[Fabrication of occlusal splints in general practice].
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The effects of stabilization splints on the electromyographic activity patterns of the masseter and anterior temporal muscles during maximal clenching in healthy subjects and subjects with different types of stomatognathic dysfunction syndrome were investigated. No marked effect of splints on the asymmetry of muscle activity during bilateral clenching was revealed immediately after splint insertion. During unilateral clenching in the intercuspal position (ICP), the relative asymmetry index (rAI) of the masseter muscles, detecting the imbalance of left and right muscular activity, was significantly increased. The use of splints suppressed the asymmetry of masseter muscle activity during unilateral clenching. This result suggests that the use of a splint is a method of suppressing clench-caused aggravation of stomatognathic dysfunction in the presence of an imbalance between left and right muscle activities.
A report is presented of a 5-year-old girl who had an 11-month history of chronic headache and nocturnal bruxism. Treatment using a removable appliance that provided maximum support in centric relation was successful in relieving the headache during a follow-up period of 22 months.
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During post-treatment examination the effect of splint therapy on 14 temporomandibular joints (TMJ) with anterior disk displacement were examined using clinical and instrumental findings and magnet resonance imaging (MRI) to judge the therapeutical success of the treatment from an orthodontic perspective. A stable reposition of the TMJ disk was achieved in four joints, which showed no relapse over a two-year period of observation. The success of the therapy was dependent on the extent of the tissue damage to the TMJ and also on patient compliance. The MRI yielded therapeutically valuable information, which is not revealed in the clinical-instrumental analysis, on the tissue structure of the disk and the ligaments. In certain cases the use of MRI is necessary to confirm the clinical diagnosis.
This article explores whether organotypic cultures of immortalized gingival keratinocytes constitute a suitable model for assessing the epithelial cell compatibility of two groups of dental resins, each of them representing one group used in orthodontics and temporo-mandibular disorders (TMD) therapy under conditions more closely resembling the actual tissue situation. The resins were tested with the agar diffusion assay (ADA) in conventional monolayer and organotypic cultures. Compared to the control exhibiting a neutral red destaining index of 3, the index of 4 obtained after exposure of monolayers to one soft permanent resin (Durabase) indicated the presence of a non-lytic but physiologically active substance. In contrast, the adaptation of the ADA to organotypic cultures revealed no apparent lesions at the epithelial surface by performing scanning electron microscopy, while histoarchitecture indicated the development of stratified surface epithelia. This was substantiated by undamaged cells in the uppermost cell layers and by the preservation of cell-to-cell contacts. Furthermore, indirect immunofluorescence for Ki-67 and the cytokeratins ck 14 and ck4 revealed that cell proliferation and epithelial structure were maintained, while differentiation was enhanced, possibly increasing epithelial resistance. The results obtained from the organotypic cultures suggest that (i) cell-affecting effects of materials visible in monolayer cultures may not be seen in epithelia resembling that in vivo and that (ii) enhanced differentiation may be associated with increased stability of the epithelial cells. Thus, organotypic cultures of gingival cells constitute a tissue model allowing short-term tissue compatibility studies of dental materials and rendering a potential candidate also for long-term studies.
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