Soft Occlusal Splint Research Articles

Effect of Hard Versus Soft Occlusal Splint on the Management of Myofascial Pain: Systematic Review and Meta-Analysis

Objectives: The project is to compare the pain intensity and muscle tenderness of hard versus soft Occlusal Splints of at least 3 months follow-up. Methods/Statistical Analysis: PubMed and Cochrane CENTRAL databases electronic searches were performed. Randomized Controlled Trials (RCTs) which compared hard versus soft Occlusal Splint were only articles to be included. Titles and abstract screened, data extracted and articles assessed for risk of bias. Meta-analyses were performed for two of included RCTs that have similar outcome measures. Findings: from 7 relevant studies identified, 3 randomized controlled trials fulfilled the inclusion criteria. The meta-analysis revealed that, no significant differences in pain intensity and muscle tenderness reduction for patients with Myofascial pain treated by hard versus soft Occlusal Splints. The included RCTs were considered of high risk of bias that indicate no enough evidence to reach robust conclusion which group is superior over the other. Application/Improvements: Well-designed RCTs should be conducted and the outcome measures evaluation should be standardized between studies to reach robust conclusion.

Soft versus hard occlusal splint therapy in the management of temporomandibular disorders (TMDs).

AimTo compare between soft and hard occlusal splint therapy for the management of myofacial pain dysfunction (MPD) or internal derangement (ID) of the temporomandibular joint (TMJ) with reciprocal clicking.Patients and methodsThis study included 50 patients (age range: 24–47 years) who had been diagnosed with MPD or ID of the TMJ in the form of reciprocal clicking. Patients were divided into two groups. They were treated for 4 months with either a vacuum-formed soft occlusal splint constructed from 2-mm-thick elastic rubber sheets (soft splint group) or a hard flat occlusal splint fabricated from transparent acrylic resin (hard splint group). Monthly follow-up visits were performed during the treatment period. Before treatment and 1, 2, 3 and 4 months after treatment, the dentist measured all parameters of TMJ function (pain visual analog scores, tenderness of masticatory muscles, clicking and tenderness of the TMJ, and range of mouth opening).ResultsAll parameters of TMJ function showed significant improvement in both groups during the follow-up period, with a statistically significant difference between the two groups at the 4-month follow-up visit.ConclusionsBoth forms of occlusal splints (soft and hard) improved TMJ symptoms in patients with MPD or ID of the TMJ. However, the soft occlusal splints exhibited superior results after 4 months of use.

Choice of biomaterials—Do soft occlusal splints influence jaw-muscle activity during sleep? A preliminary report

AimThe choice of biomaterials for occlusal splints may significantly influence biological outcome. In dentistry, hard acrylic occlusal splints (OS) have been shown to have a temporary and inhibitory effect on jaw-muscle activity, such as tooth clenching and grinding during sleep, i.e., sleep bruxism (SB). Traditionally, this inhibitory effect has been explained by changes in the intraoral condition rather than the specific effects of changes in occlusion. The aim of this preliminary study was to investigate the effect of another type of occlusal surface, such as a soft-material OS in addition to a hard-type OS in terms of changes in jaw-muscle activity during sleep. Materials and methodsSeven healthy subjects (mean±SD, six men and one woman: 28.9±2.7 year old), participated in this study. A soft-material OS (ethylene vinyl acetate copolymer) was fabricated for each subject and the subjects used the OS for five continuous nights. The EMG activity during sleep was compared to baseline (no OS). Furthermore, the EMG activity during the use of a hard-type OS (Michigan-type OS, acrylic resin), and hard-type OS combined with contingent electrical stimulation (CES) was compared to baseline values. Each session was separated by at least two weeks (washout). Jaw-muscle activity during sleep was recorded with single-channel ambulatory devices (GrindCare, MedoTech, Herlev, Denmark) in all sessions for five nights. ResultsJaw-muscle activity during sleep was 46.6±29.8 EMG events/hour at baseline and significantly decreased during the hard-type OS (17.4±10.5, P=0.007) and the hard-type OS+CES (10.8±7.1, P=0.002), but not soft-material OS (36.3±24.5, P=0.055). Interestingly, the soft-material OS (coefficient of variance=98.6±35.3%) was associated with greater night-to-night variations than baseline (39.0±11.8%) and the hard-type OS+CES (53.3±13.7%, P<0.013). ConclusionThe present pilot study in small sample showed that a soft-material occlusal splint does not seem to inhibit jaw-muscle activity during sleep. Within the limitation of the study, it appears that the choice of biomaterials for occlusal splints may have a significant impact on the neurobiological regulation of jaw-muscle activity during sleep.

Results of functional management of condylar fracture in 3 to 16 years old children

To investigate the effect of soft occlusal splint in the treatment of condylar fracture in children and adolescents. Twenty-three children with condylar fracture aged from 3 to 16 were included in this study. Impressions of both jaws were taken and stone working models poured. After occlusion was recovered by mounting on a bionic articulator, a soft occlusal splint was fabricated. The occlusal splint was worn for 1 to 3 months accompanied with functional exercise. Follow-up was carried out by clinical observation and panoramic image. Clinical satisfactory results were obtained in all the patients with good occlusion, unimpaired function and normal growth and development of the mandibles. Panoramic image showed reconstruction of the fractured condyles, which were flattened and short. Soft occlusal splint is a promising approach for treating condylar fracture in children.

Effects of jaw clenching while wearing an occlusal splint on awareness of tiredness, bite force, and EEG power spectrum

Treatment with an occlusal splint is used for temporomandibular disorders, bruxism, and occlusal disturbance to relieve orofacial symptoms such as myofascial pain and jaw movement restriction. However, the effects of various types of occlusal splints have not been elucidated. We investigated the effects of jaw clenching with soft and hard occlusal splints on the awareness of tiredness, bite force, and EEG activity. Six healthy adults were used as subjects, with a visual analogue scale utilized to evaluate the awareness of each patient's tiredness both preceding the session and following the clenching trials. In addition, a Dental Prescale was used to measure bite force and an EEG recording was conducted while performing jaw clenching. The jaw clenching task comprised 1min of maximal voluntary clenching under 3 kinds of clenching conditions: with natural dentition, and with soft and hard occlusal splints, which were each repeated 5 times. Jaw clenching with natural dentition and a hard occlusal splint did not cause a significant awareness of tiredness following repetitive jaw clenching, and there was not a significant alteration of EEG spectrum values with those conditions. In contrast, jaw clenching with a soft occlusal splint caused a significant increase in awareness of tiredness, as well as significant decreases in bite force and EEG alpha 2 power spectrum values. Jaw clenching with a soft resilient occlusal splint causes an awareness of tiredness, which might be accompanied by declines in bite force and EEG spectrum values.

EFEKTIFITAS HARD DAN SOFT OCCLUSAL SPLINT PADA GANGGUAN SENDI TEMPOROMANDIBULA (Kajian klinis pada seri kasus berdasarkan keluhan nyeri sendi temporomandibula)

Occlusal splint is commonly used for treatment of the temporomandibular joint disorder (TMD). It can be made of hard and soft material. Hard occlusal splint (HOS) which was known earlier had been recognized more effective than soft occlusal splint (SOS) which recently gained some popularity. This clinical study based on case series was to determined which type of occlusal splint was more effective for TMD. This study involved 20 subjects and they were divided into HOS and SOS group with 10 subjects in each group. HOS was processed with heat curing acrylic and SOS with vacuum former. Before and after 4 weeks of treatment, 5 TMD symptoms (impaired range of movement, impaired TMJ function, muscle pain, TMJ pain and pain on movement of mandible) were measured using Helkimo diagnostic index. The results were analyzed with Kolmogorov-Smirnov Z's test. The findings showed statistically significant improvement in impaired range of movement and muscle pain in favor of HOS group (p<0.05). Although they were not statistically significant, HOS group showed better improvement than SOS group in TMJ pain and pain on movement of the mandible. In TMJ's function, no changes were found in both groups. IN general, HOS was more effective than SOS for treating TMD in relatively short period of time. Despite of the phenomena, the popularity of SOS was not followed with its effectiveness.

Soft occlusal splint therapy in the management of myofascial pain dysfunction syndrome: A follow-up study

Myofascial Pain Dysfunction Syndrome (MPDS) has been recognized as the most common, nontooth-related chronic orofacial pain condition that confronts dentists. A variety of therapies has been described in literature for its management. The present study is a prospective study carried out to evaluate the efficacy of occlusal splint therapy and compare it with pharmacotherapy (using analgesics and muscle relaxants) in the management of Myofascial Pain Dysfunction Syndrome. Forty patients in the age range of 17-55 years were included in the study and randomly assigned to one of two equally sized groups, A and B. Group A patients received a combination of muscle relaxants and analgesics while Group B patients received soft occlusal splint therapy. All the patients were evaluated for GPI, VAS, maximum comfortable mouth opening, TMJ clicking and tenderness during rest and movement as well as for the number of tender muscles at the time of diagnosis, after the 1 st week of initiation of therapy and every month for three months of follow-up. There was a progressive decrease in GPI scores, number of tender muscles, TMJ clicking and tenderness with various jaw movements and significant improvement in mouth opening in patients on occlusal splint therapy during the follow-up period as compared to the pharmacotherapy group. Occlusal splint therapy has better long-term results in reducing the symptoms of MPDS. It has better patient compliance, fewer side effects, and is more cost-effective than pharmacotherapy; hence, it can be chosen for the treatment of patients with MPDS.

オクルーザルスプリントの材質の違いがこう筋活動に及ぼす影響について

オクルーザルスプリントの材質の違いがこう筋活動に及ぼす影響について

Soft occlusal splint therapy in the treatment of migraine and other headaches

Fifty-seven patients suffering from migraine, tension headache or tension vascular headache were prescribed a soft occlusal splint for night-time wear. Dental, psychosocial/psychiatric and neurological data were recorded prior to commencement of therapy and at the conclusion of a 3 month treatment period. A statistically significant number of patients presenting with migraine or tension vascular headache experienced marked improvement or complete relief of headache symptoms, but most patients suffering from tension headache failed to benefit from splint therapy. A majority of patients displaying intercurrent features of craniomandibular dysfunction experienced reduction in these symptoms also. There was a statistically significant association between TMJ improvement and headache type. Prior to treatment, patients who subsequently benefited from splint therapy in terms of headache improvement had experienced significantly fewer headaches than patients who failed to respond, although headache intensity and duration were similar in both groups. It is suggested that headache type and frequency may be prognostic indicators of the likely success of dental splint therapy in treatment of headache. Nevertheless, the use of occlusal splints in the treatment of patients complaining of headache in the absence of evidence of craniomandibular dysfunction should not be embarked upon until medical examination has excluded the possibility of organic neurological disorder.

The effects of hard and soft occlusal splints on nocturnal bruxism: J. P. OkesonJ. Am. Dent. Assoc. 1987;114:788–791

The effects of hard and soft occlusal splints on nocturnal bruxism: J. P. OkesonJ. Am. Dent. Assoc. 1987;114:788–791

Application of Soft Occlusal Splints in Patients Suffering from Clicking Temporomandibular Joints

This clinical study evaluated the application of prefabricated soft occlusal splints in 42 patients from a population of 84 patients with pain and dysfunction associated with clicking in the temporomandibular joints (TMJ).The soft occlusal splints were a temporary therapeutic and diagnostic modality for the relief of pain, dysfunction, and TMJ clicking over a 10- to 20-day-interim period between initial consultation and insertion of a custom-fabricated, full arch, hard acrylic, occlusal appliance or equilibration. The favorable results of this study support the use of the prefabricated, soft occlusal splints as a temporary treatment and diagnostic modality in patients suffering from reducible disk derangements of the temporomandibular joints.

The effects of hard and soft occlusal splints on nocturnal bruxism

Occlusal splints are commonly used for the treatment of nocturnal bruxism. This study investigated the effects of hard and soft occlusal splints on nighttime muscle activity. The nocturnal muscle activity of ten participants was recorded while wearing a hard and then a soft occlusal splint. The hard occlusal splint significantly reduced muscle activity in eight of the ten participants. The soft occlusal splint significantly reduced muscle activity in only one participant while causing a statistically significant increase in muscle activity in five of the ten participants.

Occlusal changes following use of soft occlusal splints

Occlusal changes following use of soft occlusal splints