Splints ; Splints* ; Tooth Wear