Mouthguard Research Articles

Optimizing the treatment of patients with intrinsic temporomandibular joint disorders

Temporomandibular joint (TMJ) dysfunctions are conditions in which there is a disruption in the anatomical and functional relationship between the various structures of the joint, including the articular disc, intra-articular ligaments, mandibular head and capsule. These disorders have a negative impact on the patient’s quality of life, resulting in limitations in masticatory function and articulation. The multifactorial nature of this pathology emphasizes the need for an individualized and comprehensive approach to the treatment of each patient. In most cases, treatment includes both surgical and orthopedic methods. Currently, combined treatment approaches aimed at synergistic effects are being actively developed to maximize therapeutic Results.The purpose of this study. To evaluate the efficacy of the combination of treatment with a repositioning mouthguard and the use of the hydraulic articular disk repositioning method in patients with internal TMJ disorders combined with dental row end defects.Materials and methods. The study included 6 patients with TMJ dysfunction and end defects of the dentition. The study was conducted between September 2023 and May 2024. As part of the study, each patient underwent cone beam computed tomography (CBCT) to evaluate the bony structures of the TMJ and ultrasound (US) to evaluate the soft tissue structures of this joint.Results. The CBCT data showed that the mean posterior temporomandibular joint displacement before treatment was 1.67, while this value increased to 3.02 after treatment. The US results showed a significant decrease in the mean value of mandibular head displacement after treatment ranging from 0.21 to 0.03, indicating a positive effect of treatment. In addition, there was a decrease in the difference in the size of the anterior and posterior parts of the articular disc, confirming the elimination of its displacement.Conclusion. The treatment combination of using a repositioning mouth guard with the hydraulic repositioning method brought about a synergistic effect on the restoration of TMJ function.

Manual Therapy Techniques Versus Occlusal Splint Therapy for Temporomandibular Disorders: A Systematic Review with Meta-Analysis

Background: Manual therapy (MT) and occlusal splint therapy (OST) are the most conservative therapies applied on patients with temporomandibular disorders (TMDs). The aim was to compare the efficacy of MT vs. OST in improving pain, maximal mouth opening (MMO), disability, and health related-quality of life (hr-QoL) in these patients. Methods: According to PRISMA guidelines, a meta-analysis (CRD42022343915) was conducted including randomized controlled trials comparing the effectiveness of MT vs. OST in TMD patients, after searching in PubMed, PEDro, SCOPUS, and WOS up to March 2024. Methodological quality and risk of bias were assessed using the PEDro Scale. Cohen’s standardized mean difference (SMD) and its 95% confidence interval (95% CI) were the pooled effect measures calculated. Results: Nine studies, providing data from 426 patients, were included. Meta-analyses revealed that MT is more effective than OST in reducing disability (SMD = −0.81; 95% CI −1.1 to −0.54) and increasing MMO (SMD = 0.52; 95% CI 0.27 to 0.76) without differences for improving pain intensity and hr-QoL. Subgroup analyses revealed the major efficacy of OST in reducing pain in myogenic patients (SMD = 0.65; 95% CI 0.02 to 1.28). Conclusions: With caution, due to the low number of studies included, MT may be more effective than OST for improving disability and MMO in patients with TMDs.

Comparison of Compression of Occlusal Splint Materials: Laboratory Mechanical Analysis

Objective: To perform a compression test to fill the gap in the literature, assess the change in the construction angle (0º, 45º, 90º) as well as investigate physical and microstructural characteristics. Theoretical Framework: Comparisons of compression tests of occlusal splint materials printed in 3D are not described in the literature, which makes informed decision making on the choice of materials complicated. Method: The materials printed in 3D using the SLA method were resins. After printing, the materials were submitted to compression (calculating the Poisson coefficient), shore hardness and density tests. Results and Discussion: Dima® Print Ortho achieved the best results in terms of compression strength and maximum deformation in the vertical position (90º) in comparison to the other materials, followed by Self BioPrint Splint Hard, PriZma 3D Bio Splint and Cosmos Splint. Research Implications: Three-dimensional devices through additive fabrication can be used in the treatment of bruxism. The position to obtain greater compression strength is vertically at 90º. Originality/Value: This study contributes to the literature by demonstrating the efficacy of 3D printing of occlusal devices using the resin polymerization method, highlighting the superior dimensional accuracy and mechanical properties of the materials employed. Furthermore, it addresses the sustainability of the process by promoting material waste reduction during fabrication. These findings have significant implications for optimizing the production of occlusal devices in clinical settings.

Understanding the clinical management of co-occurring sleep-related bruxism and obstructive sleep apnea in adults: A narrative and critical review.

Sleep-related bruxism (SRB) is a motor oral behavior characterized by tooth grinding and jaw clenching activity, reported by 8%-12% of the adult general population and 3% of older individuals. The frequency of one of its biomarkers, rhythmic masticatory muscle activity (RMMA), remains elevated across ages. Obstructive sleep apnea (OSA) is associated with the brief and repetitive pause of breathing (apnea) and with transient reduction in oxygen (hypoxia). OSA is observed at all ages and in about 50% of older individuals with a male preponderance. SRB clinical assessment is based on self-reporting of tooth grinding sound, awareness of clenching, jaw pain or headache, and clinical observation of tooth damage. OSA clinical assessment is based on sleepiness and fatigue, snoring, sleep quality, and awareness of breathing cessation, plus clinical examination of anatomical factors (e.g., obesity, retrognathia, large tonsil, macroglossia), age, gender, and body mass. Although the literature does not support association or causality between these two conditions, the co-occurrence is reported in about 30%-50% of adults. To confirm a diagnosis of co-occurring SRB and OSA, home sleep testing (HST) may be indicated. A sleep test is performed using electromyography (EMG) of jaw muscle (masseter or temporalis) and cardio-respiratory variables (e.g., air flow, respiratory effort, oxygen level, heart rate). The management of co-occurring SRB and OSA for individuals with prosthodontic needs is challenging to prevent compromising the oro-pharyngeal space and breathing efficiency. OSA treatment in the presence of SRB includes continuous positive airway pressure (CPAP) use alone or with an occlusal splint or mandibular advancement device (MAD). In addition, the following may be considered: supine sleep correction device, myofuncional therapy, medications, and surgeries. All have limitations and risks. Individual variability suggests that phenotyping is mandatory to select the most efficient and personalized treatment.

Assessment of parental attitude, knowledge and awareness towards preventive dentistry in south zone of Chhatrapati Sambhajinagar: A questionnaire based cross sectional survey

Introduction: Oral health is a pivotal aspect of overall well-being. In early childhood, primary teeth play a vital role in development of speech, chewing, maintaining proper spacing, and guiding the eruption of permanent teeth. Common oral conditions comprise dental caries, malocclusion, childhood caries, and trauma. Aim: The present study was conducted to assess paternal knowledge towards the forestallment of oral conditions and application of preventive dental procedures in children in South zone of Chhatrapati Sambhajinagar. Materials and Methods: A cross-sectional questionnaire was administered to parents of pediatric patients of age group 3 to12 years in South zone of Chhatrapati Sambhajinagar, Maharashtra, with a sample size of 270 participants. A structured questionnaire, comprising 14 questions in English, was developed, translated and back translated into the local language Marathi by experts to ensure better comprehension by the parents. The questionnaire was divided into two sections: the first focused on demographic information, while the second included 14 multiple-choice, close-ended questions. These questions included topics such as preventive treatments for dental caries, childhood caries, topical fluoride application, fluoridated toothpaste, pit and fissure sealants, habit-breaking dental appliances, malocclusion, mouth guards, and space maintainers. Additionally, the survey addressed harmful habits such as thumb-sucking, tongue-thrusting, and nail-biting. Result: 56.6% of parents sought dental care only after experiencing pain. Additionally, parents of paediatric patients have restricted knowledge about preventive dentistry. Conclusion: Parental knowledge about preventive dental procedures is limited, as is the utilization of these measures.

Influence of 3D printing system, postpolymerization and aging protocols on resin flexural strength and dimensional stability for printing occlusal splints, models and temporary restorations.

Investigate the effect of different postpolymerization protocols, aging, and 3D printing systems on the flexural strength (σ), dimensional stability, and roughness of resins used to fabricate occlusal splints, dental models, and temporary restorations. 180 bars (25 × 2 x 2mm-ISO 4049) of each type of resin (T-Temporary/Cosmos Temp, Yller; OS-Occlusal splint/Cosmos Splint, Yller; MO - Models/ Cosmos Model, Yller) were printed and divided into 12 groups (n = 15) according to the factors: "Postpolymerization" (Ctr - Control; UV - Ultraviolet oven and MW - Microwave); "Printer" (SLA- stereolithography (Forms 2/Formslab); LCD- liquid crystal display (FlashForge Foto 6.0/FlashForge)) and "Aging" (TC - 10,000 thermocycling cycles and Without). Each bar was measured with a digital caliper at 11 points before and after postpolymerization to evaluate dimensional stability. The samples were subjected to the σ test (100Kgf;1mm/min). Data was evaluated using Three- and Two-way ANOVA, and Tukey's test (5%). Weibull analysis, Scanning Electron Microscopic and optical profilometry was performed. LCD printing system and UV oven postpolymerization exhibited the highest σ (P < .05). The groups printed in SLA and post-polymerized in microwave ovens showed the greatest variations in their dimensions, for the occlusal splint resin, the OS-SLA-MW group (-4.29 ± 3.15)A showed a shrinkage of 40.2%. The resins for models (3.31 ± 0.66)A and temporary (-2.06 ± 1.52)A showed a shrinkage of 33% and 20.6%, respectively. LCD printing with UV light postpolymerization was the most effective method for resins used in occlusal splints, dental models, and temporary restorations. SLA printing with UV postpolymerization showed the most significant dimensional changes, leading to shrinkage in occlusal splint resins, while model resins and temporary restorations expanded. Resins for 3D printing should ideally be post-polymerized with UV light and printed using LCD technology, as this approach results in better mechanical properties and less dimensional change compared to microwave oven post-polymerization.

Pain Catastrophizing and Functional Activation During Occlusion in TMD Patients-An Interventional Study.

In temporomandibular disorder (TMD), the effects of standard interventions such as using an occlusal splint and its impact on pain relief and pain catastrophizing are poorly understood. Earlier work pointed to a crucial role of insula activation with changes in pain relief by occlusal splint treatment. We performed a functional imaging study using specially developed splint systems to allow for a placebo-controlled longitudinal design. Using functional MRI we examined 20 TMD patients during repetitive occlusal movements at baseline and over the course of splint therapy and also collected self-reported pain catastrophizing. For balancing performance between baseline and after intervention we used occlusion force measures in an individualized fMRI-splint system. Splint therapy lasted for approximately 7 weeks with one group selected by randomization wearing a palatine placebo splint over the first 3 weeks (delayed start; 11 individuals). As expected, fMRI activation in areas involved in pain processing (insula, primary and secondary somatosensory cortex) decreased with intervention. At baseline a positive correlation between activation of the left anterior insula and pain catastrophizing was present. Both parameters decreased over intervention while associations were primarily observable for patients with rather mild TMD.

Efficacy of added splint therapy after arthrocentesis vs arthrocentesis alone in the management of temporomandibular joint disorders: a systematic review and meta-analysis.

Occlusal splints are commonly used in the management of temporomandibular joint (TMJ) disorders (TMD). However, it is unclear if it should be used after a second-line therapy like arthrocentesis. We systematically reviewed the evidence on the efficacy of post-arthrocentesis splint therapy in the management of TMD. PubMed, Embase, Scopus, Web of Science, CENTRAL, and Google Scholar were searched for studies published until 5th August 2024. The outcomes assessed were pain and maximal mouth opening (MMO). Eight studies were included. Five studies reported data for the meta-analysis. The pooled analysis found that there was no statistically significant difference in pain scores in the arthrocentesis &#43; splint group vs arthrocentesis group at 1 month (MD: -0.01 95% CI: -0.46, 0.44), 3 months (MD: -0.02 95% CI: -0.67, 0.63) and 6 months (MD: 0.06 95% CI: -0.25, 0.37). The pooled analysis also showed that splint therapy after arthrocentesis may not significantly improve MMO as compared to no splint therapy at 1 month (MD: 0.08 95% CI: -2.11, 2.27), 3 months (MD: 0.76 95% CI: -0.84, 2.35) and 6 months (MD: 0.56 95% CI: -0.65, 1.78). Descriptive analysis of three studies showed that two supported the use of splints while one found no added improvement in outcomes. Limited evidence from low-quality studies shows that the use of splint therapy after arthrocentesis may not improve pain and MMO in patients with TMD. High-quality randomized controlled trials are needed to improve evidence.

Temporomandibular joint space variation and masticatory muscle activation during clenching with full versus partial covering occlusal splints

ObjectivesOcclusal splints are the main therapeutic choice in the treatment of temporomandibular disorders (TMD). However, their precise working mechanism is unclear. This study aimed to compare the biomechanical effect of three commercially available splint designs (full covering splint, anterior bite splint and posterior bite splint) during biting in a sample of healthy subjects.Materials and methodsMagnetic resonance imaging (MRI) was combined with jaw tracking to measure the minimal intraarticular distance (MID) of 20 human temporomandibular joints (TMJ) whilst simultaneously recording the electromyogram (EMG) of the masticatory muscles. The changes caused by clenching with a bite force of 100 N without splint (baseline) and on each splint were calculated. Repeated measures ANOVA was performed on the means of the MID variations and EMG amplitudes.ResultsClenching on the anterior bite splint resulted in two times less activation of the anterior temporalis muscle than baseline (p = 0.003), full covering (p = 0.011) and posterior bite splint (p = 0.011). MID was reduced by clenching in all conditions, but the reduction was almost three times larger with the anterior bite splint compared to no splint (p = 0.011). The full covering splint and the posterior bite splint did not differ significantly in EMG activation of both masseter and temporalis muscles and MID variation.ConclusionsThis study showed that splint designs have a different impact on the MID and EMG activation while clenching. The anterior bite splint had a greater impact on the reduction of the muscle activation, whereas clenching on the anterior bite splint led to bigger reduction of MID and thus had the greatest influence on alteration in the condylar position.Clinical relevanceThe design of the splint can affect MID and muscle activation and is a variable to consider in the treatment of patients with TMD according to their symptoms.

Recent evaluation and analysis of the clinical effect of two closed treatment methods in children with intracapsular condyle fracture

Objective: To summarize and analyze clinical characteristics of pediatric mandibular condylar fractures and the long-term therapeutic effects of closed treatment. Methods: A retrospective study was conducted for pediatric condylar fracture in the Department of Oral and Maxillofacial Surgery of Peking University School and Hospital of Stomatology from October 2015 to October 2019, including 33 males (67.3%) and 16 females (32.7%), with an average age of (8.3±2.1) years old. According to the treatment methods, the children were divided into two groups: group A was a removable occlusal splint accompanied with functional exercise, group B was a pure functional exercise. Forty-nine cases (76 sides) children with intracapsular condylar fracture were included in this study. Twenty-three cases in group A and 26 cases in group B. The maximum month opening increased from (20.0±6.2) mm to (46.0±5.3) mm 6 months after closed treatment. Subjective evaluation, special examination, qualitative analysis and quantitative analysis of imaging were used to evaluate the condylar remodeling and functional recovery of temporomandibular joint in two groups of children after closed treatment of intracapsular condyle fracture. Results: There was no significant difference in subjective evaluation, maximum opening examination, mouth open-type, mandibular protrusion, lateral movement and qualitative analysis of imaging at the six-month follow-up after injury. Quantitative imaging measurements showed that the condylar anteroposterior diameter and condylar height in Group B were significantly higher than those in Group A after 1 year of injury. Conclusions: Closed treatment for pediatric condylar fractures can achieve satisfactory results. After 6 months of injury, the children in the two groups could recover the temporomandibular joint function and promote the condylar adaptative remodeling.

Use of Hypnosis in the Treatment of Orofacial Pain: A Systematic Review.

Objectives: To conduct a systematic review on the use of hypnosis in the treatment of orofacial pain. Methods: The search was performed on February 2021 and updated in July 2024 in the following databases: MEDLINE via PUBMED, Virtual Health Library (VHL), Web of Science, Cochrane Library, Embase, Clinical Trials, ISRCTN Registry, Psycinfo, Open Grey, Google Scholar, and Brazilian Digital Library of Theses and Dissertations (BDTD). The descriptors referring to Orofacial Pain and hypnosis were used to select clinical trials on the use of hypnosis in the treatment of Orofacial Pain, in English, Spanish, Portuguese, French, and Italian, without restriction on date and place of publication. In a first stage, two independent, trained, and calibrated reviewers classified the abstracts and then the full texts. The data were extracted, and the risk of bias was assessed using the Cochrane RoB 2.0 tool. Results: Of the 642 references identified, 6 studies-published between 1986 and 2010-were included in the review, with 232 patients reported. Hypnosis was mainly used in cases of chronic pain associated with temporomandibular disorders (TMDs), compared with relaxation sessions, acupuncture, occlusal splint, minimal treatment, or no interference. Hypnotherapy was applied in different ways, either exclusively by professionals or by means of self-hypnosis in a complementary or exclusive manner. All studies showed statistical significance for the effect of the intervention (hypnotherapy). The overall RoB2 consisted of three studies with high risk of bias and three studies with some concern. Conclusions: Although there were clinical studies on the subject and they had methodological flaws, hypnotherapy (induction and/or self-hypnosis) appears to be a promising strategy for the treatment of orofacial pain, especially TMDs. There is, therefore, a need for new randomized clinical studies with adequate methodological standards to confirm the findings.

Cytotoxicity assessment of eluates from vacuum-forming thermoplastics.

This study aimed to evaluate possible cytotoxic effects of thermoplastic materials commonly used for occlusal splints and orthodontic appliances. Seven thermoplastics were included: three variants of the Essix sheets (C+, Plus, and Tray Rite; Dentsply Sirona), three thermoplastics (Bleach Heavy, Splint, and X-Heavy; Cavex Holland) and Invisalign (Align Technology). Cylindrical specimens (n = 24; 10mm diameter) were incubated in cell culture medium for 24h and 14 days. After incubation, the medium was collected, serially diluted, and dosed to primary human gingival fibroblasts in triplicate. Medium processed like the samples was used as negative control. Cell viability was evaluated by XTT and LDH assay to assess metabolic activity and membrane integrity, respectively. Next, cell cycle was assessed with flow cytometry after exposing HGFs to undiluted extracts. The 24-hour and 14-day extracts did not evoke cytotoxicity after 24-hour incubation. No significant differences in cell viability (one-way ANOVA, p > 0.05 ) in the XTT and LDH assays or in cell cycle distribution between the different materials (two-way ANOVA, p > 0.05 ). The thermoplastics tested in the study showed no evident in-vitro cytotoxic effects. Further investigation should focus on determining which compounds are released from thermoplastic materials and assessing potential toxicity related to exposure to these compounds. Our study adds to the growing body of evidence on the biocompatibility of dental thermoplastics. This can aid clinical decision-making, as thermoplastics are expected to be safe to use in terms of cytotoxicity.

Evaluation of the single and combined therapeutic effects of individually manufactured earplug therapy in patients with myogenous temporomandibular disorders: A randomized controlled clinical trial

ObjectiveTo evaluate the effect of individually manufactured earplug therapy on pain intensity (PI), symptom severity (SS), and maximum mouth opening (MMO), in patients with myogenous temporomandibular disorders (TMD).MethodsOne-hundred-twenty patients were randomly allocated to six groups: Groups EP (earplug), OS (occlusal splint), EX (exercise), EPO (earplug with occlusal splint), EPE (earplug with exercise), and C (control). Outcomes were PI (assessed with a visual analog scale (VAS)), SS (assessed with the modified Symptom Severity Index Questionnaire (mSSI)), and MMO (evaluated with a digital caliper). Measurements were performed at T0 (before the therapy), T1 (1-month follow-up), and T2 (3-month follow-up). Data were analyzed using one-way analysis of variance (ANOVA), Tukey’s HSD, and chi-square tests (alpha = 0.05).ResultsAt T1 and T2, the greatest VAS and mSSI reduction was detected for the groups EPE (VAS = 5.3 ± 1.05, 3.3 ± 0.7; mSSI = 38.2 ± 2.27, 43.6 ± 3.94) and EPO (VAS = 5.2 ± 0.91, 3.2 ± 0.78; mSSI = 36.3 ± 3.97, 42.2 ± 3.19), respectively (p < 0.05). At T1, occlusal splint groups (groups OS (34.8 ± 2.97 mm) and EPO (33.8 ± 3.49 mm)) gave the highest MMO values, while T2 values did not constitute a significant difference with T1 (p > 0.05).ConclusionsThe short-term use of combined earplug therapy resulted in a decrease in both PI and SS. Improvement in MMO in participants using occlusal splints was observed in the 1st month and was maintained through the 3rd month.Clinical RelevanceEarplug therapy can be applied as a complementary therapy to occlusal splint and exercise treatments to decrease PI and SS in patients with myogenous TMD. To achieve functional recovery such as MMO, its combined use with splints should be taken into consideration by clinicians.

Effects on Sleep Bruxism Activity of Three Different Oral Appliances: One Year Longitudinal Cohort Study.

Different oral appliances (OAs) have been proposed to control sleep bruxism (SB) detrimental effects on the stomatognathic system. The aim of the study was to evaluate the effect of different OAs on SB activity and masticatory muscle activity (sMMA) measured by EMG. This longitudinal cohort study was conducted on 51 patients (21 M, 30 F, mean age 26,5 ± 3,5) suffering from SB diagnosed with a validated portable EMG-ECG holter and wearing different OAs: occlusal splints, functional appliance with metallic bites and clear aligners followed after 1 week, 1 month, 3 months, 6 months and 12 months from delivery. A control group of 16 non-treated SB patients (6 M, 10 F mean age 27,1 ± 1,4) was used as a reference. A multiple regression analysis was performed to estimate the differences between groups. The level of significance was set as P value <0,05. Occlusal splint reduced sleep bruxism index after 1 week, 3, 6 and 12 months from delivery while functional appliance only after 12 months. Occlusal splints reduced general phasic contractions only in the first week and sleep bruxism-related phasic contractions at 1 week, 3 and 6 months after delivery with no significant reductions after 12 months. Patients wearing clear aligners showed a reduction in general tonic contractions after 6 and 12 months. Resin and metal bites can reduce sleep bruxism index, while resin bites can reduce sleep bruxism-related phasic contractions. Clear aligners do not influence sleep bruxism index but can reduce tonic contractions.

Evaluation of flexural strength of dental occlusal splints resins

Evaluation of flexural strength of dental occlusal splints resins

Laser therapy versus occlusal splint and local anesthesia injection in management of myofascial pain dysfunction syndrome.

Laser therapy versus occlusal splint and local anesthesia injection in management of myofascial pain dysfunction syndrome.

Patients' Satisfaction after the Treatment of Moderate Sleep Apnea and Nocturnal Bruxism with Botox or/and Thermoformed Occlusal Splints: A Pilot Study.

Background: Sleep apnea and nocturnal bruxism belong to sleep disorders that can affect the quality of life. The aim of this study was to investigate the effects on patients with moderate sleep apnea and nocturnal bruxism of Botox injection as monotherapy or associated with wearing thermoformed occlusal splints and to determine the patients' satisfaction degree after the applied treatments. Methods: The selected patients for study were divided into two groups: in the first group, the patients (n = 18) treatment consisted of injecting Botox (Allergan) into the masseter muscle as monotherapy; in the second group, the patients (n = 18) benefited from associated therapy, Botox injections in masseter muscle, and the wear of thermoformed occlusal splints. At baseline, at three weeks, at three months, and six months after the effectuation of therapies, the monitoring sessions were realized. Results: The associated therapy presented better results in decreasing the studied symptoms than the monotherapy. Both therapies improved patient satisfaction. Conclusions: The applied therapies for treating the specific symptomatology in moderate sleep apnea and sleep bruxism were efficacious. Patient satisfaction was very good in both groups after the applied treatments, but the associated therapy presented better results than monotherapy.

Assessing the Impact of IOS Scanning Accuracy on Additively Manufactured Occlusal Splints.

Introduction: Digital workflow and intraoral scanners (IOSs) are used to clinically obtain data for a wide range of applications in restorative dentistry. The study aimed to compare two different IOSs with inexperienced users in the digital workflow of oral split manufacturing. Material and Methods: Anonymous stone models of upper and lower dentate patients were used. Both models were scanned with a desktop 3D scanner 3Shape D2000 to obtain the reference models (STLR). Ten inexperienced operators scanned each model three times with each IOS system (3Shape TRIOS 3 and Carestream CS 3800). Finally, 20 intraoral scanners were randomly chosen from the obtained dataset (10 per IOS system) to design and manufacture 20 nightguards. All the nightguards were scanned. Trueness and precision were calculated and compared between the two IOS systems. Results: All the mean errors both for trueness and precision were below 40 µm, more than acceptable for the design and manufacturing of intraoral devices such as nightguards. All the mean errors (except one) for trueness between the inner part of the nightguards and the upper control model were below 100 µm, less than a printed layer height. For inexperienced operators, both IOSs are suitable for a digital workflow of manufacturing occlusal splints.

Effectiveness of results of complex treatment of pathological wear of hard tissues of teeth

Background:Tooth wear is a multifactorial condition that results in the loss of hard dental tissue. Physiological wear does not usually result in any subjective symptoms. Pathological abrasion of hard dental tissues is accompanied by both morphological and functional disorders of the dental system Objective: To evaluate the functional and aesthetic results of complex treatment of pathological abrasion of dental hard tissues. Materials and methods: This is a prospective controlled study that included 82 patients with a clinically confirmed diagnosis of Increased tooth wear of the first and second degree of severity (from 2020 to 2024). The age of the patients ranged from 34 to 68 years (48 men, 34 women). The examination of patients included: collecting complaints and identifying concomitant somatic diseases, X-ray examination, photographs of the patient's face, bite height, and nasolabial folds. Distribution of the group: Group 1 included patients with the first degree of hard tissue loss 47 (29 men, 18 women) Group 2 included patients with the second degree of hard tissue damage 35 (21 men, 14 women). During examination, patients complained of aesthetic defects caused by tooth wear and discoloration, discomfort when closing, chewing and phonetic disorders, typical symptoms of TMJ dysfunction, such as pain and crunching in the joints, fatigue of the masticatory muscles and muscle pain, displacement of the lower jaw to the side during vertical movements, a feeling of distension in the ears, headaches and bruxism. In patients of group 1: tooth wear was restored with orthopedic structures. In patients of group 2: temporary prosthetic structures and occlusal splints were used to normalize occlusal relationships in case of TMJ and masticatory muscle dysfunction. Gradual raising of the bite was carried out by means of a set of kappa-splints for 14 days, 1 month and 3 months from 1.0 to 5.0 mm until complete restoration of the occlusal height depending on the severity of pathological abrasion of teeth, abrasion of teeth restored by orthopedic structures. Dynamic observation of the clinical condition of the prosthesis structure was carried out in the following periods: 1 week, 1, 6, 12, 24 months,assessment of the condition of the performed restorations were recorded in the medical record of the dental patient. Results:Clinical radiological results showed satisfactory results and are encouraging in patients of groups 1 and 2. After treatment in patients of groups 2, according to the analysis of the lateral teleroentgenogram of the head, an increase in the height of the lower third of the face is noted, in 28 patients the nasolabial folds were smoothed out. Patients were satisfied with the aesthetic and functional results of the treatment Conclusions: The results of the study showed that treatment using occlusal splints at the preparatory stage in patients of group 2 with occlusion disorders due to pathological abrasion of hard dental tissues and restoration with orthopedic structures is relevant for normalizing the occlusal relationships of the jaws and this complex treatment method provides a good aesthetic and functional result.

Comparison of Trigger Point Lidocaine Injection and Stabilization Splint Use in Myofascial Orofacial Pain Treatment

Objective: This study aims to compare the short-, medium-, and long-term efficacy of trigger point local anesthetic injection and stabilization splint use for myofascial orofacial pain. Materials and methods: Group 1 comprised 15 patients who received trigger point local anesthetic injections (LAI), while Group 2 comprised 15 patients who were treated with a stabilization splint (SS). Analysis of pain-free maximum mouth opening (MMO) measurements, jaw disability checklists (JDC), short-form McGill pain questionnaires (SF-MPQ), and Visual analog scales (VAS) were used for comparison between the groups. Results: The LAI group showed a significantly greater increase in pain-free MMO in all terms (p &lt; 0.001) and had significantly lower values on the JDC in both the medium (p = 0.026) and the long term (p = 0.006). The SF-MPQ was significantly lower in the medium term (p = 0.001) in the LAI group; the VAS showed a significantly greater decrease in the short (p = 0.016) and medium terms (p &lt; 0.001) in the LAI group. Conclusion: The results indicate that a treatment choice can be made between TN lidocaine injection and occlusal splint based on patient tolerance.