Rigid Splints Research Articles

Bruxismo del sueño en el paciente infantil: revisión narrativa de la literatura.

Introduction: Sleep bruxism is a parafunctional activity in which clenching and/or grinding of teeth occurs in both the paediatric and adult population. Objective: To gather the most current knowledge available on the causes, diagnosis and treatment of sleep bruxism in children in order to facilitate the dentist and/or paediatric dentist's identification and appropriate management in daily clinical practice. Material and methods: An electronic bibliographic search of articles published in English between 1986 and 2023 on sleep bruxism in children under 14 years of age was carried out. Thirty-six articles were selected. Results: The prevalence of sleep bruxism in children ranges from 5 to 46%. Of multifactorial aetiology, its clinical manifestations are both intraoral and extraoral. Diagnosis in most cases is not easy and must be made by assessing not only its consequences but also the aetiological elements involved. Comprehensive treatment always requires an early and multidisciplinary approach combining psychological and dental techniques. The available evidence does not support the use of rigid splints in children. Conclusion: Current knowledge on sleep bruxism in children aims to focus on early diagnosis and aetiological treatment, but further studies are still needed to achieve a standardised and protocolised early diagnosis that will help clinicians' decision-making and improve the patient's quality of life in the short, medium and long term.

棉秆对夹拉拔试验台设计与试验

In order to explore the relationship between displacement-pulling force and the change of clamping force during the clamping and pulling process of cotton stalks in the field by different types of clamps, a test bench for cotton stalks clamping and pulling was designed. Based on the combination of virtual instrument technology and external hardware, the device is programmed by Gx Works2 and LabVIEW programming software to complete the operation of the test bench clamping and pulling device and the measurement and acquisition of information. From the mapping of the collected information, the average value of the maximum uplift force on the cotton stalks was 500 N, corresponding to an upward movement of 12 mm at the root of the cotton stalks. Through the collected information the effect of two types of clamps on cotton stalks clamping and pulling was analyzed, rigid splints with the clamping force of 750 N and a linear speed of 0.18m/s having the best effect on the cotton stalks clamping and pulling. Rubber splints have the best effect on cotton stalks clamping and pulling when the clamping force is 500 N and the linear speed is 0.36 m/s. Among them, the striped rubber splint has the best effect. The collected information was subjected to analysis of variance (ANOVA), and the results showed that the coefficient of friction of the clamping plate showed a high influence on both the pull-up force and the reduction of clamping force. Based on the obtained results, it can provide a reference for the design of clamping type cotton stalk harvesting machinery.

Knowledge, Attitude and Practice Towards Emergency Management of Avulsed Tooth among Dental Practionator in Pakistan: A Questionnaire-Based Survey

Background: The management of dental traumatic injuries, particularly avulsed permanent teeth, necessitates a comprehensive understanding and proficient clinical skills among dental practitioners. With the increasing prevalence of dental injuries due to various factors, the knowledge and practices of dentists in emergency and clinical management are pivotal for successful outcomes. This study aims to evaluate the current state of knowledge, attitudes, and practices among Pakistani dentists regarding the management of avulsed teeth, highlighting areas for improvement and adherence to international guidelines. Objective: To assess the knowledge, attitudes, and practices of dental practitioners in Pakistan concerning the emergency management of avulsed permanent teeth and to identify gaps in knowledge and practice compared to the International Association of Dental Traumatology (IADT) guidelines. Methods: A cross-sectional survey was conducted among 120 dental professionals in Pakistan, using an online questionnaire from August to September 2022. The survey comprised three sections: demographic information, knowledge and attitudes towards dental trauma education, and practices in the emergency management of avulsed teeth. Descriptive statistics were employed to analyze the data, utilizing SPSS version 25.0 for statistical analysis. Results: The survey revealed that 47.5% of respondents felt they received enough information during their undergraduate education, yet a significant proportion reported forgetting much of this knowledge over time. Regarding post-graduation knowledge sources, conferences and medical journals were the most cited (26.7% and 24.2%, respectively). In terms of practice, 79.2% correctly identified HBSS as the optimal storage medium for avulsed teeth, and 60% adhered to rinsing the tooth with saline before replantation. Awareness of the critical extra-oral dry time being under 60 minutes was noted in 59.2% of participants, and a majority were in favor of initiating root canal treatment 7 to 10 days post-replantation for teeth with a closed apex, aligning with IADT recommendations. However, a preference for rigid splints over flexible ones was observed in 54.2% of respondents, indicating a deviation from best practices. Conclusion: The study identified a satisfactory level of knowledge among Pakistani dentists regarding some aspects of avulsed tooth management but also highlighted significant gaps, particularly in the use of flexible splints and recollection of undergraduate training. Continuous education and adherence to IADT guidelines are essential for improving the management of dental traumatic injuries.

METHODOLOGICAL DEVELOPMENT OF PERSONALIZED ORTHOPEDIC SPLINTS THROUGH LOW-COST ADDITIVE MANUFACTURING

Orthopedic splints are widely used to immobilize parts of the body during the recovery from bone injuries, surgeries, or post-traumatic recovery. In the medical field, there are two main types of splints: the rigid and disposable ones made of plaster, and the non-disposable but detachable ones, typically made up of metallic and polymeric components. Rigid splints are economical and can be quickly applied, but they have limitations in terms of weight, ventilation, and comfort, and also require medical staff intervention for their removal. On the other hand, detachable splints offer greater comfort and breathability, but they are more expensive and their fit to the patient is less accurate. This work presents the development of personalized orthopedic splints, lighter and more breathable, at a reasonable cost and production time. To achieve this, a methodology is proposed that includes an economical scanning of the area to be immobilized, an accessible and efficient digital design, and its production using MEX additive manufacturing technology, meeting the necessary mechanical requirements for immobilization and stiffness, based on finite element simulations. This proposal is presented as an alternative to conventional splints, offering improved performance thanks to affordable and low-cost additive manufacturing technologies.

A hybrid orthosis combining functional electrical stimulation and soft robotics for improved assistance of drop-foot

Drop-foot is characterised by an inability to lift the foot, and affects an estimated 3 million people worldwide. Current treatment methods include rigid splints, electromechanical systems, and functional electrical stimulation (FES). However, these all have limitations, with electromechanical systems being bulky and FES leading to muscle fatigue. This paper addresses the limitations with current treatments by developing a novel orthosis combining FES with a pneumatic artificial muscle (PAM). It is the first system to combine FES and soft robotics for application to the lower limb, as well as the first to employ a model of their interaction within the control scheme. The system embeds a hybrid controller based on model predictive control (MPC), which combines FES and PAM components to optimally balance gait cycle tracking, fatigue reduction and pressure demands. Model parameters are found using a clinically feasible model identification procedure. Experimental evaluation using the system with three healthy subjects demonstrated a reduction in fatigue compared with the case of only using FES, which is supported by numerical simulation results.

Orthodontic Approaches in the Management of Mandibular Fractures: A Scoping Review.

Non-surgical approaches have been proposed in the management of mandibular fractures, especially in children, but there is a lack of clear guidelines on the clinical indications of conservative approaches. The aim of this scoping review is to provide the available evidence of the role of the orthodontist in the management of mandibular fractures. The PRISMA-ScR guidelines were followed to select eligible articles from the PubMed, Scopus, and Web of Science databases according to precise inclusion criteria. The research questions were formulated as follows: "what is the scientific evidence concerning the rule of orthodontists in the management of mandibular fractures" and "the preferential use of the direct bonding technique with orthodontic brackets rather than rigid arch bars"? Seventeen articles were included. Five articles presented the use of removable acrylic splints or functional appliances, six articles concerned the employment of cemented acrylic or rigid splints, and six articles described the management of mandibular fractures in adults and children using orthodontic brackets or mini-screws. Most of these techniques have been employed in children and growing subjects, while fewer data were available regarding conservative treatments in adults. Preliminary evidence suggests that condylar and some minor parasymphyseal fractures in children may be managed with conservative approaches. In adults, minor condylar and stable body mandibular fractures with minimal displacement have been reduced similarly. However, there are no sufficient elements that could suggest the preferential use of orthodontic brackets over rigid arch bars in adults. Further randomized and non-randomized clinical trials with long follow-ups will be needed to better define the clinical indications of the orthodontic approaches in the management of mandibular fractures based on severity, location, and age.

Mechanical evaluation of dental trauma splints fabricated using recently-developed photo-polymerizable composites.

This study aimed to determine functionality and mechanical properties of dental splints. Five splints were tested: a control splint Filtek Z350XT (ZF), two splints with G-Fix (GF) and Light Fix (LF), and two wire-composite splints with ZF (ZW) and Ortho Connect Flow (CW). Periotest values, elastic modulus, flexural, compressive, and diametral tensile strength were measured. ZW and CW showed no significant differences in flexibility in labial or occlusal pressure of upper central incisors. LF, GF, and ZF did not differ in labial or palatal pressure. ZW and CW had higher flexibility than LF, GF, and ZF. LF had the lowest flexural and compressive strength but the highest diametral tensile strength. This study showed that ZW and CW might be options for flexible splints, whereas LF and GF would be options for rigid splints. Additionally, CW and LF/GF might be simpler alternatives to ZW and ZF, respectively.

Influence of immobilization mode on postoperative clinical data a month after an ACL reconstruction in athletes admitted to rehabilitation center

To determine the influence of immobilization mode on postoperative clinical data a month after an ACL reconstruction in athletes admitted to rehabilitation center. We analyzed post-operative data from a recorded cohort between 4 and 6 weeks after ACL ligamentoplasty. Were included patients with first ACL reconstruction on complete rupture in athlete came to the “Centre européen de rééducation du sportif” and aged at least 15 years 9 months. They follow a specialized rehabilitation protocol from 1st February 2008 to 30th October 2010. Clinical results were analyzed at hospital release between 4 and 6 weeks. The rehabilitation protocol was common to all patients. Clinical outcome parameters were quantitative (patella mobility, quadriceps atrophy, pain measurement by EVA, range of motion and scores: subjective IKDC and PPLP1) and qualitative (trophicity by measurement of the knee effusion and subquadricipital bursa flexibility, functional assessment quadriceps lock, walk evaluation). The patients were divided according to immobilization mode: orthosis articulated rigid or no brace. We have found no significant difference between each of three groups for each parameter studied ( P < 0.05). We do not have rupture in the three groups. There was not difference among the three groups for the qualitative and quantitative parameters, markers of decreasing inflammation and functional improvement at 4–6 week. In specialized center, orthosis establishment whatever the type or not put it, does not influence the early postoperative clinical results and evolution in patients with an ACL ligamentoplasty of the athlete. These results lead us to wonder about the value of the orthotics prescription, particularly articulated very expensive compared to simple rigid splints.

Afferent sensory mechanisms involved in jaw gape-related muscle activation in unilateral biting

In unilateral biting or chewing, the working/balancing-side ratio (W/B-ratio) of masseter activities is inversely proportional to the jaw gape which was interpreted as a neuromuscular strategy to protect occlusion. This suggests that jaw separation is afferently perceived, raising the question how this perception might work. In related studies, isometric biting was exerted on rubber pieces that slightly yielded similar to compressed food in chewing. We hypothesized that minor jaw movements associated with this yielding are necessary to elicit a jaw gape-related control of relative activation in isometric biting. Surface electromyograms of masseter muscles were recorded bilaterally in 20 males during (a) unilateral chewing, (b) isometric biting on rubber pieces inducing jaw gapes of 5, 3, 2, 1, and 0.5 mm, and (c) isometric biting with teeth embedded in rigid splints causing gapes of 5 and 1 mm. With rubber, the masseter W/B-ratio increased from 100 % (5 mm) to 166 % (1 mm) (p = 0.0003) whereas with the splint it increased just slightly to 112 % (p = 0.005). With 1 mm gape, W/B-ratios in splint biting were significantly smaller than in rubber biting or in chewing (p = 0.01). We conclude that minor jaw motion preceding peak force in unilateral biting is necessary to create afferent sensory information that could elicit jaw gape-related activation of masseter muscles. Demonstrating a condition under which jaw gape-related activation can lose its occlusion protecting effect, these findings might contribute to disclose the causes of craniomandibular disorders.

Rigidity of commonly used dental trauma splints

The stability of immobilization devices varies from flexible to rigid, depending on the trauma. We evaluated the rigidity of various commonly used splints in vitro An acrylic resin model was used. The central incisors simulated injured teeth, with increased vertical and horizontal mobility. The lateral incisors and canines stimulated uninjured teeth. Tooth mobility was measured with the Periotest device. Vertical and horizontal measurements were made before and after splinting, and the difference between values was defined as the splint effect. We evaluated 4 composite splints, 3 wire-composite splints, a titanium trauma splint, a titanium ring splint, a bracket splint, and 2 Schuchardt splints For all injured teeth and all splints, there was a significant splint effect for the vertical and horizontal dimensions (P < 0.05). For injured teeth, the composite splints produced the largest changes in vertical tooth mobility; wire-composite splints 1 and 2, using orthodontic wires, produced the smallest vertical splint effects. For uninjured teeth, the Schuchardt 1 splint and the bracket splint produced the largest splint effects; wire-composite splints 1 and 2 produced only a slight change in tooth mobility. Composite splints 2 and 3 produced the largest horizontal splint effects for injured teeth, and the 4 composite splints produced the largest horizontal splint effects for uninjured teeth. The most horizontally flexible splints were the titanium trauma splint and wire-composite splints 1 and 2. According to the current guidelines and within the limits of an in vitro study, it can be stated that flexible or semirigid splints such as the titanium trauma splint and wire-composite splints 1 and 2 are appropriate for splinting teeth with dislocation injuries and root fractures, whereas rigid splints such as wire-composite splint 3 and the titanium ring splint can be used to treat alveolar process fractures.

Lycra garments designed for patients with upper limb spasticity: Mechanical effects in normal subjects

Objective: To assess the stretch of pronator muscles produced by a specifically designed upper-limb Lycra garment that could have a better acceptability than rigid splints in treating upper-limb spasticity. Design: Double-blind comparison among three garments. They were designed to produce a supinating, a pronating, and no torsional force, and were individually manufactured and tested in 10 healthy volunteers. Main Outcome Measure: Angular position and passive rotational stiffness of the forearm were measured with and without each of the garments immediately after the garment was fitted and every hour for 6 hours. Results: When put on by a trained person, the supinator garment supinated the forearm in all subjects (mean, 17°; p < .01; range, 5° to 44°) while the pronator garment pronated the forearm in 8 of 10 subjects (mean, 5°; p < .01). These effects gradually decayed over 6 hours, as garment position was not readjusted. Passive rotational stiffness of the forearm increased by about 30% with each type of garment. The garments designed to produce no torsional force exerted no intrinsic rotational effect. Conclusion: Individually made Lycra garments can produce continuous stretch of muscles for several hours and may be useful in the treatment of spasticity. The garments, however, must be put on by a trained person and their position adjusted when necessary.

Experience in treating fractures of the condylar process in children by using FKO-type rigid splints

Experience in treating fractures of the condylar process in children by using FKO-type rigid splints

Evaluation of closed reduction of fractures of the mandibular process — Use of FKO-type rigid splints

Evaluation of closed reduction of fractures of the mandibular process — Use of FKO-type rigid splints

Material Properties: A Factor in the Selection and Applicafion of Splinting Materials for Athletic Wrist and Hand injuries

Athletic injuries to the wrist and hand are common in clinical practice. When indicated, the use of a protective playing splint enables athletes to continue sports participation. The purpose of this paper is to discuss the splinting material properties that determine the materials' suitability for use in fabrication of a protective playing splint. A second aim is to present currently available splinting materials. The clinical reasoning process for material application and selection is based on understanding material properties, the type and severity of the injury, phase of treatment, and type of sport. Of the materials included in this paper, only the low-temperature materials are acceptable for use in construction of rigid splints. The no heat or layered materials can be used for fabricating the semirigid splints. It is suggested that meaningful comparisons between the material properties can only be made if laboratory and clinical comparative studies are conducted to compare the physical and mechanical properties of the splinting materials used in athletic application.

Healing of Canine Femoral Osteotomies

The effects of rigid self-compressing plates were compared with the effects of less rigid internal contact splints on the healing characteristics of osteotomized canine femora. Radiographically, the rigid fixation afforded by the compression plate produced accelerated healing as compared with the less rigid fixation obtained with splints at two to four months. At six months there was little or no difference between the two groups. Comparison of the material biomechanical properties of the healing femora suggested that the repair tissue formed early after compression plating was stronger than the callus tissue that surrounded the less rigidly fixed femora. A comparison of the structural biomechanical properties of the bones suggested, conversely, that a stronger whole bone resulted from the less rigid fixation splint. The histomorphometric data showed that some cortical bone was lost under both types of fixation plates. However, the patterns of loss were not comparable. Use of rigid internal fixation led to loss of cortical bone after four to six months, while the less rigid fixation obtained with the Eggers splint produced mild intracortical resorption only. These observations point to the desirability of rigid internal fixation early in the healing process and the possible benefit of decreasing the rigidity of the fixation device as healing proceeds.

A Systematic Study of Wound Contraction in Mammalian Skin

The phenomenon of wound contraction has been studied in the skin of rats, rabbits and guinea pigs with the aim of obtaining a standardized wound system to be used for biological assay of in vivo agonists and antagonists of granulation tissue contraction. The sex of the animal, the time of day of wounding, the size and the shape of the wounds all had no apparent influence on the wound contraction curves expressed as per cent of original area against time. The test animal's age and species did have a significant influence on contraction of skin wounds which by analogy with results obtained with rigid splints attached to the skin could be attributed to variations in the thickness, rigidity and fixation of the skin to deep tissues. The shape of the final scar was influenced by the position of the wound on the body surface. The major factor in this instance was considered to be tensile forces acting within the skin. Wound contraction curves in rats and rabbits showed three distinct phases, namely early closure, stationary and logarithmic closure. Guinea pigs lacked the early closure phase. The exact role of the panniculus carnosus in wound healing is considered to be worthy of detailed study.

A systematic study of wound contraction in mammalian skin

<h2>Summary</h2> The phenomenon of wound contraction has been studied in the skin of rats, rabbits and guinea pigs with the aim of obtaining a standardized wound system to be used for biological assay of <i>in vivo</i> agonists and antagonists of granulation tissue contraction. The sex of the animal, the time of day of wounding, the size and the shape of the wounds all had no apparent influence on the wound contraction curves expressed as per cent of original area against time. The test animal's age and species did have a significant influence on contraction of skin wounds which by analogy with results obtained with rigid splints attached to the skin could be attributed to variations in the thickness, rigidity and fixation of the skin to deep tissues. The shape of the final scar was influenced by the position of the wound on the body surface. The major factor in this instance was considered to be tensile forces acting within the skin. Wound contraction curves in rats and rabbits showed three distinct phases, namely early closure, stationary and logarithmic closure. Guinea pigs lacked the early closure phase. The exact role of the panniculuscarnosus in wound healing is considered to be worthy of detailed study.