Mouthguard Research Articles

Comparison of mechanical properties of 3D printer resins for occlusal splints using different models of 3D printers.

Considering the development of new 3D printing technologies that use different printing techniques, further studies must be conducted to evaluate the impact of different printing systems on the mechanical properties of 3D-printed materials. This study aimed to evaluate the mechanical properties of 3D-printed materials for occlusal devices using different 3D printers and printing layer thicknesses. Ninety rectangular samples were manufactured and divided into nine groups according to the 3D printer model they were printed on (AnyCubic Mono X, Elegoo Mars 2, or FlashForge Hunter) and the layer thickness (20, 50, or 100 µm) and were subjected to superficial microhardness, flexural resistance, and elasticity modulus tests. The results were analyzed using two-way analysis of variance and Tukey's statistical tests, with a significance level of 5%. The type of 3D printer significantly affected superficial microhardness (p = 0.007). Flexural strength showed a significant interaction between the 3D printer and layer thickness (p = 0.005), with both factors independently influencing flexural strength (printer: p< 0.001, layer thickness: p< 0.001). Elasticity modulus was significantly influenced by the 3D printer type (p< 0.001) and the interaction between both factors (p = 0.004). The AnyCubic Mono X 3D printer with a 20 µm layer thickness exhibited more consistent mechanical properties than the other printers. Variations in printing systems and layer thicknesses can impact the mechanical properties of 3D-printed materials. Key words:CAD-CAM. Bruxism. Temporomandibular disorders. Mechanical tests; 3-D printing.Care Team.

Does the Use of Injectable Platelet-Rich Fibrin Following Arthrocentesis for Disc Displacement Without Reduction Alleviate Pain?

The role of adjunctive injection agents at the end of temporomandibular joint (TMJ) arthrocentesis remains controversial. This study aims to compare pain reduction in patients with disc displacement without reduction treated with arthrocentesis alone (AO), arthrocentesis with injectable platelet-rich fibrin (iPRF), and arthrocentesis with hyaluronic acid (HA). A single-center, retrospective cohort study was conducted at the affiliated hospital of Health Sciences University, Hamidiye Faculty of Dentistry. Inclusion criteria were female subjects aged 18-65, who underwent TMJ unilateral arthrocentesis, and diagnosed with disc displacement without reduction. Exclusion criteria were prior use of occlusal splints, accompanying diagnosis of myalgia and bilateral arthralgia which both of the joints exceeds or equal to 50mm visual analogue scale for pain (pVAS) value. The primary predictor variable was the adjunctive injection agent: iPRF, HA, or no injection (AO as control). Primary and secondary outcomes were measured preoperatively (T0), and at 1month (T1) and 6months (T2) postoperatively. The primary outcome was pain (pVAS) at T2. Secondary outcomes were pVAS at T1 and maximum interincisal opening at T1 and T2. Demographics, preoperative and perioperative data were collected. Descriptive, bivariate, and multivariate analyses were conducted. The P value was set at ≤.05. A total of 88 subjects completed the study. The mean age of the subjects in the AO (n=30), HA (n=29) and iPRF (n=29) groups was 36.8 (±10.2), 34.8 (±8.9) and 37.6 (±11.6) respectively (P>.05). The mean pVAS scores at T0 for the AO, HA and iPRF groups were 63.2 (±8.7), 66.7 (±9.6) and 66.2 (±9.6) respectively (P>.05). The mean pVAS scores at T1 were 36.5 (±10.8), 29.0(±11.5) and 35.9 (±9.8) respectively (P<.05). The mean pVAS scores at T2 were 34.8 (±16.3), 24.7 (±12.7) and 25.3 (±13.4) respectively (P<.05). There were no differences in maximum interincisal opening between the groups at any timepoint (P>.05). iPRF and HA injections are associated with greater pain relief compared to AO. No significant difference was observed between iPRF and HA, suggesting that the choice between them can be based on cost-effectiveness.

Impact of occlusal stabilization splints on global body posture: a prospective clinical trial

ObjectivesBody posture of patients with temporomandibular disorders (TMD) has been investigated using different methods, whereas outcome and conclusions were controversial. The present clinical trial aimed to investigate the effects of splint therapy on global body posture.Materials and methods24 subjects (20 females, 4 males; age 24.2 ± 4.0 years) with TMD symptoms were examined clinically (RDC/TMD) and subsequently, splint fabrication was initiated. Along with routine therapy, all subjects underwent three-dimensional pre- and post-treatment full body scans in standing and upright sitting posture using a Vitus Smart XXL 3D scanner. Each scan was acquired in triplicate and evaluated in duplicate, measuring twelve standing and nine sitting postural parameters. Influencing factors were analyzed using analysis of variance (ANOVA), and additional Bland-Altman analyses verified the significance of the ANOVA results.ResultsThe increase of Forward Head angles and the decrease of Round Shoulders angles were consistent for both positions and sides. Forward Head angles were significantly influenced by limited mandibular mobility and myofascial pain. Round Shoulders angles showed a significant correlation with myofascial pain, joint noises and the absence of limited mandibular mobility.ConclusionThe influence of occlusal splints on global posture is limited and only small effects on cervicocranial parameters were found. In the present study, the average head position of post treatment measurements was more centered on the body’s core, whereas the shoulders were tilted more anteriorly.Clinical relevanceUnderstanding the limited influence of occlusal splints on cervicocranial parameters underscores the need for multimodal treatment strategies for TMD patients.

Neutral red/carbon dots photodynamic disinfectant spray for sports mouthguards cleaning and perishable foods preservation

Bacterial contamination of medical devices and food poses critical threat to mankind's health. Although some antibiotics can kill bacteria, their mis/overuse in healthcare and agriculture has brought about serious bacterial antibiotic resistance. Thus, developing a convenient and rapid sterilization method becomes increasingly important. Herein, the nanocomposite NR@CDs was synthesized by the assembly of neutral red (NR) with carbon dots (CDs). Compared with NR, NR@CDs has stronger reactive oxygen species (ROS) generation ability. NR@CDs can photodynamically destroy both gram-positive and gram-negative bacteria efficiently, and the minimum inhibitory concentration (MIC) is 45 μg mL−1. NR@CDs spray is an eco-friendly sterilizing agent, with favorable biocompatibility and water-washability properties. Just 1 min of irradiation, NR@CDs spray can quickly and accurately kill the bacteria on the surface of the mouthguards (MGs). As the NR@CDs aqueous solution sprays on cherries, it can effectively prolong the quality guarantee period of perishable foods. The present work provides an innovative strategy to solve the global bacterial contamination and antibiotic resistance problems.

Randomized Clinical Trial of Electrostimulation Therapies as an Adjuvant for the Treatment of Temporomandibular Disorders.

We carried out a comparison of the neuromuscular and clinical effects produced by electrostimulation therapies, as an adjuvant to the use of occlusal splints (removable muscle relaxation apparatus) in patients with temporomandibular disorders In this simple randomized clinical trial, 91 patients were randomly divided into three groups. Group A (GA) received transcutaneous electrostimulation therapy and an occlusal splint, Group B (GB) received percutaneous electrostimulation therapy and an occlusal splint, and Group C (GC) received an occlusal splint. The neuromuscular activity, as well as the signs and symptoms of each patient, were evaluated every week throughout the treatment (T0 = baseline; T1 = 7 days; T2 = 14 days; T3 = 21 days; T4 = 28 days; and T5 = 35 days). Pain was measured with a visual analog scale, and neuromuscular electrical activity was determined by the root mean square of the masseter muscles through the use of a UNAM-CINVESTAV 1.2 electromyograph. Comparisons were made using ANOVA for repeated measures (p-value = 0.05). The comparison between the groups determined that muscle fatigue (p-value = 0.001), joint pain (p-value = 0.009), and muscle pain (p-value = 0.003) decreased to a greater extent, and in the short term for the group treated with transcutaneous electrostimulation therapy as an adjuvant to the use of the occlusal splint. The comparison between the groups determined that muscle fatigue (p-value = 0.001), joint pain (p-value = 0.009), and muscle pain (p-value = 0.003) decreased to a greater extent and in a shorter term in the GA (calculation therapy, transcutaneous electrostimulation) and GB (occlusal splint). Transcutaneous electrostimulation is a feasible and faster alternative that was accepted by most of the patients for treating temporomandibular disorders.

What do Brazilian paediatric dentists know about bruxism in children? Cross-sectional study.

Little is known about the knowledge of paediatric dentists on bruxism in children. The aim of this cross-sectional study was to assess the knowledge of paediatric dentists on the concept, associated factors of bruxism and management of sleep bruxism (SB) in children'. An electronic questionnaire was sent to paediatric dentists in the state of Goiás, Brazil. Information was collected on (1) characteristics of the participants; (2) the concept of bruxism; (3) diagnosis; (4) associated factors; (5) strategies for the management of SB; and (6) updated knowledge on bruxism in children. The data were analysed descriptively. Fifty-seven paediatric dentists participated (10.7% of the total number of professionals). A high level of agreement was found with statements on the concepts of SB (94.7%) and awake bruxism (96.5%). The main strategy for the diagnosis was the combination of a parental report and a clinical examination (79.0%). Most participants indicated that bruxism is associated with anxiety/stress (96.5%), screen use (93%), airway obstruction (91.2%), and sleep apnoea (91.2%). In suspected cases of bruxism, the dentists would send the child for assessment by other health care providers (87.7%). The management options frequently indicated were the use of an occlusal splint, aromatherapy, and homeopathy. More than 70% of them considered themselves to be updated on the issue and sought information through scientific articles and discussions with colleagues. Paediatric dentists have knowledge on the concept of bruxism and associated factors. However, further information is needed on the management of this condition in children.

Occlusal splint therapy- myth or fact? -A case report

The term Temporomandibular Joint Disorders (TMD) refers to a group of intricate disorders with a variety of etiologies that frequently call for multimodal therapy strategies. Treatment of TMDs requires careful diagnosis and treatment planning to resolve occlusal and functional problems. In contemporary dental practice, splint therapy can be used as an effective and conservative means of treatment of TMDs. In this case report occlusal splint therapy was used to treat a male patient of 27yrs age who had symptoms of TMD, including pain in the head, neck, and shoulder. After 8 months of splint therapy, a clinical examination and radiographic interpretation showed considerable changes, including decreased pain frequency, better jaw function, and radiographic evidence of altered joint spaces. This case report shows the effectiveness of occlusal splint therapy in treating temporomandibular joint disorders.

Efficacy of High-intensity laser therapy in patients with temporomandibular joint disorders: A systematic review and meta-analysis.

This study aimed to assess the effects of High-intensity laser therapy (HILT) on individuals suffering from temporomandibular joint disorders (TMDs). A search was conducted across six electronic databases for randomized controlled trials (RCTs) focusing on HILT for TMDs: PubMed, Scopus, Web of Science, ScienceDirect, EBSCOhost, Cochrane Library, the PEDro database and Google Scholar (last updated on July 18, 2024). Eligible studies were chosen by independent reviewers, and their quality was assessed with the Cochrane risk of bias tool (RoB). The main outcome was pain intensity (VAS), with secondary outcomes including mouth opening (mm), disability (JFLS-20), and quality of life (OHIP-14). A meta-analysis was conducted to assess the pooled effect by calculating mean differences (MD) for these variables (95% confidence level). The heterogeneity of the meta-analyses was explored using the I2 statistic. Three studies met the selection criteria and were included in the meta-analysis. The main RoB was the blinding of participant and treaters. Statistically significant differences (p < 0.05) in favor of HILT were observed for VAS and maximum mouth opening. The pooled effect showed an MD of -14.8mm (95% CI:-27.1,-2.5) for pain intensity and 3.7mm (95% CI:0.9,6.5) for mouth opening, changes that were assessed as clinically important. According to GRADE, the evidence was rated as important, and the certainty was moderate due to the heterogeneity between studies. A sensitivity analysis was not performed to address heterogeneity, primarily due to the limited availability of RCTs. HILT has been found effective in short-term pain relief and improvement of jaw opening in TMDs, potentially enhancing quality of life by facilitating activities such as chewing, jaw mobility, and communication. However, further research is needed to confirm its long-term effectiveness. Combining HILT with interventions such as occlusal splints or therapeutic exercises could potentially enhance its effects, leveraging the existing evidence supporting these treatments. It is important to note that the high RoB associated with the lack of blinding of participants and treaters may influence data collection, compromising the internal validity of findings in some studies.

Clinical profile of Brazilian patients with temporomandibular joint disorder and orofacial pain: A 20-year retrospective study

ObjectiveTemporomandibular joint disorder (TMD) comprises several musculoskeletal conditions in the orofacial region, with chronic pain and/or dysfunction involving the temporomandibular joint (TMJ) and masticatory muscles. This study assessed the clinical characteristics of patients with TMD treated at a public tertiary care facility in Brazil. MethodsIn this retrospective study, we assessed data from adult patients attending the Center for Occlusion, TMD, and Orofacial Pain at a Brazilian school of dentistry, from 2000 to 2020. Data from eligible charts were collected: demographic variables, clinical complaints, location of pain, pain intensity (10-point VAS), duration of treatment, and therapeutic procedures. Data were analyzed using descriptive and inferential statistics at the 0.05 significance level. ResultsThe sample consisted of 2324 patients (79.4 % females) with a median age of 38 years and median duration of treatment of 35 days. Major clinical complaints were craniofacial pain (including in the TMJ region) (82.9 %), self-reported bruxism (clenching/grinding) (44.6 %), and clicking/crepitation (39.1 %). Craniofacial pain was associated with female gender and age of 39 years and older, but not with bruxism. The most frequent procedures were counseling (96.5 %), exercises (47.5 %), occlusal splints (18.5 %), and physiotherapy (13.8 %). Reduction in pain intensity was moderately associated with multiple (3 or more) therapies and longer duration of treatment. ConclusionIt can be concluded that the patients presented a diversity of clinical characteristics requiring individualized treatment. A multimodal, interdisciplinary therapeutic approach, including counseling, appears to benefit most patients with TMD-related pain.

Physical therapy in addition to occlusal splint in myogenic temporomandibular disorders: A randomised controlled trial.

Myogenic temporomandibular disorders (M-TMD) commonly involve occlusal splint (OS) therapy and musculoskeletal physiotherapy (MPT). To compare the effects of combining OS with MPT and education (EG) against OS and education (CG), in chronic M-TMD patients. In this double-blind randomised controlled trial, 62 participants were assigned to either EG or CG. The primary outcomes, pain levels at rest (VAS rest), maximum oral opening (VAS open) and during chewing (VAS chew), were measured by Visual Analogue Scale (VAS) in cm. The secondary outcome was the range of motion (ROM) for maximum oral opening. Both interventions lasted 3 months, with outcomes assessed at baseline (T0), post-treatment (T1) and 3 months post-treatment (T2). Intention-to-treat analysis revealed significant improvements favouring EG (VAS rest = -1.50 cm [CI95%: -2.67, -0.32], p = .04; VAS open = -2.00 cm [CI95%: -3.23, -0.75], p < .01; VAS chew = -1.71 cm [CI95%: -2.90, -0.52], p = .01; ROM = 4.61 [CI95%: 0.93, 8.30], p = .04). Additionally, VAS measures were influenced by follow-up times (VAS rest = -0.73 cm [CI95%: -1.30, -0.17], p = 0.03; VAS open = -0.97 cm [CI95%: -1.57, -0.37], p < .01; VAS chew = -1.15 cm [CI95%: -1.73, -0.58], p < .01). At T1, EG demonstrated higher number of responders compared to CG for VAS open (χ2(1) = 4.39, p = .04) and VAS chew (χ2(1) = 11.58, p < .01). Adding MPT to education and OS yields better outcomes in terms of pain reduction and ROM improvement, in chronic M-TMD. NCT03726060.

Efficacy of occlusal splint versus sleep hygiene and progressive muscle relaxation on perceived stress and sleep bruxism: A randomized clinical trial.

The objective was the comparison of an occlusal device (OD), and sleep hygiene and progressive muscle relaxation (SH & PMR) on perceived stress and sleep bruxism activity (burst/episode and episode/hour) in participants with sleep bruxism. Sixty-six participants with self-reported sleep bruxism were selected and randomly allocated into two groups: OD group or SH & PMR group. Assessment of perceived stress and sleep bruxism activity were the primary outcomes. The Perceived Stress Scale-10 (PSS-10 scale) was used to measure perceived stress and bruxism episodes/hour and bursts/episode recorded by electromyography of masseter and temporalis. These outcomes were assessed at baseline, 1 month, 6 months, and 1 year. The paired t-test assessed changes in PSS-10 scores and sleep bruxism activity within the same group over different time points (baseline, 1 month, 6 months, and 1 year). The unpaired t-test compared scores between two groups (OD and SH & PMR) at each time point to evaluate intervention differences. The chi-square test compared gender distribution between both groups. PSS-10 scores were found to decrease with the OD at 1 month and 6 months compared to baseline and SH & PMR at all subsequent follow-ups. This decrease was not statistically significant (p>0.05) between the OD and SH & PMR groups at all follow-ups. OD and SH & PMR significantly reduced bruxism episodes/hour and bursts/episode at all follow-ups (p<0.05). There were no adverse effects related to any intervention. The ODand SH & PMR both effectively reduced PSS-10 scores over 6 months and significantly decreased bruxism episodes and bursts per episode. Both methods are safe and effective for managing sleep bruxism and reducing stress.

Oral Health Assessment in Cleft Lip & Palate Patients During Orthodontic Treatment for Maxillary Protraction: A Periodontal & Microbiological Study.

To assess the oral health status and microbiota of subgingival plaque in patients with surgically repaired cleft lip and palate (CLP) during orthodontic treatment for maxillary protraction with two different orthodontic appliances. Randomized controlled trial. Institutional. A total of 90 patients with surgically repaired Unilateral Cleft Lip and Palate, out of initially enrolled 120 patients, were divided into 3 groups: experimental group I, experimental group II and control group, with 30 subjects each. Patients with a history of oral prophylaxis in last 6 months or antibiotic therapy within 3 months were excluded from the study. Bone Anchored Maxillary Protraction was done in experimental group I, while facemask with acrylic occlusal splint was used for maxillary protraction in experimental group II and no orthodontic intervention in control group. Plaque Index (PI), Gingival Index (GI), Gingival Bleeding Index (GBI), Probing Depth (PD), and microbiota of subgingival plaque (P. gingivalis, P. intermedia, Veillonella and Capnocytophaga) were compared at baseline (T0) and after 8 months (T1). The PI, GI, GBI and PD were observed to be significantly higher in experimental group II followed by experimental group I as compared to control group at 8 months interval (P < .001). The microbiota counts increased significantly in experimental group II and experimental group I (P < .001), as compared to control group. Maxillary protraction with facemask and bone plates was found to be a better alternative than facemask with occlusal splint, considering the overall oral health of patients with CLP.

3D Printed Occlusal Splints for Tmds Treatment: A Case Report

3D Printed Occlusal Splints for Tmds Treatment: A Case Report

Evaluation of the efficacy and quality of life in patients with temporomandibular joint disorders treated with Kovacs digital occlusal splint: a pilot study

BackgroundFew studies have been conducted on treating temporomandibular disorders (TMDs) with new digital occlusal splints, which has increasingly attracted wide attention.MethodsTo evaluate the clinical efficacy and quality of life (QoL) of Kovacs digital occlusal splint (KDOS) treatment in patients with TMD.Materials and methodsEighty-nine patients with TMD who were treated using KDOS were analyzed. The patients were divided into three groups according to the Wilkes stage. The clinical symptoms and QoL scores of the patients in each group were recorded before and at least three months after treatment, and the data were statistically analyzed and compared. The relationships between the disease severity, sex, age, and level of QoL before treatment and improvement in the clinical symptoms were analyzed using binary logistic regression.ResultsThe mean age and follow-up period of the patients were 28.0 ± 10.4 years and 4.9 ± 2.1 months, respectively. After KDOS treatment, the improvement rates of joint noise and pain were 80.4% and 69.8%, respectively. Additionally, the patients’ maximum mouth opening and global QoL mean scores significantly improved compared to those before treatment (p < 0.001). Binary logistic regression analysis revealed that the factors affecting the improvement in the clinical symptoms were disease severity and level of QoL before treatment.ConclusionsKDOS can improve the clinical symptoms and QoL of patients with TMD. Moreover, patients without osteoarthritis and with low pretreatment QoL levels are more likely to demonstrate clinical improvement.Trial registrationThe trial was registered with Chinese Clinical Trial Registry (ChiCTR) (ID: ChiCTR2300076518) on 11/10/2023.

Lifespan of Splints in a Sample of German Soldiers Hospitalised with Post-traumatic Stress Disorder (PTSD) in Combination with Sleep Bruxism and Painful Temporomandibular Disorder (TMD).

This cross-sectional longitudinal observational study aimed to clarify the question of whether painful temporomandibular disorders (TMD) in psychiatrically confirmed patients hospitalised for post-traumatic stress disorder (PTSD) therapy after using splint therapy (ST) show long-term therapeutic effects in the case of functional disorders. One hundred fifty-three (153) inpatients (123 male and 20 female soldiers, age 35.8 ± 9.2 years, 26.6 ± 2.2 teeth) with confirmed PTSD (Impact of Event Scale - Revised ≥33), grade 3 to 4 chronic pain according to von Korff's Chronic Pain Scale and the research diagnostic criteria of painful TMD (RDC-TMD) were recorded. All participants received a maxillary occlusal splint that was worn at night. Control check-ups of the therapeutic effect of the splint were conducted for up to 9 years during psychiatric follow-ups. TMD pain worsened in 22 (14.4%) patients within the first 6 weeks and led to the removal of the splint. The pain intensity (PI) at BL was reported to be a mean of VAS 7.7 ± 1.1. Six weeks after ST (n = 131), the average PI was recorded as VAS 2.6 ± 1.3. Based on the last examination date of all subjects, the average PI was recorded as 0.7 ± 0.9. Seventy-two (72) patients used a second stabilisation splint in the maxilla after 14.4 ± 15.7 months, and 38 patients used between 3 and 8 splints during their psychiatric and dental treatment time (33.7 ± 29.8 months). The presented data shows that therapeutic pain reduction remained valid in the long term despite continued PTSD. The lifespan of a splint seems to be dependent on individual factors. Long-term splint therapy appears to be accepted by the majority of patients with PTSD and painful TMD.

The role of nutraceuticals in the management of temporomandibular disorders.

Temporomandibular disorders (TMDs) are usually treated with occlusal appliances and supportive treatments such as physical therapy and drugs. Supplements can be included among potential supportive therapies, with the aim of reducing the use of drugs. To evaluate the efficacy of nutraceuticals' short-term treatment in subjects with temporomandibular disorders. The study started in January 2021 and ended in January 2022. Subjects with temporomandibular disorders and a verbal numeric scale >40 were recruited and randomly assigned to one of the following groups. If waiting to start a therapy, to the nutraceutical group or to the no treatment group, while if already undergoing splint therapy, to nutraceautical+splint group or to splint therapy group. Nutraceutical used was composed by Boswellia Serrata Casperome, Magnesium, Tryptophan and vitamins B2 and D with a posology of one tablet/day before sleep for 40days. Presence of temporomandibular pain, headache, neck pain and sleep/emotional disorders were assessed at T0 and at T1, after 40days. ANOVA was performed to compare treatments with nutraceuticals and theirrespective controls, as for the variables related to painful symptomatology. Chi- Squared was conducted to assess differences in sleep/emotional disorders between groups. The statistical significance was p<0.05. The groups using nutraceuticals showed statistically significant improvements over controls for most of the variables analyzed. The use of nutraceutical seems to be a valuable support for TMD therapy in the short term either alone or combined with occlusal splint therapy.

A New Method in Dealing With Children's Condylar Fracture by Botulinum Toxin A Injection in Lateral Pterygoid Muscle.

Condylar is one of the most vulnerable sites to be traumatized in pediatric mandible fracture, while temporomandibular joint ankylosis might be the most severe complication of condylar fracture in children. There exists a long-time controversy on the treatment of condylar fractures in children. Considering the risk of facial nerve injury and a certain probability of absorption or even ankylosis after open reduction and internal fixation (ORIF) of condylar fractures, a series of nonsurgical approaches are preferred in cases without severe malocclusion or shortening of the ramus. Our treatment plan was carried out through combining procedures of Botulinum toxin A injection in lateral pterygoid muscle with ORIF of para symphyseal fracture; subsequently, a conservative way of the occlusal splint with elastic traction was performed. Three patients of bilateral or unilateral condylar fractures, aged between 2y and 6y, were involved in this treatment. After more than 1 year's follow-up, the occlusion was satisfactory in all patients. Condylar remodeling was approximately complete in 3 months, and no unwanted complications were observed. We may expect this method to offer a new idea when dealing with children's condylar fracture.

Assessment of Temporomandibular Joint Disorders: Retrospective Study of Clinical Presentations.

This retrospective research aimed to assess the clinical presentations and management strategies for "temporomandibular joint (TMJ)" disorders. Medical records of patients diagnosed with TMJ disorders between 2017 and 2022 were retrospectively analyzed. Data collected included demographic information, clinical symptoms, radiographic findings, treatment modalities, and treatment outcomes. Statistical analysis was performed to examine associations between variables and treatment outcomes. A total of 150 patients were included in the research, with a mean age of 42.5 years. The most common presenting symptoms were pain (80.0%), limited mouth opening (60.0%), and clicking/popping sounds (40.0%). Muscle tenderness (53.3%) and jaw deviation (20.0%) were also observed. Treatment modalities encompassed pharmacotherapy, physical therapy, occlusal splints, and surgical interventions. Statistical analysis revealed significant associations between certain demographic characteristics and clinical presentations. This research provides valuable insights into the clinical presentations and management strategies for TMJ disorders. Pain, limited mouth opening, clicking/popping sounds, muscle tenderness, and jaw deviation were among the common symptoms observed. A multi-disciplinary approach involving various healthcare professionals is essential to optimize patient outcomes and improve quality of life for individuals affected by TMJ disorders.

Dental rehabilitation of a patient with a decrease in bite height due to pathological abrasion of hard tooth tissues (clinical case)

At the present stage of diagnostics and treatment of dental diseases, morphofunctional disorders of the dento-maxillary system associated with a decrease in the height of occlusion are becoming more common. In the scientific literature, this pathological condition is described under the name "occlusion" that decreases. The reasons that cause it include partial or complete loss of teeth, irrational prosthetics and untimely restoration of dentition defects, doctors' mistakes in the restructuring of the masticatory apparatus, and a generalized form of pathological abrasion of hard tooth tissues. The purpose of the study – demonstration of a clinical case of pathological abrasion of hard tissues of teeth with a decrease in bite height, complicated by defects in the dentition. Patient S., 47 years old, applied for orthopedic help with complaints of anatomical deformity, significant abration of teeth on the upper and lower jaws, increased sensitivity to various types of irritants, partial absence of teeth, impaired masticatory function, periodic clicking in the temporomandibular joint, aesthetic and phonetic defects. Based on the data obtained, we established the following diagnosis: generalized form of pathological abrasion of hard teeth tissues, subcompensated form of reduced bite height, complicated by defects in the dentition of the upper jaw – class I according to the Kenedy classification, lower jaw – class III according to the Kenedy classification. The loss of chewing efficiency according to Agapov was 68%. Patient S. was recommended a two-stage orthopedic treatment, which involves preliminary separation of the bite with the help of individual vinyl mouth guards which have an increasing thickness of 2, 4 and 6 mm, made for the lower jaw.The planned treatment period with each of the muscle relaxant splints will be 2 months. Subsequently, 15, 14, 13, 12, 11, 21, 22, 23, 24 will be restored with one-piece metal crowns with ceramic cladding, and the final defects in the lateral areas will be restored with a clasp prosthesis with a locking system of fixation. The included defect of the lateral part of the lower jaw is planned to be restored with a metal-ceramic bridge-like prosthesis with a support on 47, 45, 44, and the worn-out hard tooth tissues will be completely restored with photopolymer material. In patients with a reduction in bite height of more than 2 mm, it is advisable to carry out treatment in two stages. At the first stage, we normalize the occlusal height and rebuild the function of the masticatory muscles. At the second stage, we provide rational prosthetics. Orthopedic rehabilitation with myorelaxing splints of increasing thickness makes it possible to correctly rebuild myostatic reflexes and prevent functional disorders in the TMJ. Any case of complex treatment of patients with a decrease in bite height due to pathological abrasion of the hard tooth tissues deserves the attention of both scientists and dentists in practical health care.

The use of polyetheretherketone material as an occlusal splint

Occlusal splint is a treatment alternative that gives positive results in reducing the symptoms of temporomandibular diseases. This treatment involves placing an appliance made of various materials specifically for the cutting and chewing surfaces of the teeth. The most popular materials used in the construction of occlusal splints are soft and hard acrylic-based materials such as polymethylmethacrylate, ethylene vinyl acetate, polycarbonate, polyethylene terephthalate and polyetheretherketone. PEEK is a high performance, semi-crystalline, thermoplastic and thermally stable polymer belonging to the polyaryletherketone family. PEEK, which has very good dimensional stability against intraoral temperature changes, is not affected by the intraoral chemical environment. Since PEEK material is chemically stable, has high biocompatibility and abrasion resistance, its use as an occlusal splint material has become widespread today. The aim of this review is to provide information about occlusal splints produced using PEEK material and digital procedures, which are becoming increasingly popular in dentistry, and to contribute to the literature.