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PubMed1997

Use and effectiveness of splint appliance therapy: review of literature.

Interocclusal orthopedic appliances of varied design and application have been employed in the treatment of myofascial pain dysfunction (MPD) and temporomandibular joint disorders (TMD). These appliances provide the practitioner with a non-invasive, reversible form of intervention to manage the patient's symptoms. Literature on the use and effectiveness of these appliances has become readily available and now requires retrospective evaluation. However, comparison of results from studies making use of interocclusal orthopedic appliance therapy is difficult due to the employment of various outcome measurement scales, subjective evaluation of patient outcome, and variability in reporting of treatment outcomes. The aim of this paper is to review the effects and success rates of the various appliances reported in the literature and provide the practitioner with useful information that may be of assistance in the prediction of outcome and success of splint appliance therapy.

Electromyography↗
PubMed1997

Body position effects on sternocleidomastoid and masseter EMG pattern activity in patients undergoing occlusal splint therapy.

This study was conducted in order to determine the effects of body position on electromyographic (EMG) activity of sternocleidomastoid and masseter muscles, in 15 patients with myogenic cranio-cervical-mandibular dysfunction undergoing occlusal splint therapy. EMG activity was recorded by placing surface electrodes on the sternocleidomastoid and masseter muscles (contralateral to the habitual sleeping side of each patient). EMG activity at rest and during swallowing of saliva and maximal voluntary clenching was recorded in the following body positions: standing, supine and lateral decubitus. In the sternocleidomastoid muscle significant higher EMG activities at rest and during swallowing were recorded in the lateral decubitus position, whereas during maximal voluntary clenching EMG activity did not change. In the masseter muscle significant higher EMG activity during maximal voluntary clenching in a standing position was observed, whereas EMG activity at rest and during swallowing did not change. The opposite pattern of EMG activity supports the idea that there may exist a differential modulation of the motor neuron pools of the sternocleidomastoid and masseter muscles, of peripheral and/or central origin. This suggests that the presence of parafunctional habits and body position could be closely correlated with the clinical symptomatology in these muscles in patients with myogenic craniomandibular dysfunction.

Adult↗
PubMed1992

The treatment of severe 'gummy' Class II division 1 malocclusion using the maxillary intrusion splint.

This paper describes a modified Maxillary Intrusion Splint (M.I.S.) system which incorporates a near vertical pull headgear, and its use in the management of severe 'gummy' Class II division 1 malocclusion. The appliance was designed to reduce the visibility and vulnerability of the maxillary incisors in this difficult clinical situation by achieving the intrusion of maxillary teeth, restraining maxillary growth, and encouraging an element of subsequent forward mandibular rotation. The authors' initial experience using this system is presented in a retrospective cephalometric analysis of the lateral skull films of 26 treated patients contrasted with a similar number of comparable controls. The results showed that the principal effects of the M.I.S. were on the maxillary teeth giving decisive overjet control and incisor retraction with actual maxillary incisor intrusion. There was a similar effect on the maxillary molar and the M.I.S. provided effective en masse vertical control of the maxillary dentition. There was some degree of maxillary restraint in the M.I.S. group, but no noticeable difference in the change of mandibular position between the groups at the end of treatment. The possible reasons for this are discussed and suggestions made to improve this aspect of treatment in these patients.

Cephalometry↗
PubMed2005

Sleep nasendoscopy: a diagnostic tool for predicting treatment success with mandibular advancement splints in obstructive sleep apnoea.

This prospective, cohort study evaluated the role of sleep nasendoscopy (SNE) with simultaneous mandibular protrusion in predicting successful mandibular advancement splint (MAS) therapy in subjects with obstructive sleep apnoea (OSA). Nineteen OSA subjects diagnosed by overnight polysomnography were referred for MAS therapy, following SNE investigation. A Herbst MAS was fabricated for each subject. Once this had been adjusted for maximal, subjective, therapeutic effect, follow-up sleep studies were undertaken with the appliance in situ. The SNE was repeated with the appliance in place to allow the effects of the original mandibular protrusion and the actual effect of the MAS to be compared. The MAS was removed and the original and current site(s) of obstruction evaluated. Pre-treatment SNE showed airway obstruction at the following levels: intermittent multi-level (16 subjects), sustained multi-level (two subjects) and tongue base (one subject). In all individuals, gentle advancement of the mandible during SNE improved airway patency and reduced snoring. When the SNE was repeated with the MAS in situ, all subjects showed improvements in snoring and airway patency. Follow-up sleep studies confirmed the efficacy of the MAS, with all patients showing a reduction in the apnoea/hypopnoea index (AHI). Median reductions in AHI (from 28.1 to 6.1, P < 0.001) and Epworth Sleepiness Scale (ESS) scores (from 9 to 6, P < 0.001) were highly statistically significant. The results suggest that SNE with concomitant mandibular advancement to mimic MAS wear, could be a valuable prognostic indicator of successful MAS treatment.

Adult↗
PubMed1983

The Cherwell splint: an ankle and foot orthosis for rheumatoid arthritis.

Rheumatoid arthritis often gives rise to painful collapse or partial collapse of the foot into valgus under load-bearing conditions, limiting the subject's ability to walk. However, the ankle joint frequently remains unimpaired. Thus, in serious cases a cosmetic splint is required which supports the foot whilst allowing the ankle to plantarflex and dorsiflex. The Cherwell ankle-foot orthosis has been designed and extensively tested in Oxford and elsewhere during the last four years, and can now be prescribed and supplied from three orthopaedic centres to meet this requirement.

Adult↗
PubMed1995

An expansible splint for treatment of nostril stenosis.

Stenosis of the nostrils is an uncommon deformity frequently caused by a circumferential scar retraction after trauma, infection, or iatrogenic procedures. To avoid recurrence of postoperative stenosis, it is necessary to maintain the corrected contour of the nostril during the period of wound contraction. For this purpose, we describe a new acrylic nostril conformer that is expansible. The splint fits the patient's nostril exactly and by its expansion can even achieve an overcorrection, improving a poor surgical result.

Adult↗
PubMed2002

The stamler lid splint: a new short-term technique for achieving therapeutic ptosis.

PURPOSE: To provide an introduction to a new device, the Stamler lid splint (SLS), a disposable appliance designed to create a temporary total therapeutic ptosis. We also describe the indications for its use and analyze its limitations. METHODS: The utility of the SLS in effecting complete ptosis was examined in 33 patients. Outcome parameters examined were mean duration of (induced) ptosis, success (and failure) rate, and the incidence of side effects. RESULTS: The most common indications for using the SLS were lid closure abnormalities (n = 6) and epithelial defects after keratoplasty (n = 5). The induced ptosis lasted for a mean of 3.3 days (range, 1.5-6). The success rate of the SLS in achieving a total ptosis was 90.9%. Failure was attributed to the presence of atypical lid or orbital anatomy. No patient developed a complication specifically related to the SLS itself. CONCLUSIONS: The SLS is an inexpensive, quick, and technically straightforward means of treating a variety of ocular surface disorders in compliant patients with normal lid and orbital anatomy. The SLS is best suited to patients who require short-term therapy only.

Adult↗
PubMedDate not supplied

The Kerlix tongue-depressor splint for skin-grafted areas in burned children.

A simple, sterile splint to ensure skin take and to immobilize joints in burned children who have grafted wounds is described. It consists of sterile tongue depressors placed 2 to 3 cm apart on the circumference of the limb and entwined at various layers with wrapped Kerlix. In our practice this device is advantageous because of its evaporative properties; it is lightweight and easily removed.

Burns↗
PubMed1988

Comparison of flexion versus extension splinting in the treatment of Mason type I radial head and neck fractures.

At an average of 18.4 months after fracture, 20 adult patients with nondisplaced radial head or neck fractures were examined regarding manner of treatment and functional outcome: 11 patients were initially immobilized in 90 degrees flexion and nine patients were immobilized in straight extension. Loss of range of motion of the injured elbow averaged 1 degree loss of flexion, 2 degrees loss of extension, 1 degree loss of supination, and 2 degrees loss of pronation. No patient reported any functional impairment, and only five patients (25%) reported any symptoms referable to the injured elbow on follow-up. The manner of initial treatment did not seem to affect ultimate outcome; symptomatic treatment and splinting followed by early range of motion would appear to produce uniformly good results.

Adult↗
PubMed2004

Posttraumatic radioulnar synostosis treated with a free vascularized fat transplant and dynamic splint: a report of two cases.

Two cases of posttraumatic radioulnar synostosis are presented. The patients were treated with excision of the cross-union and interposition of a free vascularized fat transplant. A newly devised pronation-supination dynamic splint was employed for 3 months postoperatively in both patients. After a 1-year postoperative follow-up, an increased range of motion was restored in both cases, and there was no evidence of recurrent synostosis formation in subsequent radiographs. We suggest that an interposed vascularized fat graft may be an ideal biologic barrier to fill the space created by cross-union excision.

Adult↗
PubMed1980

A constant tension dynamic splint.

We have presented a new method of dynamic splinting that allows a greater range of protected motion under constant tension. The device has been designed for use with newer methods of tendon repair in situtations where early controlled motion is allowed.

Biomechanical Phenomena↗
PubMed1988

A nipple splint.

An easily constructed, inexpensive splint for postoperative maintenance and protection of corrected flat, depressed, or inverted nipples and the method of its use are described.

Breast↗
PubMed1991

Further experience in rehabilitation of zone II flexor tendon repair with dynamic traction splinting.

A review of all flexor tendon repairs in the "no man's land" performed from January of 1985 to June of 1987 was done to evaluate the efficacy of our method of rehabilitation. There were 60 fingers (57 patients) with complete laceration of the flexor digitorum profundus and flexor digitorum superficialis tendons in zone II. Fingers with phalangeal fractures, joint injuries, or significant skin loss were excluded. Follow-up ranged from 12 to 48 months. Rehabilitation consisted of a 12-week protocol using the U.S. military combined regimen of controlled motion. Features from the technique of controlled active extension against rubber band passive flexion as well as those of controlled passive extension and passive flexion were incorporated. The palmar pulley modification of Kleinert's dynamic traction splint was utilized. Strickland's total active motion formula was employed to determine results. The results were classified into the four categories of excellent, good, fair, and poor. Fifty-two fingers (86 percent) were rated excellent, 4 fingers (7 percent) were rated good, 1 finger (2 percent) was rated fair, and 3 fingers (5 percent) were rated poor.

Exercise Therapy↗
PubMed1995

A new splint for the nasal tip.

A new nasal tip splint is described. It is used to reduce the disadvantages of prolonged postoperative edema and fibrosis after mestizo nose surgery with the techniques of open rhinoplasty with or without skin columellar incision. It thus offers more predictable long-term results, similar to those observed during surgery.

Humans↗
PubMed2004

Direct skeletal traction for Le Fort I halo distraction replacing an intraoral dental splint and connecting traction hook.

To obviate dental inconveniences after Le Fort I halo distraction using an intraoral dental splint and connecting traction hook, the authors initiated direct skeletal traction using an traction wire at the parapyriformis buttress area. Halo distraction using this procedure was conducted for 11 cleft lip and palate patients (age range, 13-21 years; 6 females and 5 males). Distraction amount ranged from 11 to 15 mm. A satisfactory occlusion was obtained in all patients. All 11 patients complained of pain during the distraction period, but it was controlled by regular oral intake of the usual amount of analgesics. No other particular complications were encountered during the postoperative follow-up of 8 to 18 months. This form of direct skeletal traction proves effective for Le Fort I halo distraction.

Adolescent↗