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PubMed1985

An electromyographic study of the immediate effect of an occlusal splint on the postural activity of the anterior temporal and masseter muscles in different body positions with and without visual input.

With the mandible at rest, the clinical postural position was measured and electromyographic recordings (in seated and supine position, eyes open and eyes closed, before as well as 15 min after insertion of an occlusal splint) were from the anterior temporal and masseter muscles in thirty-one patients with signs and symptoms of mandibular dysfunction and nocturnal bruxism. The results indicated that when the patients were seated upright, there was a distinct postural activity in the anterior temporal and in some patients also in the masseter muscles. This postural activity decreased significantly with closure of the eyes and in supine position. Fifteen minutes after insertion of an occlusal splint, the postural activity in the temporal muscles decreased in 52%, increased in 22% and remained unchanged in 26% of the patients. Moreover, the postural activity reached its lowest level in supine position. The results indicate that the supine position is the body position to be preferred for centric relation recording as well as for occlusal and splint adjustment.

Adolescent↗
PubMed2006

Clinical factors affecting the outcome of occlusal splint therapy of temporomandibular joint disorders.

The purpose of this study was to test the hypothesis that (1) the presence of a clinical temporomandibular joint-related disorder has effects on short-term changes in temporomandibular joint pain, and that (2) clinical variables of time since pain onset predict treatment outcomes of occlusal splint therapy. The study comprised 76 patients with unilateral temporomandibular joint pain. The clinical disorder subgroup included 47 patients with a clinical pain side-related diagnosis of internal derangement type I (n = 16), internal derangement type III (n = 19), and degenerative joint disease (n = 12). The clinical non-disorder subgroup consisted of 29 patients without a temporomandibular joint disorder. A logistic regression analysis was used to compute the odds ratio for the clinical variables of time since pain onset, adjusted for age, gender, pretreatment pain level, and clinical subgroup. For the temporomandibular joint pain measurements there was no significant 'session'/'clinical subgroup' interaction (P = 0.470). Significant increase in benefit of a successful outcome of 'pain reduction >70%' occurred with a time since pain onset of 2 years might belong to the unsuccessful treatment group of 'pain reduction <30%' was strong (6.0) and significant (P = 0.026). Diagnosis of temporomandibular joint disorder proved not to be linked to changes in therapeutic outcome measures of temporomandibular joint pain. Time since pain onset was an important prognostic determinant of successful occlusal splint therapy.

Adolescent↗
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↗
PubMed1998

[Evaluation of the treatment effect for bruxism by using myomonitor and occlusal splint].

OBJECTIVE: To evaluate the treatment effect of bruxism by using myomonitor and occlusal splint therapy. METHODS: By using EMG, audiocontrolled recorder and myollectronic recording device to record and analyse the muscles functional state before and after treatment. RESULTS: Splint therapy was more effective than the myomonitor did, such as teeth grinding stopped in 12 cases to 1 case, grinding time decreased in 13 cases to 10 cases and no significant effect in 2 cases to 17 cases. SPD and V/T curve slope of muscles decreased. CONCLUSION: This indicates that the functional state of masticatory muscles got improved. Splint therapy is one of the effective treatment method for bruxism.

Adult↗
PubMed2000

Bilateral effect of a unilateral occlusal splint on the expression of myosin heavy-chain isoforms in rat deep masseter muscle.

Many studies have shown that various myosin isoforms are involved in muscle contraction. A search for specific antibodies directed against the myosin heavy chain (MHC) resulted in the identification of at least two main classes, referred to as MHC type I and type II. In this study, immunohistology and gel electrophoresis were used to determine the proportion of MHC isoforms in rat deep masseter muscle at different times after the insertion of an unilateral occlusal splint. An increasing proportion of MHC type I isoforms was found in both deep masseters soon after splinting, and this trend continued until 7 days after splint insertion. The type I fibres were clearly distributed on either side of the central axis of the muscle. At 15 days, a significant decrease in the percentage of the type IIb MHC isoform was observed on the occlusal splint side compared to the contralateral side. After 30 days of unilateral splinting, the proportion of type IIb fibres on the splint side returned to baseline whereas on the contralateral side there was an increase in the proportion of this type. The results suggest an initial adaptation after the unilateral occlusal disturbance in which muscles of both sides react in the same way; later, the muscles of each side adapt their expression of MHC isoforms according to altered functional demand.

Adaptation, Physiological↗
PubMed1986

A clinical and electromyographic study of the long-term effects of an occlusal splint on the temporal and masseter muscles in patients with functional disorders and nocturnal bruxism.

The postural activity of the temporal and masseter muscles in thirty-one patients with signs and symptoms of functional disorders were studied: before, during and after 3-6 months of occlusal splint therapy. The fluctuating signs and symptoms, as well as the postural activity of the temporal and masseter muscles were significantly reduced after treatment. Further, the coefficients of correlation within pairs of postural activity of the right and left muscles increased significantly. After cessation of the splint therapy the signs and symptoms recurred to the pre-treatment level within 1-4 weeks in about 80% of the patients. The results indicate that an occlusal splint can eliminate or diminish signs and symptoms of functional disorders and re-establish symmetric and reduced postural activity in the temporal and masseter muscles, which can facilitate procedures, such as functional analysis and occlusal adjustment.

Adolescent↗
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↗
PubMedDate not supplied

Occlusal splint therapy in MPD and internal derangements of the TMJ.

Although occlusal splints are useful in the treatment of MPD and internal derangements, they must be used in a rational manner. Two basic appliances are employed in Phase I palliative therapy: a maxillary full coverage (MAR) and a mandibular orthopedic repositioning appliance (MORA). The MAR is used in MPD patients primarily to disengage the occlusion and reduce parafunctional activity. In many cases of internal derangement, protrusive mandibular repositioning is indicated. By using the MORA during the day and the MAR at night, the disadvantages of each appliance are minimized.

Humans↗
PubMed1995

Occlusal splint prescription in the management of temporomandibular disorders.

The case records of 159 patients who had been treated for temporomandibular disorders at the School of Clinical Dentistry Queen's University of Belfast were analysed retrospectively to determine which type of occlusal splint had been prescribed. Full maxillary occlusal coverage polycarbonate vacuum formed splints were prescribed most frequently, being used in 45% of cases, whilst lower splints were rarely constructed. After treatment 54% were asymptomatic which is slightly greater than that described by others as a placebo effect in splint therapy. This low success rate was, at least, in part attributable to a poor overall management strategy. The study highlights the need for a structured management strategy in treating patients with temporomandibular disorders and suggests a need for continuing postgraduate education in the care of these patients.

Humans↗
PubMed1997

Occlusal splint therapy with a positioning orifice.

The authors studied the effect of a positioning orifice introduced in the anterior palatine region of occlusal splints for patients with craniomandibular disorders of swallowing and speech patterns. The patients were evaluated in four distinct situations. It was concluded that the splint orifice significantly favored swallowing and speech while the splint was being used, and is more comfortable for the patient.

Adaptation, Physiological↗
PubMed1989

Prognostic features of value in the management of temporomandibular joint pain-dysfunction syndrome by occlusal splint therapy.

Fifty consecutive patients diagnosed as suffering from a temporomandibular joint pain-dysfunction syndrome that required occlusal splint therapy were studied. Particular attention was given to observable features that could be analyzed during resolution as indicated by using successive visual analogue scales for pain assessment. By photographing occlusal registrations before and after each splint adjustment visit it was shown that the stabilization of occlusal patterns as resolution progressed gave a good indication of the success of treatment in most patients. In patients in which stabilization of patterns occurred but pain continued there was an indication of a complicating psychosocial disorder.

Adolescent↗
PubMed2004

Occlusal splint therapy and magnetic resonance imaging.

AIMS: To investigate the efficacy of the anterior repositioning splint and the canine-protected splint in relieving the signs and symptoms of anterior disc displacement with reduction, and to evaluate the effects of both splints on disc position using a standardized magnetic resonance imaging measurement technique. MATERIAL AND METHODS: A sample of 18 adult subjects was studied. The joint disorder was dually diagnosed via pretreatment clinical examination and magnetic resonance imaging. The sample was randomly divided into two groups. In the first group, each subject received an anterior repositioning splint; in the second group, each subject received a canine-protected splint. The treatment lasted 3 months. A standardized magnetic resonance imaging 10-step procedure was developed. Posttreatment clinical examinations and magnetic resonance imagings were done. Pretreatment and posttreatment records were statistically compared. RESULTS AND CONCLUSIONS: Both types of splints were effective in eliminating pain and clicking. All magnetic resonance imaging measurements showed that the canine-protected splint was superior to the anterior repositioning splint, as it allowed the articular disc to resume its normal length and shape while moving in a posterior direction toward recapture. Disc recapture was demonstrated via magnetic resonance imaging in 25% of the subjects from the anterior repositioning splint group, in 40% of the subjects from the canine-protected splint group, and in 33.3% of the subjects from both groups. Thus, noninvasive treatment techniques (such as occlusal splint therapy) might be the treatment of choice for anterior disc displacement with reduction.

Adolescent↗
PubMed1997

Clinical effect of full coverage occlusal splint therapy for specific temporomandibular disorder conditions and symptoms.

PURPOSE: The purpose of this retrospective study was to evaluate the effect of maxillary full-coverage occlusal splint (stabilization splint) therapy for specific temporomandibular disorders and their symptoms/signs. MATERIAL AND METHODS: This study assessed the outcome of 232 patients who were suffering from chronic pain on movements, joint noise except reciprocal clicking, and difficulty of mouth opening. All were treated with the stabilization splint alone. RESULTS: The total remission rate was 41% and, including those reporting some improvement, the rate was 84%. The presence of displaced disk significantly decreased the success rate. However, the presence or absence of radiographic changes in the temporomandibular joint did not influence the treatment outcome. CONCLUSION: From this study, it is suggested that the stabilization splint therapy may be a useful treatment modality in treatment of temporomandibular disorders, especially for the patients without clinical evidence of displaced disk.

Adolescent↗
PubMed1992

[Effects of difference of occlusal splint contacts on masticatory system].

The short-term effects of the difference of occlusal splint contacts on the jaw function were investigated on five healthy subjects. The maxillary stabilization splint (S-type) was fabricated and sectioned into three parts: an anterior section (A-type) and two posterior sections (P-type). These 3 types of splints were used for 10 days for each subject. The EMG activity of the masseter and the anterior and the posterior temporal muscles were measured during the maximum clenching in the intercuspal position and on the wearing splint. Subsequently on the bite force-measuring device with two transducers the bite and the EMG activity were measured during the maximum clenching, and the intercuspal occlusal contacts were recorded. The results were as follows: 1. After wearing the P-type, the total EMG activity during clenching in the intercuspal position was decreased, then increased after removal. 2. After wearing the S-type and the A-type the anteroposterior distribution of the bite force during clenching was changed, then returned after removal. 3. After wearing the A-type, the occlusal contact area of the anterior teeth in the intercuspal position was decreased, then increased after removal, while after wearing the S-type and the P-type that of the posterior teeth was decreased, then increased after removal.

Adult↗
PubMedDate not supplied

Aggravation of respiratory disturbances by the use of an occlusal splint in apneic patients: a pilot study.

PURPOSE: This pilot study was designed to test the hypothesis that the use of a single oral splint may aggravate respiratory disturbance in sleep apneic patients. MATERIALS AND METHODS: A group of 10 patients with a history of snoring and a recording night confirming a diagnosis of sleep apnea were included. Patients were then invited to spend 2 nights in the sleep laboratory: night 2 to establish baseline data (baseline night) and night 3, 1 week later, to assess the influence of an occlusal maxillary splint on sleep (splint night). The following variables were analyzed under blind conditions: total sleep time, sleep efficiency and number of awakenings, microarousals, apnea-hypopnea index per hour of sleep (AHI), respiratory disturbances index per hour of sleep (RDI), and percentage of sleeping time with snoring. RESULTS: No statistically significant difference in AHI was noted between baseline and splint nights. However, four patients experienced an aggravation in apnea diagnosis category on the night they used the splint. The AHI was increased by more than 50% in 5 of the 10 patients. The RDI showed a 30% increase from baseline to splint nights. The percentage of sleeping time with snoring also increased by 40% with the splint. CONCLUSION: This open study suggested that the use of an occlusal splint is associated with a risk of aggravation of respiratory disturbances. It may therefore be relevant for clinicians to question patients about snoring and sleep apnea when recommending an occlusal splint.

Adult↗
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↗
PubMed1982

Comparison of effects of electromyographic biofeedback and occlusal splint therapy on mandibular dysfunction.

In order to evaluate and compare the effects of biofeedback and occlusal splint therapy on mandibular dysfunction, 30 patients were randomly divided into two treatment groups. The patients were women aged 20--40 years without any obvious organic reasons for their symptoms. There were no significant differences between the two groups before the start of treatment in respect of signs and symptoms of mandibular dysfunction. One group used full coverage splints at night for 6 weeks. The other group received biofeedback training up to six times, 30 min per session. One month after completion of the therapy the patients were re-examined. Both groups showed a significant reduction in symptoms, both subjectively and clinically. No significant differences between the groups were found. The two treatments were thus equally effective in the short-term perspective in patients with signs and symptoms of mandibular dysfunction.

Adult↗