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PubMed2006

The importance of splinting of teeth in the therapy of periodontitis.

AIM: The deep periodontal disease often leads to dental mobility with further aggravation of the symptomatology. The aim of the paper is to verify the importance of splinting of teeth in the therapy of periodontitis on the basis of parameters commonly studied [probing depth (PD), bleeding on probing (BOP), plaque index], and the role of the occlusal trauma as primary factor or second leading factor in periodontal diseases. METHODS: Thirty patients suffering from periodontitis have been treated with the splinting of teeth, neither preceded nor followed from topical and systemic pharmacological therapy, nor from surgical or non surgical treatment of the periodontal tissues involved. During the 4 visits provided by the study, T0 (0 days), T1 (30 days), T2 (90 days) and T3 (180 days), PD, BOP and plaque index have been estimated. RESULTS: From the comparison of the T0 PD and BOP with the T3 PD and BOP, a significant improvement of these parameters is observed (P<0.05). CONCLUSION: On the basis of the clinical data obtained in this research, the authors suggest that the therapy by means of splinting improves the prognosis of teeth affected by periodontal disease; occlusal trauma and dental mobility cause the aggravation of periodontal lesions.

Bite Force↗

PubMed1987

Decrease of proteoglycan granule number but increase of their size in articular cartilage of young rabbits after physical exercise and immobilization by splinting.

The effects of physical exercise (running) and immobilization by splinting on the number and size of proteoglycan (PG) granules and the diameter of collagen fibers of the articular cartilage were studied with the transmission electron microscope with a stereological method. The lateral tibial condyles of 24 young rabbits were examined. The analysis was carried out in the superficial, middle, and deep zones of uncalcified articular cartilage and also in the pericellular, territorial, and interterritorial regions of each zone. PGs were demonstrated in situ by using en bloc staining with the cationic dye ruthenium red, which binds to negative groups of glycosaminoglycans. Results of the control group showed that there was a large pericellular number of PG granules, and the number of granules tended to increase through cartilage depth. The mean diameter of PG granules was highest in the superficial zone and decreased through cartilage depth. The collagen fibers were thicker in the interterritorial than in the territorial region and their diameters increased from superficial toward the deep zone of uncalcified cartilage. Results of the experimental groups showed that the number of ruthenium-red-positive PG granules decreased by 3-46% in all zones and regions after both physical exercise and joint immobilization. On the other hand, the diameter of PG granules increased by 4-42% in all zones and regions in all groups. Collagen fibers in the territorial region of the middle zone were thinner in the exercised and in the splinted knee, while thicker in the contralateral knee to the splinted limb, as compared with the controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

PubMed1991

Hand splinting in rheumatoid arthritis. A perspective on current knowledge and directions for research.

A theoretical rationale for the use of hand splints in rheumatoid arthritis and selected literature relevant to the efficacy of splints in the acutely inflamed or chronic rheumatoid joint are briefly reviewed. The purposes of this review are to provide a broad perspective on nonsurgical hand splinting and to suggest some directions for future research based on this perspective.

Acute Disease↗

PubMed2004

Silver ring splints improve dexterity in patients with rheumatoid arthritis.

OBJECTIVE: To study the effect of Silver Ring Splints (SRSs) on hand function in patients with rheumatoid arthritis (RA). METHODS: RA patients with stable disease and finger deformities eligible for splinting received 1 or more SRSs. Primary outcome was dexterity, which was measured with the Sequential Occupational Dexterity Assessment (SODA). Secondary outcome measures were self-reported hand function (Dutch Arthritis Impact Measurement Scales 2), hand pain, grip and pinch strength, Disease Activity Score in 28 joints (DAS28), and patient satisfaction. RESULTS: Seventeen patients (median age 65 years; median disease duration 21 years) received a total of 72 SRSs. After 1 year, 48 SRSs were regularly used. Two patients dropped out because of adverse events related to SRSs. In the remaining 15 patients, SODA dexterity scores increased significantly (median 71 at baseline, 81 at 3 months, and 85 at 12 months), Wilcoxon signed ranks test P=0.005 and P=0.026. DAS28 scores did not change at 3 months and improved slightly after 12 months (-0.5; P=0.019). Grip strength, self-reported hand function, and hand pain showed no significant changes. Eleven patients stated they would continue using their splints. CONCLUSION: SRSs can improve dexterity in selected patients with rheumatoid hand deformities. For a satisfactory result, careful patient preassessment and optimal adjustment of SRSs are essential.

Activities of Daily Living↗

PubMed2004

Long-term effectiveness of steroid injections and splinting in mild and moderate carpal tunnel syndrome.

To evaluate the long-term efficacy of non-surgical treatment methods for mild and moderate carpal tunnel syndrome, 120 patients with clinical symptoms and electrophysiologic evidence were included in a prospective, randomized and blinded trial: 60 patients were instructed to wear splints every night, 30 received injections of betamethasone 4 cm proximal to the carpal tunnel, and 30 received injections distal to the carpal tunnel. After approximately 1 year (mean, 11 months; range, 9-14), 108 patients were available for final evaluation. We assessed clinical symptom severity and performed detailed electrophysiologic examinations before and after treatment. Splinting provided symptomatic relief and improved sensory and motor nerve conduction velocities at the long-term follow-up when the splints were worn almost every night. Proximal and distal injections of steroids were ineffective on the basis of both clinical symptoms and electrophysiologic findings.

Adult↗

PubMed1994

Splinting for carpal tunnel syndrome: in search of the optimal angle.

Carpal tunnel syndrome (CTS) is the most common of the compression neuropathies. Several studies have demonstrated the efficacy of wrist splinting in relieving the symptoms of CTS; however, the chosen angle of immobilization has varied. Wick catheter measurements of carpal tunnel pressures suggest that the neural position has less pressure and, therefore, greater potential to provide relief from symptoms. This study is a prospectively gathered, blind trial comparing the symptom relief experienced by wearers of splints immobilized at 20 degrees extension and at neutral. The results indicate that the neutral angle provided superior symptom relief, and that the relief did not often improve between 2 weeks and 2 months of wear. Relief of symptoms was not related to the length of time that the patient had experienced of CTS symptoms. The results also indicate that the results of the electromyography/nerve conduction study (EMG/NCS) do not provide information about the subjects' likely response to splinting.

Carpal Tunnel Syndrome↗

PubMed1993

Compressive plastic splint for postoperative management of the ear.

A new splint for use after ear reconstruction is described. This splint adjusts suitably to the complicated contours of the ear without requiring any impressions before fabrication. The splint controls expansion and contractile forces and consequently prevents some of the complications following ear surgery.

Adult↗

PubMed1984

Transmission of pressure into the human limb from pneumatic splints.

The anterior compartment of the leg of 4 volunteers was used to study the transmission of externally applied pressure into a limb. The pressure from a pneumatic splint was found to be transmitted directly into the leg and was found to be added to the resting intramuscular pressure. The median inflation pressure of such a splint applied by trained ambulance personnel was 25 mm Hg (range 15-36 mm Hg). When the resting intramuscular pressure was raised experimentally, either by voluntary muscular contraction or venous engorgement, numerical addition of externally applied pressure was again observed. A moderate rise in compartment pressure commonly occurs after injury. Due care should be taken in the use of pneumatic splints or compressive dressings as the total pressure generated within a limb may be sufficient to induce ischaemia.

Humans↗

PubMed1979

An evaluation of a polyvinyl occlusal splint for improving the health of inflamed maxillary supporting mucosa of complete denture patients.

A study was made to determine the effects of a polyvinyl occlusal splint on improving the health of inflamed maxillary supporting mucosa. Color slides were made before and after treatment of the maxillary supporting mucosa of 22 edentulous patients wearing dentures during a 15-day test period. The control group consisted of 13 patients, and the experimental group was comprised of nine patients who wore the occlusal splint over the maxillary denture. The 35 mm color slides taken before and after treatment were evaluated by 50 examiners to determine if the health of the maxillary supporting mucosa was better, the same, or worse after the 15-day test period. Fourteen of the examiners were retested to determine the reliability of the viewer. An observable change was noted in the experimental group at a p value less than 1 in 100,000. These findings indicate that the occlusal splint was effective in improving the health status in 64.7% of the experimental patients and that the experimental method was valid.

Dental Occlusion↗

PubMed1981

The modified Hawley occlusal splint.

The use of occlusal prostheses is reviewed from the beginning of the twentieth century. The modified Hawley occlusal splint is described as it is used in integrated treatment in oral rehabilitation. The aims of treatment with the modified Hawley occlusal splint are listed and explained in detail. Contraindications and abuse of the Hawley occlusal splint are discussed also.

Dental Occlusion↗

PubMed1985

A technique for evaluation of centric relation tooth contacts. Part II: Following use of an occlusal splint for treatment of temporomandibular joint dysfunction.

The purpose of this study was to determine the effect of TMJ dysfunction on the recording of centric relation. Centric relation was recorded using an anterior occlusal stop and by bimanual manipulation. Changes in occlusal contacts were recorded before and after occlusal splint therapy in six subjects with TMJ dysfunction. The pantographic reproducibility index and clinical signs and symptoms were used to determine the presence or absence of dysfunction. Use of the anterior occlusal stop resulted in a more posterior, superior initial tooth contact position when compared with bimanual manipulation. Occlusal contact positions were less consistent in TMJ dysfunction subjects than in control subjects. Initial occlusal contacts changed toward centric relation as the dysfunction disappeared. Final occlusal contact was found on the side where clinical signs and symptoms occurred. The condyle on the affected side appeared to be repositioned posteriorly and superiorly in most instances. Occlusal splint therapy was more effective when the splint was adjusted weekly. This study indicates the need to eliminate TMJ dysfunction before recording centric relation or adjusting the occlusion. Occlusal interferences found with TMJ dysfunction are not the same as occlusal interferences found when TMJ dysfunction is absent. Abnormal features on pantographic tracings may aid in indicating the presence of occlusal interferences. Occlusal adjustment in the presence of TMJ dysfunction would result in erroneous occlusal reduction.

Dental Occlusion↗

PubMed1986

Acid-etched splinting to a ceramometal abutment.

This technique describes an acid-etch metal splint with a ceramometal abutment. The internal surface of the DuraLingual Wing Form patterns provide undercuts necessary for composite bonding. The external surface provides a smooth solid metal surface when cast. Since this system uses mechanical undercuts, the resin-bonded splints can have multiple try-ins without the detrimental effects of burnishing and contamination that occur with electrolytically etched metal surfaces. If an abutment for a resin-retained fixed partial denture requires a ceramometal crown, a DuraLingual Wing Form can be incorporated onto its lingual surface thereby providing mechanical undercuts for bonding. The opposite undercuts of the crown and splint provide excellent bond strength for the system.

Acid Etching, Dental↗

PubMed1989

An efficient method for constructing a soft interocclusal splint.

A silicone rubber interocclusal splint can be made chairside in a few minutes and can be used in a variety of situations including MPD syndrome. A step-by-step technique is presented. Soft interocclusal splints are not intended to replace splints of hard plastic, but rather to supplement them.

Dental Occlusion↗

PubMed1989

A short-term evaluation of the effectiveness of stabilization-type occlusal splint therapy for specific symptoms of temporomandibular joint dysfunction syndrome.

To clarify the short-term effectiveness of stabilization-type occlusal splint therapy, a specific symptom approach was used toward 30 temporomandibular joint dysfunction patients with more than two major symptoms (temporomandibular joint and/or masticatory muscle pain, temporomandibular joint sounds, and limitation of mandibular movement). Eighty-seven percent of the patients with pain responded with this therapy and more than 50% had complete relief of pain 4 weeks after insertion of the splint. Temporomandibular joint sounds and limitation of mandibular movement responded more slowly than pain. These results suggest that the stabilization-type occlusal splint should be selected as a first choice among several therapies and that temporomandibular joint pain is particularly susceptible to this therapy.

Acrylic Resins↗

PubMed1990

Use of protrusive splint therapy in anterior disk displacement of the temporomandibular joint: a 1- to 3-year follow-up.

Sixty-eight patients, who were determined clinically (by the presence of audible and palpable-joint sounds) and arthrographically to have meniscus displacement with reduction, had protrusive splints constructed, and the results were evaluated for a minimum of 1 year to a maximum of 3 years. Eighteen additional patients, arthrographically determined to have meniscus displacement with reduction, served as a nontreatment group for comparison. Odds ratios were calculated to compare the proportions of subjects who experienced follow-up symptoms on the two regimens. Results indicated that with splint therapy there was a statistically significant reduction of the intensity of jaw joint pain, temporal headache, ear pain, and pain in front of the ear, and there was a decrease in the probability of a closed lock condition developing. Splint therapy is less likely to reduce frontal headache, neck pain, and clenching of teeth.

Adult↗

PubMed1991

Fixed cantilever splints on teeth with normal and reduced periodontal support.

Photoelastic models were used to visualize stresses developed in teeth and supporting bone by cantilever fixed partial dentures where the most distal abutments had either crater or trough osseous defects. The effects of splinting the periodontally involved teeth to one or more additional sound teeth were studied. It was shown that for a cantilever fixed partial denture with either normal periodontal support, or a distal abutment with a moderate degree of mobility and bone loss, the following can be concluded: (1) occlusal forces on a cantilever fixed partial denture were significantly distributed to only the three teeth closest to the loaded cantilever, (2) optimum stress reduction occurred with the splinting of a periodontally compromised tooth to two periodontally sound teeth. Increasing the number of splinted abutments did not result in a proportional reduction of stress in the periodontium, and (3) no significant cross-arch sharing of occlusal loads was seen.

Alveolar Bone Loss↗

PubMed1992

Making an alternative occlusal splint.

An occlusal splint is commonly used in the diagnosis and management of temporomandibular disorders. In a partially edentulous patient a poorly adapted removable partial denture can prevent the use of a conventional occlusal splint. This article describes the fabrication of an occlusal splint that also incorporates a provisional removable partial denture.

Dental Occlusion↗

PubMed1993

Effect of a full-arch maxillary occlusal splint on parafunctional activity during sleep in patients with nocturnal bruxism and signs and symptoms of craniomandibular disorders.

This study was designed to investigate the effects of the occlusal splint on parafunctional oral motor behavior (grinding and clenching) during sleep in patients with bruxism and craniomandibular disorders. The results revealed that the splint does not stop nocturnal bruxism. In 61% of the patients, wear facets on the splint were observed at every visit (2-week intervals) and in 39%, from time to time. The wear facets reappeared in the same location with the same pattern and were caused mainly by grinding. The extension of the facets showed that, during eccentric bruxism, the mandible moved laterally far beyond the edge-to-edge contact relationship of the canines.

Adolescent↗