Mouthguard Research Articles

Biomechanical behavior of customized splint for the patient with temporomandibular disorders: A three-dimensional finite element analysis

The mechanical overloading of temporomandibular joint (TMJ) is generally linked to temporomandibular disorders (TMD). However, in patients with a typical combination of maxillofacial morphology and occlusal features, the reduction of joint load and treatment with general occlusal splints are often ineffective. This study investigates the biomechanical behavior of the stomatognathic system in a TMD patient with personalized splints by finite element analysis. The therapeutic position, determined based on the intercuspal position, served as the basis for designing personalized customized splints. The design of occlusal contact and splint structure was evaluated in terms of their impact on the maximum stress level in the TMJ and the biting forces on the dentition. The relationship between joint stress and biting force was further examined during treatment with different customized splints. In preoperative case, there was a significant increase in stress level and stress concentration in the medial to posterior band of the articular disc. However, in all customized splint cases, the highest stress area shifted to the intermediate zone and exhibited a decrease. Notably, the bi-splints demonstrated superior ability in relieving overloading and balancing the occlusal force on both sides of the dentition, as verified by clinical treatment. The predictable simulated results offer valuable interactive information regarding TMJ overload, aiding doctors in making better-informed clinical decisions in future.

Rapid prototyping: A future in orthodontic

<abstract> <p>The term “rapid prototyping” (RP) refers to a variety of methods for creating “physical models based on computer-aided design and computer-aided manufacturing”. With the aid of RP technology, practically any variation of the surface and interior anatomical structure may be replicated in a medical model that is constructed layer by layer. To create the physical model, layer-by-layer construction is carried out using a variety of processes, including stereolithography, selective laser sintering, inkjet printing, and fused deposit modeling. Data for RP is received from magnetic resonance imaging and computed tomography scans, which are then turned into digital images and then into standard triangulation language files. The use of this computerized programming in orthodontics incorporates “diagnosis and treatment planning”, the creation of removable “orthodontic appliances”, “impression trays” for indirect bonding, “3D printed occlusal splints and aligners”, prototype models used in various orthognathic surgeries, and the production of a distractor for distraction osteogenesis. It increases a crucial understanding at the time of preoperative treatment planning and raises the effectiveness of the therapy, yet, clinical judgment is still essential. Applications of RP for an orthodontist vary, and if we utilize it creatively, the future appears more hopeful. This article briefly reviews key advancements, challenges, and prospects in the integration of rapid prototyping and 3D printing, shaping a promising future for orthodontics.</p> </abstract>

Finite element analysis of stabilization splint pressure distribution in a patient with disc displacement without reduction: A preliminary study.

This study was performed to investigate the pattern of condylar pressure distribution in the discs of a patient diagnosed with disc displacement without reduction. This research consisted of a pre- and post-test observational clinical study. A patient diagnosed with disc displacement without reduction underwent treatment with an occlusal splint for 3 months. Finite element analysis employed a 3-dimensional model constructed from magnetic resonance images of the patient, taken both before the application of the splint and 3 months after its use. The post-test model demonstrated a decrease in condylar pressure on the disc, with measurements dropping to 72 MPa from the pre-test level of 143 MPa. In the pre-test, the pressure distribution pattern was concentrated on the lateral posterior border, whereas in the post-test, it shifted toward the intermediate zone of the disc. Utilization of a stabilization splint for 3 months resulted in decreased pressure and a marked change in the pressure distribution pattern on the temporomandibular disc.

Prótese sobre implante em pacientes com bruxismo

ABSTRACT Objective: This study aimed to review the literature on the types of treatments proposed for patients with bruxism and implant supported, discussing a treatment protocol for those patients, for the purpose of prolonging the treatment longevity. Methods: A literature search in MEDLINE (PubMed), Google Scholar and SciELO databases, with the analysis of the literature published between 2006 and 2024. The descriptors used were “bruxism” and “dental implants” and “Dental Prosthesis, Implant-Supported”. Results: A total of 47 articles were identified in the PubMed online database, 24 in Google Scholar, 1 in SciELO, with a total of 72 articles. After reading the titles and abstracts, 56 works were selected, which were read in full. After full analysis of the studies and application of the inclusion and exclusion criteria, 13 articles remained that were included in this review. Conclusion: The study discusses the key factors to success of implant supported prosthesis treatment in patients with bruxism, which is a relevant risk factor for implant failure. The characteristics of the implant, such as the surface, modulus of elasticity, grade of titanium, diameter, length, location of the implant, implant-protected occlusion, type of prosthesis material and the need for an occlusal splint.

Evaluation of the effects of occlusal splint and masseter muscle injection in patients with myofascial pain: a randomised controlled trial

Myofascial pain is one of the common symptoms in patients with temporomandibular joint disorders (TMD). Occlusal splint (OS) and masticatory muscle trigger point (TP) local injections are primary treatment options. We aimed to investigate the effects of these treatments using clinical and elastography measures. Patients who were diagnosed with myofascial pain according to Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) were included. There were 16 patients in each group. Group 1 was treated with occlusal splint, Group 2 was treated with occlusal splint and masseter muscle lidocaine injection, Group 3 was treated with masseter muscle lidocaine injection and Group 4 consisted of healthy volunteers. Degree of pain and maximum mouth opening (MMO) were recorded. Masseter muscle stiffness was evaluated by Shear wave elastography. Measurements were repeated at 1st and 3rd months of post-treatment. Pain decreased at all times in all the patients (p = 0.001). Pain in Group 2 and Group 3 approached 0 level at 3rd month. MMO increased from baseline to 1st month and from 1st month to 3rd month and masseter stiffness decreased from baseline to 1st month and to 3rd month (p = 0.001) in all groups. Occlusal splint and masseter muscle lidocaine injection were effective in reducing pain and increasing MMO in patients with myofascial pain. All treatments reduced masseter muscle stiffness. All the treatment modalities had clinically similar and successful outcomes.

Occlusal effects on text reading: an eye-tracker study.

Asymmetric electromyographic (EMG) activity during teeth clenching has been linked to cognitive impairment, as evaluated by the Spinnler-Tognoni matrices test, and to asymmetric pupil size (anisocoria). Anisocoria indicates an asymmetric Locus Coeruleus activity, leading to an asymmetric hemispheric excitability worsening cognitive performance. Bite splint wearing corrects EMG asymmetry, reduces anisocoria and improves cognitive performance. This study explores the possible effect of EMG asymmetry on oculomotor behavior during text reading. In subjects showing different degrees of EMG asymmetry during clenching, the number and duration of fixation periods during a reading task, performed under two different occlusal conditions were analyzed. The first lecture was executed with a dental impression (imprint) interposed between the dental arches (corrected condition) and the second one with the arches in direct contact (habitual condition), without clenching effort. The imprint reduced the EMG asymmetries during clenching. In both occlusal conditions, total reading time correlated with duration of fixations, but not with their number. An inverse relation was observed between the number of fixations and their duration across individuals. Fixation frequency and duration were positively and negatively correlated with the amplitude of EMG asymmetry, respectively. Differently, total reading time was not related to the EMG asymmetry. When switching from the corrected to the habitual condition, an increase in the number of fixations and a reduction in their duration was observed, while total reading time could be either increased or decreased. An increased fixation frequency was observed in most of the subjects, while a reduced duration only among individuals with shorter reading times in habitual condition. In the habitual condition, EMG asymmetry influences reading patterns (more saccades/shorter fixations, less saccades/longer fixations) in our sample. The changes in text reading behavior elicited by occlusal correction can be explained by assuming that occlusal disharmony negatively interferes with the reading task by increasing the number of saccades necessary for text scanning. This finding may also indicate an increased difficulty in processing of visual information. The potential involvement of trigeminal pathways in the relation between occlusal factors and oculomotor control is discussed.

Impact of Using Mouth Guard on The Ventilatory Responses and Oxygen Consamption to Incremental Exercise in Combat Athletes

Bu çalışmanın amacı, mücadele sporcularında koruyucu sporcu dişliği kullanımının aşamalı artan egzersiz sırasında solunum cevapları ve oksijen tüketimine etkisini araştırmaktır. Sporcu dişliği kullanmaya alışkın on bir üst düzey erkek mücadele sporcusuna, koşu bandında rastgele çapraz deney deseni doğrultusunda koruyucu dişlikli ve dişliksiz olarak iki defa egzersiz testi uygulanmıştır. Oksijen tüketimi, dakika ventilasyonu ve solunum frekansı test sırasında dört submaksimal şiddet noktasında (3., 6., 9. ve 12. dakikalarda) kaydedilmiş ve ayrıca her değişkenin maksimum değerleri belirlenmiştir. Verilerin analizi için tekrarlı ölçümlerle iki yönlü varyans analizi (deneme x zaman) ve eşleştirilmiş örneklemlerde t-testi kullanılmıştır. Tekrarlı ölçümlerde iki yönlü varyans analizine göre oksijen tüketimi (p<0.01) ve dakika ventilasyonu (p<0.01) ve solunum frekansı (p<0.01) değişkenlerinde zaman için anlamlı ana etki bulunmuştur. Ancak, submaksimal yoğunluklarda denemeler ve deneme-zaman etkileşimleri için anlamlı bir ana etki tespit edilmemiştir. Dişlik kullanılarak yapılan test sırasında belirlenen maksimum soluk frekansı değerlerinde anlamlı düşüş (p<0.05) tespit edilmiştir. Maksimum soluk frekansı dışında, diğer değişkenler açısından sporcu dişliği kullanılan ve kullanılmayan denemeler arasında anlamlı bir fark saptanmamıştır. Sonuç olarak, sporcu dişliği kullanmaya alışkın olan erkek üst düzey mücadele sporcularının sportif performans sırasında dişlik kullanmasının solunum fonksiyonları ve oksijen tüketimine olumsuz bir etkisi olmadığı görülmüştür.

Fully digital workflow for the fabrication of occlusal stabilization splints based on individual mandibular movement

ObjectiveThis study was conducted to present a completely digital workflow for the fabrication of occlusal stabilization splints using CAD/CAM systems and a digital face bow based on optical sensor technology. MethodsDigital scans of the maxillary and mandibular arches of 20 volunteers were obtained using an intraoral scanner. Jaw relation and mandibular movements were recorded with a digital face bow via optical sensors. The virtual increase of the vertical dimension of occlusion (VDO) was then performed, after which computer-aided design (CAD) of the occlusal stabilization splints was carried out. The corresponding splints were then manufactured using digitally controlled technology. ResultsA completely digital workflow for the manufacturing of occlusal stabilization splints was found to be clinically feasible. The corresponding data analysis revealed high congruence between virtual and physical occlusal contacts on the occlusal splint. Moreover, the appropriate guidance of the anterior teeth area was easily obtainable, and the time for adjusting the occlusion was less. ConclusionsThis study demonstrated that the fabrication of occlusal stabilization splints using a fully digital workflow is feasible. Compared to traditional impression-based manufacturing, several advantages of digital manufacturing include easy accessibility, time-efficient manufacturing, high-level accuracy in splint quality, and potential to manufacture duplicate splints. Clinical significanceThe proposed fully digital approach may help young dentists fabricating stable occlusal splints with beneficial curative effects. Meanwhile, it could also improve the production efficiency of stable occlusal splints, saving time for both doctors and patients while reducing labor costs.

(Invited) Cavitas Biosensors for Non-Invasive Monitoring of Blood Chemicals

More than ten years have passed since various wearable sensors such as wristband sensors have been developed and commercialized, but most of them are for the purpose of measuring physical information such as heart rate. In medical and healthcare science, wearable sensors that measure biological and chemical information from the body are required. Of course, biosensing of interstitial fluid chemicals is possible like Abbott's Libre, but there is a need for non-invasive and unrestrained sensing techniques, and the development of such wearable sensors will expand future market size.We have developed several cavitas biosensors targeting the chemical analytes in the human body cavities. So far, we have developed a soft contact lens-type glucose sensor, enabled continuous measurement of tear glucose, and reported its correlation with blood glucose levels. In addition, we fabricated a mouth guard type sensor with excellent aesthetics incorporating a small potentiostat and a Bluetooth transmitter (total weight: 1 g) and reported that it is possible to monitor oral information with some smart-watches with Bluetooth communication.In addition, we constructed an imaging system that converts blood-derived gas components into bio-moving images and succeeded in producing moving images of percutaneous gases from various skin surfaces. As a result, we found that transcutaneous gas can be stably and highly sensitively measured from the external auditory canal. As a new cavitas biosensor, we also fabricated headset-type gas sensors to monitor not only percutaneous ethanol gas after drinking alcohol, but also acetone gas (a lipid metabolite) from the ear canal, thus indicating the possibility of a new wearable biosensor.In this presentation, I will discuss the above research results and the possibility of future non-invasive wearable biosensors such as cavitas devices. Figure 1

Temporomandibular disorders, occlusal splints, and treatment options: a survey-based investigation

Background: The term "temporomandibular disorders" (TMDs) refers to a group of painful conditions that affect both the hard and soft orofacial anatomical structures. The primary objectives of TMD treatment are to lessen pain and enhance mandibular movements, re-establishing proper functioning. One of the widely used treatment options for TMDs pathology is the occlusal splint. This non-invasive intraoral device, determines both the muscle relaxation and reversibly repositions the temporomandibular joint structures. The study aimed to compare the efficacy of different occlusal splint designs or materials in managing TMD symptoms. Methods: Twenty-six patients, nineteen of whom were female and seven of whom were male, ranging in age from twenty to seventy, met the criteria needed participate in this study. Two different questionnaires were formulated: a patient-focused and a clinician-focused questionnaire. The patient's data encompassed general health status and TMD signs and symptoms, whereas the clinician's questions addressed assessment and treatment alternatives, including the particularities of occlusal splint therapy. Results: The majority of the patients were diagnosed with disc displacement with reduction (61.5%), followed by myalgia (26.9%). The only form of treatment preferred by physicians was the Michigan occlusal splint, which was mainly used on the maxillary dental arch (84,6%). After the splint therapy was completed and the intended results were obtained, the treatment plan was finished using selective grinding, prosthetic dental restorations, orthodontic therapy, or a combination of these procedures. The patient was required to continue physical therapy (7,7%), wear a full-arch night guard (42.3%), and undergo rigorous periodic control sessions (34.6%) to maintain the final aesthetic and functional results. Conclusions: Occlusal splints are an efficient and reliable initial therapy preference for patients with temporomandibular disorders. In addition to improving symptoms in the temporomandibular joint, occlusal splints may determine mandibular repositioning, which also implies a variety of treatment approaches, ranging from the minimally invasive to the most complex, to achieve a functional occlusal status.

Current developments in bruxism identification

Background and Objectives: Bruxism is a parafunctional activity that can have several causes. Patients with bruxism need an interdisciplinary approach to treatment planning and individualized treatment options. The present study evaluates dentists' knowledge of the bruxism condition and their need for further education. Diagnosis and treatment methods used by practicians from different specialties are emphasized. Materials and Methods: A prospective cross-sectional, observational, and analytical cohort study was conducted. It employed a questionnaire based on information on etiology, diagnosis, and treatment methods and included data from 80 dental practitioners from Cluj County. Results: Most dentists (81.3%) recognized awake and sleep bruxism as separate entities. Most participants identified psychological status as the primary etiological factor (80%), followed by occlusal interferences (13.8%) and other factors (genetics). Anamnesis and clinical examination were performed for bruxism diagnosis (90%). Occlusal balance (%) and occlusal splints (%) were the most encountered treatment methods. Only 27.5% of the practitioners referred patients to other specialists. Physiotherapy and psychotherapy were the primary interdisciplinary approaches. Cognitive behavioral therapy was employed by 43.8%, whereas pharmaceutical therapy by 20% of the practitioners. Conclusions. There is a need for standardized training among dentists due to a lack of information on this topic. When combined with an interdisciplinary approach, complementary diagnostic methods such as polysomnography and BruxApp can yield accurate diagnosis.

Recording the maxillomandibular relationship with the Aqualizer system prior to occlusal splint therapy for treating temporomandibular disorders: a randomized controlled trial

Temporomandibular disorders (TMD) present a public health issue and are one of the most common musculoskeletal conditions causing chronic pain. This study compares the outcomes of occlusal splint therapy in patients with TMD following two different maxillomandibular relationship (MMR) registration techniques. 40 TMD patients were randomly allocated to MMR registration with the Aqualizer system (AQU) or with chin point guidance (CPG) prior to fabricating occlusal splints. TMD symptoms, subjective pain intensity, and quality of life (QoL) were recorded at baseline and after 3 and 6 months. The treatment led to an overall reduction of TMD symptoms in both groups (Conover test, p < 0.00001). TMJ sounds, TMJ pain with palpation and muscle pain with palpation subsided regardless of the type of MMR registration method used (Cohen’s d > 0.8). AQU-based occlusal splints led to a better improvement of TMJ pain with maximum opening compared to CPG-based occlusal splints (Cohen’s d = 0.9; CPG d = 0.13). In both groups, occlusal splint treatment had little to no effect on correcting lateral mandible deviation or improving restricted jaw opening. After 6 months occlusal splints in both groups had a large effect on improving subjective pain intensity (Cohen’s d > 0.8), however, patients reported a higher QoL in the AQU group compared to the CPG group (Mann–Whitney-U-test, p < 0.05). The results of this study support the premise that occlusal splints are effective in relieving pain-related TMD symptoms. The Aqualizer can be considered for determining MMR in cases, where guided registration techniques are not possible.Trial registration: DRKS00031998.

COMPLEX TREATMENT OF INTERNAL TMJ DISORDERS IN PATIENTS WITH DIFFERENT BIT TYPES

Objective: To assess the impact of physiological and pathological types of occlusions on the effectiveness of the treatment of patients with internal disorders of the TMJ. Material and Methods: A comprehensive examination and treatment of 139 patients with internal TMJ disorders with subluxation and chronic dislocation of the articular disc was carried out. The patients were divided into three groups. All groups included patients with both physiological and pathological occlusion. The first group included 28 (20.1%) patients who were treated only with occlusal splint therapy; the second group included 95 (68.3%) patients who were treated with a combination of occlusal splint therapy and the use of arthrocentesis; in the third group (16 people (11.5%), along with splint therapy and arthrocentesis, TMJ arthroscopy was performed. The examination included a survey and examination of patients, a study of diagnostic models of the jaws to determine the types of occlusion and occlusal contacts, magnetic resonance imaging (MRI) and ultrasound examination (ultrasound) of the TMJ. Patients underwent a phased treatment, including occlusive splint therapy (stage I); with insufficient effectiveness - occlusive splint therapy and arthrocentesis (stage II); occlusive splint therapy and arthrocentesis in combination with arthroscopy (stage III of treatment). Results: As a result of the study, it turned out that the groups of patients differed significantly in the complexity and duration of the treatment. Thus, in patients with internal TMJ disorders and pathological type of occlusion, in 82.6% of cases, additional use of arthrocentesis was required and in 34.8% - arthroscopy (95 patients out of 139), while patients with physiological types of occlusions (orthognathic, progenic, biprogenic and direct) needed these treatments in 80.2% and 7.8% of cases, respectively In the groups of patients, the duration of therapy, as well as the number of arthrocentesis performed in patients at the second and third stages of treatment, significantly differed. In the first group, the duration of treatment was 6.2 months for patients with normal occlusion and 8.7 (p&lt;0.01) months for patients with pathological occlusion; additional methods of treatment (arthrocentesis and arthroscopy) were not used. In the second and third groups of patients, the duration of treatment for patients with occlusion pathology was also longer: in the second group 4.9 and 6.8 (p&lt;0.01) months for patients with physiological and pathological types of occlusions, respectively, in the third group with the use of splint therapy, arthrocentesis and arthroscopy in patients with normal occlusion was 13.1 (p&lt;0.05) months, and in patients with occlusion pathology 14.5 months Conclusion: Patients with internal TMJ disorders need a comprehensive examination for the timely detection of occlusion pathologies. The relationship between internal TMJ disorders and the type of occlusion must alway

Treatment with botulinum toxin of masseter hypertrophy, myalgia of the tendons and attrition induced by bruxism

Bruxism is a disabling condition in which unconscious contractions of the masticulatory muscles lead to teeth grinding and jaw clenching. Symptoms include toothache, temporomandibular dysfunction, headache and attrition. Treatment options range from conservative approaches to invasive interventions. Education, stress reduction, avoidance of stimulants, and relaxation techniques can help in mild cases. Wearing an occlusal splint can reduce attrition. Botulinum neurotoxin type A (BoNT-A) injections are a treatment option temporarily causing partial paralysis of the masticulatory muscles. BoNT-A is a treatment for reducing symptoms and improving the quality of life of patients with bruxism that has been proven safe and effective. The effects usually last several months. To achieve the best results and minimize side effects, BoNT-A injections should be applied by an experienced practitioner.

Literature Review of an Anterior Deprogrammer to Determine the Centric Relation and Presentation of Cases.

The increasing demand for dental aesthetics, articulation corrections, and solutions for pain and frequent bruxism demands quick and effective restorative dental management. The biomedical research aimed to create a beneficial, ecological, and readily available anterior deprogrammer to determine the centric relation (CR) of cases. This medical device is additively manufactured from a biocompatible material. Size is customizable based on the width of the patient's anterior central incisors. This is a pilot study with two subjects. The task was to develop a complete data protocol for the production process, computer-aided design (CAD), and three-dimensional (3D) printing of the anterior deprogrammers. The research focused on creating simple and practically applicable tools for the dentist's prescription (anterior deprogrammer in three sizes), and secondly for the communication between the dentist and the patient (computer application). The tested hypothesis was whether, according to these novel tools, it is possible to produce functional occlusal splints, which could be manufactured using current technologies. This study compared a traditional splint with a digitally designed and 3D-printed one. The tested hypothesis was whether manufactured occlusal splints differ in patients' subjective perception of comfort. Each conservative treatment was monitored for ten weeks. Initial results are promising; no statistically significant difference was found between the productive technologies.

Survival and Success of Dental Implants Placed in a University Setting

Purpose: The aim of this study was to assess the impact of experience and specialty training on the success and survival of dental implant therapy for single-unit fixed restoration of missing teeth in a university setting.&#x0D; Methods: A retrospective study was conducted using data from the electronic patient record system at the Adams School of Dentistry. The Office of Computing and Information Systems provided dental records from January 1, 2013 to December 31, 2018, following the inclusion criteria. The records were manually reviewed by one evaluator (TC). Extracted from the records were subjects’ demographics; medical, dental, and social history; implant parameters; grafting procedures; and timing of placement/restoration/loading. Also recorded were the specialty training and level of experience, i.e., pre-doctoral student, resident, and faculty; the restoration type; radiographic confirmation of osseointegration before restoration; and occlusal splint fabrication. Fisher’s Exact Test was applied to determine if the providers’ specialty training and experience had any statistical significance on implant success and survival.&#x0D; Results: A total of 501 implants were included in the study. Statistically significant were provider training (AEGD versus specialties, implant survival and success), subject’s gender (implant survival), implant type/manufacturer (implant survival and success), and immediate placement (implant survival). The overall survival rate was 97.0% while the success rate was 85.4%.&#x0D; Conclusion: The type of clinical training impacted implant outcome, only when comparing AEGD versus specialties. Operator’s experience has no significance on the results.

Aging Processes and Their Influence on the Mechanical Properties of Printable Occlusal Splint Materials.

Three-dimensional (3D)-printed occlusal splints are becoming more prevalent in the treatment of tooth substance loss due to their fast and cost-effective production. The purpose of this in vitro study was to investigate whether the mechanical properties (tensile strength-TS, modulus of elasticity in tension-ME, and Vickers hardness-HV) vary between the materials (printed dimethacrylate-based resins: Keyprint KeySplint soft-KEY, Luxaprint Ortho Plus-LUX, V-Print splint-VPR, printed methacrylate-based resins Freeprint splint 2.0-FRE, and milled methacrylate-based material, CLEAR splint-CLE), and the influence of aging processes (extraoral storage conditions and nightly or daily use) was examined. The printed methacrylate-based resins (FRE, LUX, and VPR) had much higher TS (43.7-48.5 MPa compared to 12.3-13.3 MPa), higher ME (2.01-2.37 GPa compared to 0.43-0.72 GPa), and higher HV (11.8-15.0 HV compared to 3.3-3.5 HV) than both of the methacrylate-based resins (KEY and CLE) after the production process. Although the TS, ME, and HV of the printed dimethacrylate resins (FRE, LUX, and VPR) decreased significantly under humid conditions with possibly elevated temperatures (thermocycling as well as 37 °C), these mechanical properties were significantly higher than both methacrylate-based resins (KEY and CLE). Therefore, printed dimethacrylate resins should be used rather than methacrylate-based resins for high expected masticatory forces, low wall thicknesses, or very long wearing times (≥6 months).

Digital jaw relation recording to evaluate a new vertical dimension of occlusion using CAD/CAM-fabricated tooth-colored splints: a case report.

Pronounced defects of the dental hard tissue can be caused by different etiologic factors. Most frequently, they are associated with changes in the vertical dimension of occlusion (VDO), which may also influence the condylar positions. These defects can lead to irreversible loss of tooth structure and have dramatic functional and esthetic consequences, often requiring complex rehabilitation. In this situation, CAD/CAM-fabricated occlusal splints made of tooth-colored polycarbonate are a proven and safe pretreatment approach in terms of esthetics and function. Rebuilding lost dental hard tissue to restore the occlusion and VDO to an adequate condylar position is a prerequisite for any sustainable and functional rehabilitation. In the future, digital systems will support this complex process, customizing it and making it simpler and more precise. The DMD-System (Ignident) provides patient-specific jaw movement data to optimize the CAD/CAM workflow. This system allows real movement patterns to be digitized and analyzed for functional and potential therapeutic purposes, integrating them into the dental and laboratory workflow. In the present case, the familiar tooth-colored CAD/CAM-fabricated occlusal splint is supplemented by digital centric jaw relation recording and individual movement data.

Prevalence of dental trauma in permanent anterior teeth in 6-12-year-old children in school going children of East Delhi

Background: Traumatic dental injury affects many children and adolescents, and it considered a challenging public health problem. Injuries involving permanent teeth are one of the most common types of trauma to the maxillofacial area. The prevalence of traumatic dental injuries varies greatly, and it ranges from 4% to 58% Methods: A cross-sectional survey was carried among 700 school children aged 6 and 12 years in East Delhi. A list of primary and secondary schools of East Delhi area was obtained. A multistage random sampling technique was adopted to select the study population. The children aged 6-12 years with signed consent and in whom permanent anteriors had erupted were included in the study. The oral examination was conducted by a single calibrated examiner using WHO oral health assessment Performa 2013. Results: Overall prevalence was 7.71%. Dental trauma was 1.90%, 10.27% and 10.12% respectively in Group I, Group II and Group III respectively. Female reported with 7.57 % and males with 10.81% (p=0.001). Maxillary Central incisors were found to be the most frequent teeth to be injured. Conclusions: Parents may lack information regarding the consequences of dental trauma and don't report for dental consultation. Along with seeking dental care, patient must be educated about the use of protective mouth guards while playing contact sports which may help to reduce the incidence and severity of dental injuries.

Comparative efficacy of different thicknesses of soft and hard splints in reducing clinical symptoms in patients with temporomandibular disorders

Introduction: The effectiveness of two soft and hard splint thicknesses in reducing temporomandibular joint (TMJ) pain and dysfunction was compared.&#x0D; Materials and Methods: Sixty patients with TMJ pain and dysfunction were randomly assigned to four groups (n=15); the patients treated with hard occlusal splints of 1 and 3mm thicknesses were assigned to Groups A and B, respectively, and those treated with soft occlusal splints of 1 and 3mm thicknesses were assigned to Groups C and D, respectively. Maximum mouth opening (MMO) and the severity of pain based on the visual analog scale (VAS) were assessed before treatment and after 7, 30 and 90 days.&#x0D; Results: After both 7 and 30 days, no significant differences were found between the groups for any variable (P&gt;0.05). However, Group C had a significantly lower MMO compared to Groups A and B after 90 days (P=0.001). Additionally, and in relation to masticatory muscle pain, Group C had a significantly higher VAS score than other groups (P&lt;0.05). The VAS score for TMJ pain at rest was also significantly higher in Group C compared to Groups A and B (P&lt;0.05).&#x0D; Conclusion: A 3-mm hard occlusal splint seems to be the best treatment to reduce pain and dysfunction of the TMJ.&#x0D;