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PubMedDate not supplied

An alternative splint design for trigger finger.

Conventional resting splints used to treat digital stenosing tenosynovitis (trigger finger) are often discontinued or not worn consistently by patients. Informal reports by patients indicate that the splints are too bulky, interfere with activities of daily living, and are visibly too noticeable. Since resolution of the condition may take as long as 9 weeks, this is a significant issue. A new splint design has been developed to avoid these shortcomings in hopes that physicians and therapists will have successful compliance when utilizing splinting in the treatment of this condition. It is both cost-effective and noninvasive. This article describes the condition and treatment options for digital stenosing tenosynovitis and fabrication techniques for the proposed alternative splint.

Constriction, Pathologic↗

PubMed2000

Evaluation of the Herbst Mandibular Advancement Splint in the management of patients with sleep-related breathing disorders.

Sleep-related breathing disorders such as snoring and obstructive sleep apnoea syndrome are the cause of significant social disruption and hypersomnolence. Several intraoral appliances for the treatment of these disorders have been described, especially where nasal continuous positive airway pressure is poorly tolerated. Mandibular Advancement Splints, such as the Herbst splint used in this study can also be offered to patients with mild to moderate sleep apnoea and simple snorers. The success and compliance rate noted in the literature are quite diverse. Few side-effects have been reported. We therefore undertook this study to assess: (1) the compliance; (2) the effectiveness; and (3) the side-effects in the long- and short-term. All patients for whom a Herbst splint had been prescribed in the last 18 months were sent a postal questionnaire regarding the above mentioned issues. In all, 179 questionnaires were posted and on analysis of the 132 returned it was noted that 82% of splints were worn and 88% of patients found the device to be effective. The long-term side-effects were minimal. In addition objective assessment on 10 patients with and without a jaw-retaining device was also obtained. We conclude that the Herbst Mandibular Advancement Splint is a justifiable option in selected subjects with sleep-related breathing disorders.

Female↗

PubMed1998

Effects of a bite-raising splint on the duration of the chewing cycle and the EMG activities of masticatory muscles during chewing in freely moving rabbits.

Metal bite-raising splints of 0.5 mm thickness were attached to the upper molar teeth on both sides of the jaw in rabbits. The effects of these splints on masticatory behaviour during the chewing of soft food (bread) by freely moving rabbits were investigated. We recorded electromyograms (EMGs) of the masseter and digastric muscles. The animals exhibited prolongation of the chewing cycle, decreased EMG activity of the masseter muscle and increased EMG activity of the digastric muscle during chewing after introduction of the bite-raising splints. The effects of the splints on the activities of masticatory muscles were abolished by bilateral sectioning of the maxillary and inferior alveolar nerves. It seems likely that afferents from oral sensory receptors were responsible for the changes in masticatory behaviour after the introduction of the occlusal splint.

Animals↗

PubMed2000

Evaluation of the effect of a stabilization splint on occlusal force in patients with masticatory muscle disorders.

The purpose of this study was to evaluate the effect of stabilization splint therapy on occlusal force in patients with masticatory muscle disorders (MD). Six female patients with myalgia or myofascial pain participated in this study. The occlusal points and load on the dental arch in maximum clenching was measured using the computerized system with Dental Prescale(R) before and after the use of the splint. There were no significant changes in the number of occlusal points, mean occlusal pressure, and asymmetry in occlusal balance between before and after the use of the splint. However, there were significant differences in the extent of the area of occlusion and in the integrated occlusal loads. The integrated occlusal load converged to the normal level with the use of the splint. From the results of this study, it is suggested that the use of the stabilization splint has the effect of normalizing the occlusal force.

Adolescent↗

PubMed2000

Results after surgery for severe Dupuytren's contracture: does a dynamic extension splint influence outcome?

Seventy-six consecutive patients were operated on for advanced Dupuytren's contracture and the results evaluated after nine months with special reference to the use of a dynamic extension splint. The patients were separated into three groups: those in whom the splint was used according to our guidelines (n = 15); those in whom the splint was used, but inadequately (n = 15); and those who did not require splinting (n = 24). Our results nine months postoperatively were similar to those of other studies in showing that the fifth proximal interphalangeal joint constituted the greatest problem. Comparison of the three groups indicated that splinting the way we used it did not influence the natural course of the disease after operation.

Dupuytren Contracture↗

PubMed1994

Influence of stabilization occlusal splint on craniocervical relationships. Part I: Cephalometric analysis.

This study was conducted in order to determine the effect of an occlusal splint on craniocervical relationships, in subjects with muscle spasms in the sternocleidomastoid and trapezius muscles. A full-arch maxillary stabilization occlusal splint was made for each of the 15 subjects. Two lateral craniocervical radiographs were taken for each subject, with and without an occlusal splint. Cephalometric analysis showed that the splint caused a significant extension of the head on the cervical spine. There was also a significant decrease in the cervical spine lordosis in the first, second and third cervical segment. These cervical changes could be a compensation mechanism caused by the extension of the cranium on the upper cervical spine. The change in the curvature implies that it is necessary to periodically evaluate the changes occurring in the craniocervical relationships after the occlusal splint has been inserted.

Adult↗

PubMed1994

Influence of stabilization occlusal splint on craniocervical relationships. Part II: Electromyographic analysis.

The aim of this study was to determine the effect of stabilization occlusal splints on electromyographic (EMG) activity of sternocleidomastoid and trapezius muscles in subjects with spasm in the mentioned muscles. A full-arch maxillary stabilization occlusal splint was made for each of the 15 subjects. In the sternocleidomastoid muscle, tonic and saliva swallowing EMG activity decreased significantly with the splint, whereas maximal clenching activity did not change. In the trapezius muscle, no significant changes were observed with the occlusal splint. The different pattern in both muscles during tonic and swallowing EMG activity with the splint is attributed to differences in the synaptic inputs to the respective motoneuron pools, suggesting that a differential modulation of the motor neuron pools may exist of both muscles, of peripheral and/or central origin.

Adult↗

PubMed1997

Effect of occlusal splint on masticatory movement in healthy individuals.

To investigate the effects of wearing an occlusal splint on masticatory movements in healthy individuals, twelve healthy individuals were examined. A full maxillary stabilization splint made of heat-cured acrylic resin was fabricated for, and worn by, each individual for 24 hours. Masticatory movement was measured before and after the 24-hour period using a 3-D mandibular movement analyzing system. While the duration of a masticatory cycle+ did not change, the occlusal time significantly decreased after use of the splint. The lateral displacement of the opening phase to the balancing-side area also decreased after use of the splint, showing a vertical pattern of the opening path. Measurement in more healthy individuals and patients should help clarify the therapeutic mechanism of the splint in the treatment of temporomandibular disorders.

Adult↗

PubMed1989

Effect of hand splints on stereotypic hand behavior of girls with Rett syndrome: a replication study.

The purposes of this study were to replicate a recent report of the positive effects of hand splinting on the stereotypic hand movement of children with Rett syndrome and to evaluate the generality of these results to a different setting. Two 5-year-old girls diagnosed with early Stage-III Rett syndrome were introduced to hand splints in accordance with the multiple-baseline design used in the Naganuma and Billingsley study. Splint wear ranged from 30 to 50 days for the two subjects. Data were analyzed as a percentage of time and as actual time in minutes. Unlike the previous study, in which a decrease in hand-wringing behavior was noted, neither subject in our study demonstrated a decrease in stereotypic hand behavior or a subsequent increase in independent feeding skills when wearing the splints. There was also no evidence of increased hand wringing following withdrawal of the splints. The differences in ages of the subjects and different functional levels (stages) may have been contributing factors to the conflicting results and should be considered in managing this group of children.

Child, Preschool↗

PubMed1989

Basic principles of splinting the hand.

This article presents the basic principles needed in the fabrication of static and dynamic splints. The principles are defined, and examples are used as illustrations. The biomechanics of dynamic splinting are described, with special attention given to low-profile dynamic splinting. Several low-profile dynamic splints are described, with current indications presented in case studies with supporting documentation for appropriate splinting protocols.

Adult↗

PubMedDate not supplied

Have you tried the sandwich splint? A method of preventing hand deformities in children.

The prevention of contractures of the burned hand is an arduous problem in the young pediatric burn patient. Difficulty in applying splints, along with the time-consuming fabrication of complex splints, led to the development of the "sandwich" splint. This easily produced splint provides a means of preventing and treating hand deformities in this patient age group. Positive results have been noted with the use of this splint in conjunction with the patient's usual active physical therapy program.

Burns↗

PubMedDate not supplied

Analysis of materials for splinting of the thermally injured patient.

Good results have been achieved in the treatment of patients with burns with new splinting materials and proper splinting techniques. This article focuses on the thermoplastic splinting materials Clinic and Spectrum (Northcoast Medical Inc., San Jose, Calif.) and the comparable thermoplastic products Polyform (Smith & Nephew Rolyan, Inc., Menomonee Falls, Wis.) and Orthoplast (Johnson & Johnson Orthopedics, New Brunswick, N.J.). Qualities such as self-bonding, recyclability, and rigidity were tested for these materials. Splint rigidity was measured by a calibrated hook scale and determined by the force per pound needed to bend the material 20 degrees. Spectrum and Clinic products were judged more economical and, we contend, they are therefore better choices for splinting the thermally injured patient.

Burns↗

PubMed1991

Influence of an occlusal splint on integrated electromyography of the masseter muscles.

In order to examine the effect of an occlusal splint on the integrated electromyography (EMG) of the masticatory muscles, EMG of bilateral masseter muscles of 23 patients with temporomandibular joint disturbance syndrome (TMJDS), with and without an occlusal splint, was measured and integrated on line during maximum clenching. It was found that the integrated myoelectrical value of the masseter muscle on the involved and non-involved side was reduced with the occlusal splint. The absolute difference between integrated myoelectrical values in the left and right masseter muscles was reduced with an occlusal splint, but the relative difference remained virtually unchanged. These results indicate that the occlusal splint can decrease masseter muscle activity and thus exert a therapeutic effect.

Adult↗

PubMed1995

Effects of occlusal splints on the asymmetry of masticatory muscle activity during maximal clenching.

The effects of stabilization splints on the electromyographic activity patterns of the masseter and anterior temporal muscles during maximal clenching in healthy subjects and subjects with different types of stomatognathic dysfunction syndrome were investigated. No marked effect of splints on the asymmetry of muscle activity during bilateral clenching was revealed immediately after splint insertion. During unilateral clenching in the intercuspal position (ICP), the relative asymmetry index (rAI) of the masseter muscles, detecting the imbalance of left and right muscular activity, was significantly increased. The use of splints suppressed the asymmetry of masseter muscle activity during unilateral clenching. This result suggests that the use of a splint is a method of suppressing clench-caused aggravation of stomatognathic dysfunction in the presence of an imbalance between left and right muscle activities.

Adult↗

PubMed1995

The temporal/masseter co-contraction: an electromyographic and clinical evaluation of short-term stabilization splint therapy in myogenous CMD patients.

The short-term effect (3-6 weeks) of the use of a stabilization splint was investigated in a group of 35 myogenous craniomandibular disorder patients. The patients were clinically examined and surface EMG recordings of the temporal and masseter muscles were made during clenching in the intercuspal position (ICP), immediately after the insertion of the splint (SSP), and after at least 3 weeks of splint treatment (SSP 3). With the use of the error variance of the activity index changes in EMG activity were investigated. Three groups of patients were then recognized. One group showed a decrease in temporal muscle activity during splint treatment. Another group did not show any significant change during splint treatment. The third group showed an increase of temporal muscle activity. In general, significant reductions in the amount of static pain were found. In the group with a significant reduction of temporal muscle activity (n = 15) there was a greater decrease in the amount of static pain (P < 0.05) than in the group (n = 4) with a significant increase of temporal muscle activity. The results may indicate that the temporal muscle plays an important role in the perception of static pain in the masticatory system.

Adolescent↗

PubMed1976

Influence of splints and temporary crowns upon electric and thermal pulp-testing procedures.

The influence of different splints and temporary crowns upon the reliability of electric and thermal pulp-testing procedures was examined in 10 patients with vital maxillary central incisors and 10 patients with vital maxillary central incisors and 10 patients with unilateral pulp necrosis of a central incisor. The pulp-testing procedures were: (1) Bofors Pulp Tester, (2) Siemens Sirotest, (3) heated guttapercha, (4) ice, and (5) carbon dioxide snow (Odontotest). The splints or temporary crowns were: (1) silver cap splint, (2) acrylic cap splint, (3) Hawley orthodontic plate, (4) Saur's arch bar, (5) orthodontic bands, (6) stainless steel crown, and (7) stainless steel crown with labial surface removed. A reliable electrometric pulp response could only be elicited if the pulp tester was applied directly upon enamel and preferably upon the incisal edge. In this instance metal splints or partial steel crowns applied to the tooth had no effect on the pain threshold. A false positive reaction in case of pulp necrosis was only elicited when the electrode was placed directly upon metal which contacted neighboring vital teeth. The use of ice and heated guttapercha appeared to be of limited value, due to inconsistent pulp responses. Carbon dioxide snow gave a reliable response, unless applied on the incisal edge.

Adult↗

PubMed1994

A study of forces originating from orthodontic appliances for splinting of teeth.

Management of dental trauma in children sometimes requires the use of a dental splint. This can be constructed with composite materials, kevlar, fiberglass, wire and composite or orthodontic wires and brackets. However, there have been no studies of the control of dental movement when orthodontic materials are used for a dental splint. The purpose of this study was to determine the forces exerted by an orthodontic appliance used as a dental splint. To measure such forces, a transducer with a detection of 0.01 N (+/- 5%) was inserted into a maxillary dental arch model. The results showed that the orthodontic wire was rarely passive and the forces developed ranged from 0 to 27 x 10(-2) N. The force developed was independent of the length of the dental splint (p < 0.05) and wire size (p < 0.05). The mean force developed by nickel-titanium wires (14.27 x 10(-2) N) was significantly greater (p < 0.05) than the mean force developed by stainless steel and cobalt-chromium wires. Moreover, the mean force developed by rectangular wires (12.07 x 10(-2) N) was significantly greater (p < 0.05) than the mean force developed by square and round wires. The results suggested that stainless steel or cobalt-chromium, square or round wires should be used for construction of a dental splint.

Analysis of Variance↗

PubMed1995

Splints made of wire and composite: an investigation of lateral tooth mobility in vivo.

In 103 posttraumatic splints, later tooth mobility was measured with Periotest immediately before and after the routine splint removal. The splints were made of composite resin and an 0.017 X 0.025" orthodontic steel wire. 481 teeth were measured. A statistic evaluation revealed that the immobilisation effect did not exceed normal tooth firmness. Fixation to one neighbouring tooth had less effect than fixation to two. Adjacent tooth gaps reduced the effect. Splint extensions had no influence. With the use of the Periotest device, more than 50% of all teeth with a true mobility of 20 Periotest-units or more were detectable as mobile in spite of the fixed splint.

Adolescent↗