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PubMed1995

Effects of splint therapy in TMJ dysfunction: a study using magnetic resonance imaging.

This pilot study was undertaken to correlate clinical and MRI diagnoses in seven symptomatic TMJ dysfunction patients and to account, if possible, for the clinical improvement in the signs and symptoms after the use of a maxillary stabilizing splint. The symptomatic TMJs were evaluated by means of MRI prior to splint insertion. Sagittal open/closed, and coronal closed images were obtained with a 0.3 T Fonar MR Scanner. A follow-up MRI was taken after three months of splint therapy for the purposes of a comparative study. All subjects responded positively even at the early phase of splint treatment. By the end of the three month period, six subjects experienced full remission of pain in the TMJ and associated masticatory muscles with one subject experiencing only partial remission following therapy. Baseline MRI study revealed that only three subjects had anterior disc displacement while the other four subjects had normal disc/condyle relationships and morphology. In the follow-up MRI study, there were no signs of recapture of the three anteriorly displaced discs despite there being evidence of improved jaw movement and remission of pain symptoms. The use of MRI in this preliminary study indicates that some but not all TMJ pain dysfunction syndromes are caused by internal derangements of the joint. A larger MRI study using the same clinical parameters is indicated for future research.

Adolescent↗

PubMed1984

Inflatable splints--what are they doing?

The pressure to which splints were inflated was measured to determine whether splintage was effective and if vascular complications were likely. The prevalence of their use by the ambulance service was also investigated. The findings indicate that inflatable splints are in common use, and are rarely inflated to pressures likely to cause vascular complications. However, they are extremely inefficient in holding their pressure and rapidly become ineffective as splints. The therapeutic range between effective splinting and risk of complications is narrow and it is recommended that blow-off valves are incorporated into the manufacture of all such devices.

Emergency Medical Technicians↗

PubMed2002

Classification of hand splinting.

The terminology in describing splint or orthosis has been reviewed but there is no one single system adopted universally. Joint efforts by doctors, therapists and orthotists had been set up to review the classification of splint. Four ways of classifying hand splints have been introduced: namely, eponym, acronym, descriptive classification system and the classification system proposed by the American Society of Hand Therapists. These systems include the use of rote memory or logical deduction in grouping of splints. This paper describes the advantages and disadvantages of each classification system. Neither one of the systems stands out to be the best. A combination of the advantages of different systems, such as precision and logical deduction, may be an option for developing a new system. Moreover, communication, documentation and other environmental factors should also be considered.

Communication↗

PubMed2002

Splinting for peripheral nerve injury in upper limb.

The prognosis and speed of peripheral nerve recovery depend very much on the level of injury, severity of injury, the surgical intervention and the subsequent rehabilitative process. Many high level injuries may take years or months for the affected peripheral nerve to recover. Prolonged muscle imbalance causes joint contractures and over-stretching of denervated muscles. Without proper care, hand function recovery may be limited even the nerve regenerated afterwards. During the nerve regeneration period, splinting is one of the most useful modality to minimise deformities, prevent joint contractures and substitute loss motor control. Proper splinting encourages early use of the injured hand in daily activities. There are different types of splinting design for median nerve palsy, ulnar nerve palsy and radial nerve palsy. Dynamic splinting techniques are frequently employed to allow early prehension activities. Other therapeutic techniques, including pressure garment and sensory re-education are useful to enhance better functional return after nerve repair.

Arm Injuries↗

PubMedDate not supplied

Effect of body positions and splints in bioelectrical impedance analysis.

The objective of this study was to evaluate body composition as measured by bioelectric impedance analysis using splints and body positions differing from the standard supine position. Forty-three patients, randomized into two groups of different body positions, and 101 healthy volunteers were prospectively studied. Resistance and reactance of body tissues were measured by bioelectric impedance analysis. Body composition is described by a three-compartment model composed of body fat, body cell mass, and extra cellular mass. The patients were measured in the standard supine position and then randomized into two groups. They were then remeasured with the appropriate splinting device or position change. Volunteers were measured in the standard supine position and all four alternative positions. There was a statistically significant difference demonstrated in whole body resistance, whole body reactance, body cell mass, and the ratio of extracellular mass to body cell mass in some body positions. The percentage of change with different body positions and splints, when compared with the standard supine position, was generally below 2%, a clinically insignificant difference. We conclude that the reliability of resistance and reactance as measured by bioelectric impedance analysis is clinically valid using any of the tested body positions and/or splints. The three-compartment model may be a useful concept to measure body composition changes in both healthy and sick persons.

Body Composition↗

PubMedDate not supplied

Soft playing splint for protection of significant hand and wrist injuries in sports.

A simple custom-made soft splint has been devised to allow safe sports participation for significant hand and wrist injuries. Made from readily available materials, this "rubber splint" has been used successfully in 113 injuries reviewed in this report. This splint is a result of a modification of an original "Duke" splint described by Dobson, Davis, Lincoln, and Basset, (Exhibit at American Academy of Orthopaedic Surgeons, San Francisco, California, 1971) and the soft cast used at the University of Virginia by McCue and Gieck (personal communication).

Athletic Injuries↗

PubMed1998

Oral splints: the crutches for temporomandibular disorders and bruxism?

Despite the extensive use of oral splints in the treatment of temporomandibular disorders (TMD) and bruxism, their mechanisms of action remain controversial Various hypotheses have been proposed to explain their apparent efficacy (i.e., true therapeutic value), including the repositioning of condyle and/or the articular disc, reduction in the electromyographic activity of the masticatory muscles, modification of the patient's "harmful" oral behavior, and changes in the patient's occlusion. Following a comprehensive review of the literature, it is concluded that any of these theories is either poor or inconsistent, while the issue of true efficacy for oral splints remains unsettled. However, the results of a controlled clinical trial lend support to the effectiveness (i.e., the patient's appreciation of the positive changes which are perceived to have occurred during the trial) of the stabilizing splint in the control of myofascial pain. In light of the data supporting their effectiveness but not their efficacy, oral splints should be used as an adjunct for pain management rather than a definitive treatment. For sleep bruxism, it is prudent to limit their use as a habit management aid and to prevent/limit dental damage potentially induced by the disorder. Future research should study the natural history and etiologies of TMD and bruxism, so that specific treatments for these disorders can be developed.

Behavior Therapy↗

PubMedDate not supplied

Early mobilization using dynamic splinting with acute triceps tendon avulsion.

Avulsion of the triceps tendon is rare, and no previous report of a completed dynamic splinting rehabilitation plan was found in the literature. A case of a military member and power weightlifter who sustained a triceps tendon avulsion and repair is presented with a six-month follow-up. The rehabilitation program included early active elbow flexion and passive extension using a dynamic elbow splint. The Disabilities of the Arm, Shoulder and Hand (DASH) 1-3 questionnaire was used to monitor the patient's use of his right dominant arm while in the dynamic splint. The DASH scores indicated that he experienced improved use of his affected arm during the splinting period. The end result was a good return of function within 13 weeks and full resumption of work and bodybuilding activities in six months, three months earlier than others reported in the literature who were immobilized after surgery. 4,5.

Adult↗

PubMedDate not supplied

Periodontal splinting in general dental practice.

Splinting periodontally involved teeth is a technique that has been in use for centuries. This article gives a brief history and review of the literature concerning periodontal splinting and outlines the rationale and indications for the correct application of periodontal splinting in modern dental practice. The common types of splint and clinical techniques involved are described, addressing some of the clinical problems.

Dental Bonding↗

PubMed2001

Occlusal splints and temporomandibular disorders: why, when, how?

Occlusal splints are one form of treatment in the management of patients with a temporomandibular disorder. Appliances are often used in conjunction with other forms of treatment such as physiotherapy or medication. A variety of splints is described in the literature and the dentist must ensure that the splint prescribed is of a design that has a proven success rate for the specific diagnosis. General principles that apply to the provision of all splints are outlined in this paper.

Bruxism↗

PubMed1979

Nocturnal electromyographic evaluation of myofascial pain dysfunction in patients undergoing occlusal splint therapy.

Twenty-five patients with symptoms of myofascial pain and abnormal jaw function were treated with use of a full arch maxillary occlusal splint. The level of nocturnal activity of the masseter muscle was monitored as were symptoms before, during, and after occlusal splint therapy. A decreased nocturnal EMG level during treatment was noted for 52% of the patients. A return to pretreatment EMG levels after removal of the splint was noticed in 92% of the patients; in 28% no change was shown and in 20%, an increase was shown in nocturnal EMG levels. The splint was most likely to reduce nocturnal EMG levels in patients with least severe symptoms.

Adult↗

PubMed1980

Technique and rationale for splinting.

Stabilizing teeth after impact injuries is an essential consideration in endodontic therapy. The basic method of treating avulsed, luxated, or fractured teeth should incorporate the orthodontic wire and the acid-etch splinting system. In some particular situations, a simple donut splint, a cross-suture sling, and cemented occlusal acrylic splint have been more useful. All of the splints are economical, efficient, and easy to use in the emergency treatment of injuries.

Acid Etching, Dental↗

PubMed2006

The treatment of temporomandibular disorders with stabilizing splints in general dental practice: one-year follow-up.

BACKGROUND: The authors evaluated temporomandibular disorder (TMD) outcomes in general dental practice one year after treatment with stabilizing splints (SS) or nonoccluding control splints (CS). METHODS: Seventy-two randomly allocated subjects completed initial treatment. The outcomes measures were a pain visual analog scale (VAS), muscle tenderness, temporomandibular joint (TMJ) tenderness, interincisal opening, TMJ clicks and headaches. After initial treatment, 81 percent of the subjects were found to have been treated satisfactorily. The dentists referred the remaining subjects to a dental hospital. At one year, the authors recalled 52 of the original subjects for evaluation. RESULTS: Improvements after initial treatment were maintained at one year for all outcomes, except for TMJ clicking, which returned to pretreatment levels. Eighty-one percent of the subjects rated their treatment as either good or excellent in reducing jaw pain. The authors found that subjects were aware of more of their TMJ clicks than dentists observed at the one-year clinical examination, but most subjects thought their clicking or the associated pain had been reduced. Fifty-five percent subjects had used their splints in the previous six months, but only 31 percent of these had done so daily. There were no significant differences between splint groups. CONCLUSION: At one year, a good response to TMD treatment in general practice had been maintained, but many subjects still had clicking TMJs. CLINICAL IMPLICATIONS: Trained dentists can manage TMD satisfactorily, with only a small proportion of patients needing specialist attention.

Adult↗

PubMed1982

The effect of a partial bite raising splint on the occlusal face height. An x-ray cephalometric study in human adults.

20 patients (18 - 50 years) with pathological attrition of upper and/or lower anterior teeth were treated, as a temporary measure, by means of a partial chrome-cobalt splint covering the palatal surfaces of the six upper front teeth. Tantalum implants to provide reference points were placed in the basal portion of upper and lower jaw bones. Lateral cephalometric radiographs were taken with and without the splint at the beginning of treatment and thereafter every two months till the difference between measurements was as small as possible. Changes in the occlusal face height were evaluated. Measurement reliability proved to be very high. Continuous use of the splint caused intrusion of the front teeth and eruption of the others in all patients. The intrusion was on an average 1.05 mm and the eruption 1.47 mm after 6 - 14 months, indicating a possible potential for tooth eruption in human adults. More eruption than intrusion appeared to take place in the youngest age groups. Sexual differences could not be established. Use of the splint did not cause the common symptoms of mandibular dysfunction. Lisping was the most serious complaint.

Adolescent↗

PubMed1992

Acupuncture and occlusal splint therapy in the treatment of craniomandibular disorders. II. A 1-year follow-up study.

Eighty patients, of whom 22 were men and 58 women, participated in a 1-year follow-up study. All participants in the study showed signs and symptoms of craniomandibular disorders (CMD) and had had pain for more than 6 months at treatment start. The patients were randomly assigned to either acupuncture or occlusal splint therapy. Those patients who did not respond to either of the treatment modes were offered various additional therapies. The result showed that 57% of the patients who received acupuncture and 68% of the patients treated with occlusal splint therapy benefited subjectively (p < 0.01) and clinically (p < 0.001) from the treatment over a 12-month period. No statistically significant difference was found between the two groups as to the assessment variables. Those patients who received various additional therapies after acupuncture and/or occlusal splint therapy responded favorably to additional treatment in only a few instances. The study showed that acupuncture gave positive results similar to those of occlusal splint therapy in patients with primarily myogenic CMD symptoms over a 1-year follow-up period.

Activities of Daily Living↗

PubMed1987

A versatile hand splint.

Splintage plays a major part in the management and rehabilitation of the hand following injury, infection and operation. It is essential to have a simple, comfortable, and firm but flexible splint. This should be available "off the shelf", but be acceptable to the patient and to the treating clinician. This paper will describe a splint which not only has these qualities, but is cheap and is re-usable after washing. The splint is made of high density Plastazote and is available in two sizes for each hand. It is moulded into the shape of the functional position of the hand and can easily be trimmed with bandage scissors to give a precise fitting. The splint has been evaluated following surgery on fifty hands. Its fabrication, use and simplicity are discussed.

Casts, Surgical↗

PubMed1991

Scoliosis in growing rabbits induced with an extension splint.

An external splint was applied to 49, 6-week-old rabbits to induce lordosis in the thoracolumbar junction. The splint was retained for 8 weeks, and the animals were killed after 6 months. Scoliosis developed in 23 rabbits during the splinting period. The deformity occurred about the thoracolumbar junction, and was more frequent in rabbits whose lordosis was sustained when the splint was removed after 8 weeks. The results support the view that sagittal changes are primarily or secondarily involved in the pathomechanics of scoliosis.

Animals↗

PubMed2006

Efficacy of splinting and oral steroids in the treatment of carpal tunnel syndrome: a prospective randomized clinical and electrophysiological study.

OBJECTIVE: To study the efficacy of splinting and oral steroids in the management of carpal tunnel syndrome (CTS). DESIGN: Prospective, randomized, open-label, clinical and electrophysiological study with 3-month follow-up. MATERIALS AND METHODS: Forty patients with CTS were randomly divided into splint group (N-20), wearing splint in neutral position for 4 weeks; and steroid group (N-20), who received oral prednisolone 20 mg/day for 2 weeks followed by 10 mg/day for 2 weeks. Clinical and electrophysiological evaluations were done at baseline and at 1-month and 3-month follow-up. Independent 't' test and paired 't' test were used for statistical analysis. OUTCOME MEASURES: Primary outcome measure was the symptom severity score and functional status score. Secondary outcome measures were median nerve sensory and motor distal latency and conduction velocity. RESULTS: At the end of 3 months, statistically significant improvement was seen in symptom severity score and functional status score in both groups (P<0.001). Median nerve sensory distal latency and conduction velocity also improved significantly in both the groups at 3 months. Improvement in motor distal latency was significant (P=0.001) at 3 months in steroid group, while insignificant improvement (P=0.139) was observed in splint group. On comparing the clinical and electrophysiological improvement between the two groups, except for the functional status score, there was no significant difference at 3-month follow-up. Improvement in functional status score was significantly more in steroid group (P=0.03). CONCLUSION: There was significant improvement in both groups, clinically as well as electrophysiologically, at 3 months. On comparing the efficacy of the two treatment methods, except for the functional status score, there was no significant difference between the two groups.

Administration, Oral↗