Modified maxillary occlusal splint for prevention of cheek biting: a clinical report.
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The muscle relaxation appliance (MRA) has been used in the treatment of myofascial pain dysfunction (MPD) patients. The neuromuscular orthotic is a version of the MRA and is constructed from a three-dimensional mandibular position when muscles are in a state of minimal electromyographic (EMG) activity. The purpose of this study was to investigate the affect of two muscle relaxation appliances and a placebo (cotton rolls) on EMG activity of the functional masseter and anterior temporalis muscles. A centric relation mandibular MRA and a neuromuscular orthotic were constructed under controlled protocols for 12 women MPD patients with a mean age of 38 years. EMG measurements were taken during a 10-second clench of both appliance and placebo. No statistical difference was found between the centric relation mandibular MRA and neuromuscular orthotic. A statistically significant difference was found between the mean EMG values of the placebo and two treatment appliances.
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This study presents a technique for constructing an occlusal appliance. The central relation position must be located with Gothic arch registration. A central bearing post is fixed to the upper vacuum-adapted sheet and a registration plate is made for the lower cast. For the eccentric guidance construction, a prefabricated guiding ramp is secured just behind the most anterior point of the Gothic arch. The eccentric guidances, which harmonize with condylar movements, are printed by the mandibular canines on the surface of the self-curing resin as the post slides on the inclined surface of the ramp.
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