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There are many methods of fabricating an occlusal splint. The advantages of the technique described are as follows: (1) little intraoral adjustment is required, (2) there is ease in construction, and (3) only one set of diagnostic casts can serve for both occlusal analysis and splint construction. The disadvantage is that an occlusion with group function cannot be produced by this method.
The effect of splinting on abutment tooth movement was investigated in an in vitro study. An acrylic resin mandibular model with missing molars and a removable partial denture framework were constructed. The roots of the premolars and edentulous ridges were coated with silicone rubber. A modified Ney surveyor was used for load application, and abutment tooth movement measurements were made with a macroperiodontometer. Four conditions were tested by applying unilateral loadings: 1. Single abutments of both sides 2. Load side double abutment 3. Nonload side double abutment 4. Double abutments of both sides The results showed that a significant decrease in the magnitude of movement resulted when the abutment teeth were splinted.
Occlusal splints are often constructed to aid in treatment of temporomandibular joint meniscus displacement. Techniques for arthrographically locating the point of meniscal displacement and for fabrication of an appropriate occlusal splint are described.
After repositioning splint therapy, 51 patients were evaluated for a minimum of 6 months. Forty-five (88%) of the patients were considered to have been treated successfully, whereas six (12%) patients required surgery to correct meniscal displacement. A detailed analysis of signs and symptoms before and after splint treatment is in progress.
Internal defects of the nose result from congenital abnormalities, trauma, tumor excision, and complications of cosmetic or airway enhancement procedures. Since the nose is a prominent feature of the face, and nasal deformities present complicated reconstructive problems, the rehabilitation of this structure assumes great importance. Surgical and/or prosthetic procedures using intranasal prostheses, splints, or stents have been developed to improve both form and function. Intranasal prostheses, splints, and stents during nasal rehabilitation can (1) establish and maintain airway patency, (2) maintain tissue position, (3) reduce tissue contracture after surgery, or (4) support mobile tissue in the construction and retention of facial prostheses. Although techniques for managing common problems have been presented in this article, unique clinical situations will arise. Much of the execution and ultimate success of nasal prosthetics will depend upon the ingenuity of the dentist performing the service.
Forty patients with three different types of symptomatic disk-interference disorders were treated with anterior repositioning splint therapy for 8 weeks. At the end of that period 80% of the patients were free of joint sound and pain. Each patient's splint was then gradually modified until the patient's original occlusal condition was reestablished. Each patient was then allowed to function in that position. The patients were reevaluated an average of 2 1/2 years later. Seventy-five percent of the patients had no joint pain and 66% had a return of joint sounds. Sixty-six percent of the patients did not find the need to seek additional treatment for jaw pain and dysfunction.
In the past, the maxillary and mandibular teeth have been firmly indexed on the mouthpiece prosthesis, which can produce significant occlusal discrepancies. The construction of a mouthpiece consisting of a maxillary interocclusal splint is described. The two advantages for this type of mouthpiece are (1) it can be adjusted clinically to accommodate errors in the mounting of the casts and the laboratory processing of the prosthesis, and (2) the use of the maxillary interocclusal splint will reduce the likelihood of the development of masticatory muscle spasms.
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.
An individual mouth splint device that applies continuous or intermittent pressure to stretch commissures and fibrotic muscles in patients treated for microstomia resulting from facial and neck burns is presented. After an individual lip tray is prepared, the method uses the impression and cast of the region of the lips to construct a pink acrylic resin splint. By using the device, split horizontally and activated with a Hyrx screw, an opening of 14 mm can be obtained within 2 weeks. The device is recommended as being easily constructed, inexpensive, almost painlessly inserted, and progressively activated.
The effect of the Michigan splint was evaluated graphically in a group of 19 patients. Gothic arch tracings were registered before and after a period of therapy of 4 months, and the two tracings were compared photographically. The position of the apex of the Gothic arch was displaced in most patients, while the shape of the arch was more regular in almost all patients. The validity of the use of the Michigan splint was confirmed.
A stenosis is produced when a rat's transected small intestine is repaired with a conventional inverting line of silk or catgut sutures. In the new technique, the cut surfaces are apposed over a splint made of dry macaroni of suitable diameter, and then joined end-to-end with polyglactin stitches. The internal splint is quickly softened and digested. The suture material is absorbed without concomitant inflammation, and does not interfere with the cutting of sections for histology. Examination revealed, in every case, a fully patent anastomosis with alignment of the layers of the intestinal wall. This is preferable to an inverting anastomosis for investigations of intestinal wound healing and for physiological studies of the propagation of movements along the gut.
Splint therapy is often the initial nonsurgical treatment selected to manage patients who have anterior displacement of the temporomandibular joint (TMJ) meniscus. It is usually effective if the splint restores normal meniscocondylar relationships. An accurate method for assessing meniscocondylar relationships by means of direct sagittal computed tomography (CT) is described. The precise protocol for this noninvasive CT method and the criteria used to interpret the CT images are presented.
Prosthodontic restoration in edentulous patients who have undergone hemisection of the mandible is difficult because of the instability of the mandible after resection and the lack of teeth necessary for successful retention of a guidance appliance. Successful prosthodontic restoration was accomplished through the use of a two-piece Gunning splint both for intermaxillary fixation and as a guidance appliance in an edentulous patient who underwent a hemisection of the mandible subsequent to treatment for an ameloblastoma. Because mandibular guidance therapy is most successful in patients whose resection involves only bony structures with minimal loss of soft tissue and no radical neck dissection or radiation therapy, the patient treated for ameloblastoma is an ideal candidate for the use of a two-piece Gunning splint for intermaxillary fixation and mandibular guidance therapy.
The problem of resorption during replantation in relationship to the epithelial rests and a lack of splinting was studied. Ten mongrel dogs were used. Two dogs served as control subjects, while eight had their mandibular incisors intentionally replanted and studied histologically. It was observed that where rests of Malassez were present we did not see resorption, and the lack of splinting did not result in resorption or loss of teeth. It appears we can stain epithelial rests of Malassez with immunofluorescent antibodies and use this technique for further study of this tissue.
This article illustrates the scope of use for pressure-formed splints in two frequently encountered fields of oral surgery: maxillary segmental surgery and management of fractures of the mandible through the dental arch. The use of these splints in both fields allows significant modification of generally accepted procedures.
Over a ten-year period, 129 patients with idiopathic pelviureteric obstruction were randomly selected for splinted or unsplinted pyeloplasties. Of these groups, the patients with splinted pyeloplasties had a lower incidence of postoperative complications. The long-term results were similar in both groups.
Percutaneous ureteral splinting using a modified catheter technique is described, and experience in treating 5 patients (4 with postoperative fistulas and 1 with stricture) is reported. The method offers an effective alternative to surgery in achieving ureteral splinting and renal drainage.
79 infants with congenitally dislocatable hips diagnosed clinically soon after birth were examined sonographically and randomised in a controlled trial to immediate splinting (n = 41) or sonographic surveillance for 2 weeks (38). Infants from this second group were splinted at age 2 weeks if instability persisted (11 of 38) or if sonographic abnormality had shown no improvement (4 of 38). Sonographic findings or clinical outcome did not differ between the two groups at birth or at 6 and 12 months' follow-up. We conclude that dislocatable hips may be safely watched for 2 weeks after birth to allow spontaneous resolution, but that this approach requires considerable resources and attention to detail. Our experience confirms the importance of the dynamic sonographic scan. The low specificity (70%) of sonographic examination in the first week of life makes it an unsatisfactory primary method of screening at birth, but it is a most useful adjunct to the clinical screening and management of congenital dislocation of the hip.