Clinical comparison of conventional and additive manufactured stabilization splints

Christian Berntsen,Martin Kleven,Marianne Heian,Carl Hjortsjö

doi:10.1080/23337931.2018.1497491

Christian Berntsen, Martin Kleven + Show 2 more

Open Access

https://doi.org/10.1080/23337931.2018.1497491

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Abstract

The aim of this study was to compare conventional and digital additive manufacturing of hard occlusal stabilization splints (SS) using technical and clinical parameters. 14 subjects were subjected to DC/TMD Axis I clinical examination protocol and Axis II questionnaire. The subjects underwent treatment with splints over a period of 12 weeks. All subjects underwent both conventional alginate impression and intraoral digital scanning. Seven subjects received conventional manufactured stabilization splints (CM-SS), and seven subjects received CAD-CAM additive manufactured stabilization splints (AM-SS). 12 subjects completed the 12 weeks follow-up period. The subjects significantly preferred digital intraoral scanning compared to conventional alginate impression. There was a significant difference in VAS between CM-SS and AM-SS. The mean VAS result was 15 for AM-SS and 42 for CM-SS, 0 represented excellent comfort and 100 very uncomfortable. This was significant. Splint manufacturing method had no influence on treatment outcome. There was no significant difference in mean delta change for unassisted jaw opening from baseline to 12 weeks between the two groups, for CM-SS it was 2 mm difference and for AM-SS the difference was 3 mm. All subjects in both treatment groups showed improved oral function. In this study, the scanning procedure is more accepted by the subjects than alginate impressions, however the first procedure was more time consuming.

Highlights

Occlusal stabilization splints (SS) are often used as an interocclusal appliance for managing symptoms associated with temporomandibular disorders (TMD)
When comparing the impressions technique in favor of additive manufactured stabilization splints (AM-SS), and second when comparing time needed for impressions in favor of conventional manufactured stabilization splints (CM-SS)
The essential findings of this study are that the subjects self-reported experience for intra oral scanning was significant better when compared to conventional impressions, meaning that intraoral scanning was perceived to be more comfortable compared to alginate impressions

Summary

Introduction

Occlusal stabilization splints (SS) are often used as an interocclusal appliance for managing symptoms associated with temporomandibular disorders (TMD). TMD is a collective term for dysfunction and pain related to the masticatory musculature, the temporomandibular joints and associated structures [1]. These symptoms are often of low intensity and confined to within a specific area. Some patients on the other hand experiences chronic pain that last for at least 3–6 months [2] and are associated with behavioral, psychological and psychosocial factors [3]. Treatment with a hard interocclusal SS is scientifically recognized, have a low risk of side effects and is commonly used all over the world [4,5,6]. The therapeutic aim of SS is pain relief, and it is shown that a change in vertical dimension is one mechanism that can induce this

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