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The effect of the bite plane splint on the electromyographic silent period duration.

An electromyographic study of the masseter and anterior part of the temporalis muscles was performed on ten patients presenting temporomandibular joint dysfunction symptoms. The EMG silent periods (SP) produced in the open-close-clench cycle and jaw-jerk reflex were compared for duration before and after treatment with an occlusal bite splint. Following use of the splint, there was a shortening of SP indicating the possible use of the duration of SP as a diagnostic measurement, and also as an indication of treatment effectiveness.

Adult↗

Effect of occlusal splints on the EMG activity of masseter and temporal muscles in bruxism with clinical symptoms.

An electromyographic study of the masseter and anterior temporal muscles was performed on fifteen bruxism patients with clinical symptoms such as muscle pain, fatigue and tenderness. The slopes of the voltage tension (V/T) curves (calculated as the value of the relative inclination between the integrated electromyogram and the biting force) were compared before and after treatment with an occlusal splint. Following use of the splint, the steep slopes of the V/T curves, common in bruxism, became gentle and similar to those of healthy subjects. The difference found in the slopes of different types of bruxism (grinding, clenching, grinding and clenching) might be useful as a diagnostic tool. Follow-up recording of the slopes was considered to be a useful indicator of treatment effectiveness.

Adolescent↗

Subjective and objective evaluation of bruxing patients undergoing short-term splint therapy.

Subjective and objective criteria were utilized to evaluate the effectiveness of short-term bite splint therapy on bruxistic behaviour. A simple bruxism monitoring device was used to check pre-treatment and post-treatment nocturnal bruxism. This preliminary study suggests that short-term splint therapy is effective in eliminating mild to moderate facial pain and dysfunction while reducing bruxistic behaviour. The bruxism monitoring device is a simple and effective tool for diagnosing bruxism quantitatively.

Adult↗

Experiences with resin-bonded bridges and splints--a retrospective study.

In a joint evaluation of 496 resin-bonded bridges and splints anchored by various retention principles and composites, the initial experiences of seventeen clinicians were compiled. The main indications for treatment were congenital anodontia and loss of teeth due to caries and trauma. After 3 months, 95% of the bridges were still in place without need of reattachment procedure. After 6 months the figure was 91%, after 1 year 81.5% and after 1 1/2 years 73%. Seventy-five per cent of the loosened bridges were attached successfully a second time. The success rate for splints was significantly lower.

Adolescent↗

Vectorial analysis of the equilibrium of forces transmitted to TMJ and occlusal biteplane splints.

A mechanical model (link quadrilateral bell crank) is used to demonstrate the equilibrium of normal force vectors transmitted to the masticatory system and maxillary occlusal biteplane splints with different designs. Occlusal contacts were imposed on the proposed models under the action of a masticatory force vector with an arbitrary value of 40 kgf. The consequence of this force action created different responses within the joint and at the level of the dentition. When compared to the intercuspal position in centric occlusion, intra-oral appliances with either smooth contacting surfaces or indentations, both with increased vertical dimension, forced the mandible to assume an anterior position with a concurrent increase of joint forces. The bite-splint that produced the least amount of joint force was the stabilization type with minimal increase of vertical dimension.

Biomechanical Phenomena↗

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↗

A simple and practical method in treatment of ingrown nails: splinting by flexible tube.

BACKGROUND: The ingrown nail (or onychocryptosis) is a common problem that occurs mostly in the big toe and causes high amounts of morbidity in affected patients. Many therapeutic methods have been described, most of them leading to severe damage to the nail or to frequent relapses. The nail splinting technique is a successful, simple and non-invasive therapeutic method for treating ingrown nails. OBJECTIVE: To determine efficacy of the plastic tube insertion technique in patients with ingrown toenail and its use as a standard treatment. MATERIALS AND METHODS: We encountered 32 cases (age range 9-67 years) of ingrown toenails in this clinical trial. All of the patients were treated using the plastic nail tube insertion technique for 7 to 15 days. Patients were examined daily for the first 3 days of treatment and were evaluated 3 and 6 months after treatment. All patients were followed up by a single observer. RESULTS: Recurrence was seen in only two patients after 6 months of treatment (6.25%). CONCLUSION: The low recurrence rate using the nail splinting technique in the treatment of ingrown toenail, as well as its simple application, shows that this treatment constitutes an effective, non-invasive method. It appears that this technique can substitute other more invasive surgical methods, particularly in the early stages of this disease.

Adolescent↗

Facilitated cement removal technique between splinted crowns.

A technique for facilitating cement removal between splinted crowns is described. The technique involves tying dental floss with the large-diameter yarn portion around the embrasure of the splinted crown before cementing, and pulling it through before the cement has reached a final set. This simple, quick technique achieves removal of cement without damage to the interproximal crown surface.

Cementation↗

Reproducibility of pocket depth and attachment level measurements when using a flexible splint.

Pocket depth, attachment level and bone level assessments were carried out using flexible splints to produce readily identifiable reference points and to standardize the probing spot and the direction of probe insertion. The pocket depth and attachment level measurements were carried out twice at intervals of 3 weeks, both before and 3 months after periodontal treatment. The level of alveolar bone was measured by transgingival probing ("sounding") and again following elevation of a mucoperiosteal flap. The measurements were made with a periodontal probe to the nearest higher millimeter. Complete agreement was found between the first and second measurements of pocket depths and attachment level for approximately 60% of the examined surfaces, both before and after periodontal treatment. A deviation of 1 mm or less was found for approximately 95% of the surfaces, and the difference between the first and second measurement never exceeded 3 mm. When transgingival probing measurements were compared to the measurements of the periodontal bone level assessed after elevation of a mucoperiosteal flap, complete agreement was found for 60% of the surfaces, and a deviation of 1 mm or less was found for 90% of the surfaces. No discrepancy exceeding 3 mm was observed. The results of this study indicate that readily identifiable reference points can be produced by flexible splints in assessments of pocket depth, attachment level and bone level alterations in studies on the effect of periodontal treatment.

Adult↗

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↗

Immediate electromyographic response in masseter and temporal muscles to bite plates and stabilization splints.

The immediate influence on masticatory muscle activity of bite plates and stabilization splints was investigated in control subjects and patients with craniomandibular disorders. Electromyographic surface recordings were performed from the masseter and temporal muscles bilaterally with and without the appliances in situ. In the rest position, no significant change in average activity was registered in any muscle with either appliance. Activity during maximal biting on stabilization splints was not different from that without the appliance while bite plates caused a decrease in activity in both muscles in both groups. The reduced maximal activity was probably due to the smaller number and exclusively anterior positioned occlusal contacts on the bite plate.

Adult↗

An alternative method for splinting of traumatized teeth: case reports.

Injuries to the dentoalveolar complex are fairly common and can be caused by a number of reasons. There are many techniques for repositioning and stabilizing traumatically luxated or avulsed teeth. Many of the splinting techniques previously advocated were time-consuming. Not only were the splints difficult to fabricate and difficult to remove, they also contributed to injury of the soft and hard supporting tissues. Ribbond (Ribbond Inc., Seattle, Wash) is basically a reinforced ribbon which is made from ultrahigh molecular weight polyethylene fiber having an ultrahigh modulus. It is used in dentistry for various purposes. The use of Ribbond appears to be an adequate and easy method for stabilization and fixation. It can be used in the treatment of dental injuries. In this article the use of Ribbond for the treatment of dentoalveolar injuries is described.

Child↗

A case series of temporomandibular disorders treated with acupuncture, occlusal splint and point injection therapy.

A treatment regime combining acupuncture, occlusal splint and point injection therapy for temporomandibular disorders (TMD) is presented. There were 89 consecutive patients treated by the regime in this case series but four patients dropped out after two to three visits. Data and treatment results of the remaining 85 patients who had treatment completed were analysed. It was found that 73 (85%) of patients with TMD had symptoms relieved within six visits under this regime. Complications were rare and minor. Acupuncture treatment, in combination with splint therapy and point injection therapy, appears to be effective for managing TMD. However, further research, using randomised controlled trials should be conducted to ascertain its effectiveness over other treatment modalities.

Acupuncture Points↗

Pressure relief splinting for an infant: a systemic approach.

BACKGROUND: This case report describes a unique splinting design used on a 6 month-old infant with a grade II heel pressure sore. Traditional methods of attaining pressure relief such as gel pads and repositioning may benefit an inactive, relatively healthy child. However, a 6 month-old infant who is actively at the developmental age of reciprocal kicking is less likely to respond to these interventions. Furthermore, children with multiple systemic diagnosis may demonstrate a rapid deterioration of their pressure sore when the most effective intervention is not initially chosen. METHOD: This paper reviews the multiple systems which impact wound healing to assist the occupational therapist in choosing efficient methods of pressure relief. The splint design described was chosen due to the age and the complex medical history of the infant. PRACTICE IMPLICATIONS: The effectiveness of total pressure relief initiated early in the infant's treatment resulted in complete visual healing within one month. It was worn for six weeks to avoid recurrence on an already susceptible area of skin.

Equipment Design↗

An interdisciplinary methodology for the comparative evaluation of splinting materials (orthotics, thermoplastics, clinical research).

The methodology developed includes both the use of laboratory evaluation and clinical assessment in an area where there are no standard requirements, no specifications, nor any continuity of data available on the various thermoplastic splinting materials now on the market. A series of laboratory tests and clinical trials were devised such that these could be interpreted with regard to clinical considerations, cost analyses and serviceability factors relating to the materials. Laboratory testing covered possible effects on the chemical and mechanical properties of material likely to be caused by various environmental, sterilization and working factors. The complementary clinical evaluation to highlight the behaviour of materials during the fabrication and wearing of splints consisted of specific information generated with the assistance of experienced occupational therapists, occupational therapy students and patients. Biocompatibility studies were also carried out. The data to be published will provide needed information to physicians, occupational therapists, physical therapists, orthotists, prosthetists, and administrators with regard to their making informed decisions on the selection, purchase and use of thermoplastic materials.

Canada↗

Jaw muscle silent periods: the effect of acrylic splints.

Jaw muscle silent periods were recorded in response to a chin tap during maximal clench in asymptomatic subjects. The insertion of a palatal splint did not change the silent period duration. However, an occlusal splint, or part of it, caused a significant increase in the duration of the silent period.

Acrylic Resins↗

The effect of an occlusal stabilization splint and the mode of visual feedback on the activity balance between jaw-elevator muscles during isometric contraction.

The aim of the present study was to gain an insight into the influence of a vertical bite-rise (clenching in intercuspal occlusion vs. clenching on an occlusal stabilization splint), the mode of visual feedback (VF; obtained from the compound masseter signal, from the compound anterior temporalis signal, or from the compound signal of both masseter and anterior temporalis muscles) and the EMG clenching level (10% MVC and 50% MVC) on the muscle balance between the masseter and the anterior temporalis muscles. The muscle balance was quantified as the logarithmic value of the ratio between the summated mean rectified EMG activity of the masseter muscles and this activity of the anterior temporalis muscles. The muscle balance was influenced significantly by the mode of VF (p < 0.01), the muscle balance shifting toward the group of muscles from which VF was obtained. When VF was obtained from the masseter muscles, a decrease in the anterior temporalis EMG activity was observed when the vertical dimension was increased (p < 0.05-0.01). When VF was obtained from the anterior temporalis muscles, the activity of the masseter muscles was raised with respect to that of the anterior temporalis muscles during clenching with a vertical bite-rise (p < 0.05-0.01). When VF was obtained from both groups of muscles, the masseteric EMG activity increased, whereas the anterior temporalis EMG activity decreased. Hence, regardless of the mode of VF, a relatively lower activity level of the anterior temporalis muscles was achieved after insertion of an occlusal stabilization splint.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

The bookend nasal septal splint.

A malleable nasal septal splint is presented. Its purpose is to hold the septum in the midline, and to depress the floor of the inlet over the premaxillary wings. Blunting of the nasal valves is avoided. This appliance can be both firmly seated and well tolerated, since its pedestals can be curved up laterally within the lateral crura. Additional splints can be threaded onto the first one to reach high posterior synechiae. A useful modification is provided to support nasal bones when nasal packing must be avoided.

Humans↗