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We describe a non-rigid procedure using brackets for splinting teeth after traumatic avulsion. This type of appliance preserves alveolodental ligament physiology and enables immediate mastication without occlusal obstruction. Installation is easy, except when severe bleeding or alveolar fracture occurs.
The purpose of this retrospective study was to evaluate the clinical performance of and patients' satisfaction with maxillary overdentures retained by splinted and unsplinted implants. Patients who had been treated with maxillary implant-retained overdentures because of functional problems with conventional complete dentures were identified and invited to participate in the study. A total of 16 patients fulfilled the enrollment criteria and agreed to participate. Eleven patients were treated with bar-retained overdentures with 3 to 6 clips (mean follow-up 32 months), and 5 patients wore overdentures retained by 2 to 6 ball attachments (mean follow-up 54 months). All subjects were satisfied with their prostheses, and most subjects experienced improvement in their oral function after treatment with implant-retained overdentures. At the time of clinical examination, 92% (n = 77) of the 84 implants placed were functioning satisfactorily. The cumulative survival rate for the implants after 72 months was 90%. Loss of bone support correlated with peri-implant probing depth (r = 0.29; P < .02). No differences in mean bone loss between the subjects with ball-retained or bar-retained overdentures were found. The presence of plaque or peri-implant bleeding was not associated with the type of attachment.
In a study of 118 patients with temporomandibular dysfunction treated with occlusal splint therapy, symptoms of pain and limited mobility of the mandible had decreased more distinct than clicking sounds of the temporomandibular joints. Interestingly, an untreated control group showed similar results after two years follow-up.
AIM: To assess the efficacy of a mandibular advancement splint (MAS) in the treatment of obstructive sleep apnoea syndrome (OSAS). METHODS: Nineteen patients using a MAS for symptomatic OSAS underwent polysomnography, with MAS use randomised to one half of the night. Indices of snoring and OSAS were compared. Side effects, compliance and treatment response were evaluated by questionnaire. RESULTS: Use of the MAS improved total respiratory disturbance index (RDI) from 22.2 +/- 19.8 (SD) events per hour to 16.5 +/- 21.4/hr (p = 0.03), supine RDI (30.8 +/- 23.8/hr to 18.8 +/- 22.1/hr, p = 0.01), arousal index (25.2 +/- 18.9/hr to 19.3 +/- 14.2/hr, p = 0.01) and snoring intensity (52.7 +/- 4.1 to 50.7 +/- 2.7 dB, p = 0.02) but not total snore frequency (p > 0.05). Using polysomnographic criteria, MAS treatment was completely successful in four (21%) patients, partially successful in ten (52.6%) and a failure in five (26.3%). Treatment over a median of 6.5 weeks (range 2-48) was perceived as beneficial by ten of eleven partners. Fifteen patients (79%) reported side effects, 9 (46%) did not use the device every night and four (21%) used the device less than three nights per week. CONCLUSION: The use of the MAS resulted in significant reductions in indices of OSAS and snoring. However, a significant number of patients had difficulty tolerating and regularly using the device.
This case report describes the complex occlusal rehabilitation of a patient with signs and symptoms of temporomandibular disorders with utilization of an occlusal acrylic splint as a means of initial treatment for neuromuscular reprogramming and repositioning of the condyle within the mandibular fossa for occlusal stability, thus allowing adaptation to a new occlusal vertical dimension.
OBJECTIVES: to evaluate the effectiveness of mandibular repositioning splints in the young and adult patients with TMJ dysfunction. SUBJECTS AND METHODS: 23 adult and 14 adolescent patients with TMJ dysfunction selected by Helkimo's index and the criteria of the American Academy of Craniomandibular disorders. RESULTS: upon anamnestic follow up, almost a total disappearance of the functional pain was reported by all patients, while for the headache, a cyclic onset was present, but with an uncertain etiology. Patients had a complete control of the mandibular movements with some articular sounds. But a modicum of muscular tenderness remained possibly due to the psyche of the patient. DISCUSSION: the prevalence of dysfunction in the growing patients was an intriguing observation. Not Angle's classification, but the presence of open bite, deep bite, or unilateral cross was the significant etiological factors.
PURPOSE: This randomized controlled clinical trial aimed to evaluate the efficacy of splinted implants versus unsplinted implants in overdenture therapy over a 10-year period. MATERIALS AND METHODS: The study sample comprised 36 completely edentulous patients, 17 men and 19 women (mean age 63.7 years). In each patient, 2 implants (Brånemark System, Nobel Biocare, Göteborg, Sweden) were placed in the interforaminal area. Three to 5 months after placement, they were connected to standard abutments. The patients were then rehabilitated with ball-retained overdentures, magnet-retained overdentures, or bar-retained overdentures (the control group). Patients were followed for 4, 12, 60, and 120 months post-abutment connection. Group means as well as linear regression models were fitted with attachment type and time as classification variables and corrected for simultaneous testing (Tukey). RESULTS: After 10 years, 9 patients had died and 1 was severely ill. Over 10 years, no implants failed. Mean Plaque Index, Bleeding Index, change in attachment level, Periotest values, and marginal bone level at the end of the follow-up period were not significantly different among the groups. DISCUSSION: The annual marginal bone loss, excluding the first months of remodeling, was comparable with that found around healthy natural teeth. CONCLUSION: The fact that no implants failed and that overall marginal bone loss after the first year of bone remodeling was limited suggested that implants in a 2-implant mandibular overdenture concept have an excellent prognosis in this patient population, irrespective of the attachment system used.
Excessive loss of dental hard tissues caused by mechanical, chemical or traumatic influences--or a combination of these factors--poses difficulties for subsequent prosthetic tooth restorations. Traditionally reconstructive treatment to restore affected teeth has been provided using rather invasive methods like porcelain-fused-to-metal crowns or ceramic overlays. For patients with a tooth substance loss caused by an acidic diet, where a payment of the costs by the social insurance cannot be expected, a less expensive treatment modality would be of interest. The presented case report describes an alternative treatment modality of vertical tooth substance loss by using direct adhesive composite restorations. To establish a simple and controlled build-up, a mini-plast splint based on an ideal wax-up was used.
This is a case presentation of a root fracture that was treated and followed intermittently for 23 years. The treatment outcome supports the newly evolving protocol that root fractures are most successfully treated using a flexible splint over a relatively short duration.
Wrist braces with, and without, thumb extensions (so-called "Futura" splints) were introduced into the Emergency Departments of Cork City Hospitals in July 2001. Constructed of rigid aluminium with a soft synthetic covering and Velcro strapping, they are designed for use in less severe upper limb injuries (such as wrist or thumb sprains or clinically suspected scaphoid fractures with normal X-rays). Their introduction coincided with a relaxation of the guidelines for immobilizing suspected scaphoid fractures.
Occlusal appliances are used as a reversible treatment modality of temporomandibular disorders. This article describes a protocol to produce a stabilization splint with a minimum of chair time, and an improved compliance, aiming at an overall improvement of the therapeutic potential. Maintaining the existing occlusion in stead of using centric relation is part of the procedure. The main phases of the protocol are the initial clinical phase of impressions and recording treatment position of the mandible, the technical phase, the control phase, and the insertion of the appliance.
The gastroesophageal reflux (GER) disease is a very frequent digestive disorder, mainly characterised by the reflux of the gastric acidic content to the esophage in abnormal quantities. There are different situations that favour this situation but almost in all of them rely an incompetence of the esophagic sphincter. The clinical consequences are many, including oral manifestations. Among all of them the most frequent is the esophagitis followed by symptoms at the pharynx or larynx and finally, the oral cavity. At this level fundamentally we will find enamel and oral mucosa erosions. We report the case of a patient who was indirectly diagnosed of her esophague disease by the observation of the alterations in the occlusal splint induced by the gastric reflux. We review the literature concerning the above topic and its possible association with the miofascial syndrome.
Coaptation splinting is an accepted form of treatment for humeral shaft fractures in both children and adults. However, application may be difficult when working alone or with an uncooperative patient. We describe a modified method, involving supplies easily found in most emergency departments and cast rooms, that mitigates these problems.
Blink reflex time records were obtained from patients with temporomandibular joint disfunction (TMJD), before and after treatment with occlusal splint, since blink reflex time helps to study the trigeminal-facial functional relationship. Results suggest that the impaired sensory-motor function in the trigeminal-facial complex of TMJD patients, may return to normal latency values following such treatment.
All clinicians using removable repositioning orthotics are faced with the dilemma of lack of patient compliance. The author has solved this problem by using a maxillary appliance with an anterior inclined plane with intraocclusal acrylic in the bicuspid area. After mandibular reposturing is accomplished, the inclined plane can be removed, thus converting the appliance to a bicuspid buildup splint. This conversion creates an appliance that is esthetic and allows for normal phonation and a new bicuspid-only centric occlusion.
This chapter presents a method of measuring casts in a scientifically duplicatable manner, using the orthopedic relator to diagnose the plane of occlusion. This allows the practitioner to determine if occlusal equilibration is a viable treatment modality for a particular patient. For patients who do not meet the criteria for occlusal equilibration, a detailed technique for correcting the occlusal plane discrepancies through use of the orthopedic splint is presented.
The objective of the present study was to relate changes in reflex-vegetative functions and phonetics to the etiology of temporomandibular joint dysfunction-pain syndrome. Myofunctional therapy associated with an occlusal splint had a very significant effect in relieving the pain and dysfunction caused by this type of disorder.
This study compares the changes that occur in latency before and after use of splint therapy in patients with TMJ dysfunction. The sensory fibers of the upper branch of the trigeminal nerve were stimulated and the time required for the sensory and motor responses to occur were measured. A reduction in latency occurred in the late component. Also a reduction of the delay occurred between ipsi and contralateral late responses. This finding can be attributed to the lateral reticular formation in the blink reflex arc. This study demonstrates a method for evaluating TMJ dysfunction and a way to monitor clinical response.