Splint In Patients Research Articles

Merocel versus a new septal clip with splint in post septal surgery cases: a prospective study

Septoplasty is one of the most frequently performed surgical procedures in otorhinolaryngology to overcome nasal obstruction. Following septal surgery, nasal packs are commonly inserted by surgeons to support and appose septal flaps the types of which depend on the preference and experience of the surgeon.Background We conducted a study to compare the Merocel sponge with that of a newly developed septal clip with the splint in patients who underwent septoplasty or submucosal resection to find out which one is better. A total of 50 patients were included in the study over a period of 3 years. Patients were divided into 2 groups of 25 each where group M is for patients receiving Merocel after surgery and group C is for patients receiving septal clips with splints.Aim The aim of this study was to assess and compare the effects of a Merocel pack on nasal functions with that of the septal clip and their eventual complications and outcome in the post-operative period.Results The main observations that were found in both groups in the immediate postoperative period were (1) pain (2) nasal obstruction (3) sleep disturbance (4) headache (5) epiphora (6) dryness of mouth and (7) postnasal drip. Pain was mild to moderate in the case of group M (MPS was 2.4) and moderate to severe degree in the case of group C (MPS was 5.7).Nasal obstruction was more common in Merocel group patients. Sleep disturbance, headache, epiphora, post-nasal drip, and dryness of mouth were also more in the Merocel group. After pack removal in both groups, the nasal examination was done to see crusts, vestibulitis, and septal ulcers. All these findings were more in the septal clip with the splint group.Conclusions It was observed that Merocel nasal packing causes significant morbidity and discomfort in the immediate post-operative period as compared to septal clips. It is also expensive. The new septal clips with splints can be used as an effective alternative to Merocel for approximation of flaps after septal surgery.

Comparison of Outcome of Septoplasty with and without Intranasal Splintage in Patients Admitted to a Tertiary Care Hospital, Peshawar

Objective: To compare outcome of septoplasty with and without intranasal splints in patients admitted in Khyber Teaching Hospital, Peshawar Methodology: A Randomized controlled trial was done at department of ENT, Khyber Teaching Hospital, Peshawar from 21-01-2020 to 21-07-2020. Patients with diagnosis of symptomatic DNS, aged between 15 to 30 years, both genders and undergoing septoplasty for symptomatic Deviated Nasal Septum for primary surgery were included. Patients were randomly allocated into two groups using a coin toss method. Patients in group A were subjected to intranasal splintage packing while patients of group B were not be subjected to intranasal splintage. Patients in both groups was assessed on the first postoperative day, for degree of pain. Follow-up visits were scheduled after first and third weeks following the surgery. All the data was entered and analyzed in SPSS Version 23.0. Results: The mean age of the whole sample was 22.7 ± 4.9 years. Average age in the group A was 22.3 ± 4.9 years compared to 23.3 ± 5.0 years (p = 0.271). 60% in group A were males compared to 61.7% in group B (p = 0.852). On follow-up, out of an overall sample of 120, mild, moderate, and severe pain and bleeding were recorded in 35%, 45%, and 20% (pain) and 35%, 30%, and 35% (bleeding), respectively. In group A, 30% had mild pain compared to 40% in B group (p = 0.467), 50% in A group had mild bleeding compared to 20% in B group (p = 0.002), 30% in A group developed crusting compared to 20% in the B group (p = 0.206), and 20% in the A group had synechiae compared to 10% in the B group (p = 0.125). Conclusion: The outcome of septoplasty with splints not observed significantly differ from septoplasty without splints, except in the case of postoperative bleeding.

Steroid versus placebo injections and wrist splints in patients with carpal tunnel syndrome: a systematic review and network meta-analysis.

A network meta-analysis of randomized controlled trials compared the effectiveness of corticosteroid injections with placebo injections and wrist splints for carpal tunnel syndrome, focusing on symptom relief and median nerve conduction velocity. Within 3 months of the corticosteroid injection, there was a modest statistically significant difference in symptom relief compared to placebo injections and wrist splints, as measured by the Symptom Severity Subscore of the Boston Carpal Tunnel Questionnaire; however, this did not meet the minimum clinically important difference. Pain reduction with corticosteroids was slightly better than with wrist splints, but it also failed to reach clinical significance. Electrodiagnostic assessments showed transient changes in distal motor and sensory latencies in favour of corticosteroids at 3 months, but these changes were not evident at 6 months. The best current evidence suggests that corticosteroid injections provide minimal transient improvement in nerve conduction and symptomatology compared with placebo or wrist splints.

Are there any benefits for post-operative splinting after carpal tunnel release? A systematic review and meta-analysis.

There is a controversy on the effectiveness of post-operating splinting in patients with carpal tunnel release (CTR) surgery. This study aimed to systematically evaluate various outcomes regarding the effectiveness of post-operating splinting in CTR surgery. Multiple databases, including PubMed, EMBASE, CINAHL, Web of Science, and Cochrane, were searched for terms related to carpal tunnel syndrome. A total of eight studies involving 596 patients were included in this meta-analysis. The quality of studies was evaluated, and their risk of bias was calculated using the methodological index for non-randomized studies (MINORS) and Cochrane's collaboration tool for assessing the risk of bias in randomized controlled trials. Data including the visual analogue scale (VAS), pinch strength, grip strength, two-point discrimination, symptom severity score (SSS), and functional status scale (FSS) were extracted. Our analysis showed no significant differences between the splinted and non-splinted groups based on the VAS, SSS, FSS, grip strength, pinch strength, and two-point discrimination. The calculated values of the standardized mean difference (SMD) or the weighted mean difference (WMD) and a 95% confidence interval (CI) for different variables were as follows: VAS [SMD = 0.004, 95% CI (-0.214, 0.222)], pinch strength [WMD = 1.061, 95% CI (-0.559, 2.681)], grip strength [SMD = 0.178, 95% CI (-0.014, 0.369)], SSS [WMD = 0.026, 95% CI (- 0.191, 0.242)], FSS [SMD = 0.089, 95% CI (-0.092, 0.269)], and the two-point discrimination [SMD = 0.557, 95% CI (-0.140, 1.253)]. Our findings revealed no statistically significant differences between the splinted and non-splinted groups in terms of the VAS, SSS, FSS, grip strength, pinch strength, and two-point discrimination. These results indicate that there is no substantial evidence supporting a significant advantage of post-operative splinting after CTR.

The use of Stack splint or aluminum finger splint in the conservative management of acute Doyle type IVb bony mallet finger

BackgroundThe aim of this study was to compare the functional outcomes and direct costs of Stack splints and aluminum finger splints when used in the conservative management of patients with acute Doyle type IVb bony mallet finger. MethodsWe retrospectively analyzed demographic and clinical characteristics, functional outcomes (using the Crawford classification, DIP flexion angles, and extension lag measurements), time to confirmation of union, and splint costs of 24 patients treated with aluminum finger splints (Group 1) and 20 patients treated with Stack splints (Group 2). ResultsOf 44 patients, the median age was 38 (range, 20–59) years, 14 (32%) were smokers, 23 (52%) had fourth digit injuries, 32 (70%) had injuries to the dominant hand, 30 (68%) had a mechanism of injury of a fall, and median follow-up was 15 (range, 12–18) months; none of these differed significantly between Group 1 and Group 2 (all p > 0.05). In Group 1, functional outcomes were excellent and good in 14 (58%) and 10 (42%) patients, respectively; in Group 2 functional outcomes were excellent and good in 13 (62%) and 7 (35%) patients, respectively; and there was no significant difference between the groups. Median extension lag was 3.2° (range, 3.0°–3.5°) in group 1 and 3.4° (range, 3.2°–3.8°) in group 2, indicating no significant difference between groups. Complete union was confirmed radiographically in all patients. Per-patient cost was significantly lower for aluminum finger splints (0.208 TRY [US $0.03]) than for Stack splints (25 TRY [US $3.60]). ConclusionsGood functional outcomes are possible with the use of either Stack or aluminum finger splints in patients with acute Doyle type IVb mallet finger, confirming that conservative management may be appropriate for these injuries. Direct costs of Stack splints are many times greater than those of aluminum splints, though the costs for both are relatively low. Level of evidenceTherapeutic, Level III.

Conservative Therapies for TMJ Closed Lock: A Randomized Controlled Trial.

Background. Acute anterior disc displacement without reduction (ADDWoR) is characterized by permanent TMJ disc displacement, pain and functional limitations. Occlusal appliances (OA) are among the therapies of choice. Methods. A single-blind randomized study was carried out to compare the therapeutic success of two different types of splints in patients with ADDWoR. A total of 30 subjects were eligible for the study out of the 330 screened. Group I (n = 15) received RA.DI.CA splint therapy and Group II (n = 15) received stabilization splint therapy. Temporomandibular pain, headache, neck pain and functional excursions were evaluated at baseline (T0), after 4 weeks (T1) and after 6 months (T2). Descriptive and inferential statistics were performed. Results. There was a significant increase in maximum jaw opening and a reduction in pain in both groups (p < 0.05), except for neck pain in Group II. Significant differences in between- and within-subject factors emerged in all of the parameters evaluated, especially between T1 and T2 scores, with a greater trend of improvement in Group I than Group II. Conclusion. RA.DI.CA splints were found to be more effective for the considered sample, especially in the treatment of comorbidities and functional movements, probably due to the greater orthopedic action and joint mobilization.

Comparative Effects of Neurodynamics With and Without Wrist Splint in patients with Carpal Tunnel Syndrome

Aim: To compare effectiveness of neurodynamics with and without wrist splint in patients with carpal tunnel syndrome.Study design: Randomized controlled trial. Settings: Farooq Hospital &amp; Akhtar Saeed Trust teaching hospital,Lahore. Methodology: In present study 34 patients were randomly allocated into two groups in which each group contains 17 patients. Group A received combined treatment approach of neurodynamics and wrist splint while group B received only neurodynamics for two weeks .Improvement in functions and pain were recorded after 2 weeks .Initially baseline measurements were taken on DASH questioner and VAS. Present RCT study was carried out at Akhtar Saeed Trust Hospital,Lahore. Analysis was established through SPSS. Results: Independent sample t test was applied in present study of 34 patients as the mean difference was greater in group A in which combined treatment approach of wrist splint and neurodynamics were applied as compared to other group B in which only neurodynamics were applied.The p value is &lt; 0.05 which shows results were significant. Results were more significant and superior in group A as compared to group B. Conclusion: Group A in which neurodynamics and wrist splint were used found to be more effective as compared to group B in which only neurodynamics were used. Keywords: Carpal tunnel syndrome; neurodynamics; wrist splint.

An In-vivo Study to Evaluate the Onset of Relief from Ibuprofen, Placebo and Occlusal Splint in Patients with Acute Myalgia in Muscles Related to Temporomandibular Joint: A Comparative Pilot Study

Purpose: The treatment priority in management of Temporomandibular Joint (TMJ) pain is directed towards the causative factor along with symptomatic treatment. In this process many times psychological aspect is overlooked. Hence with this pilot study, importance of psychological aspect of Temporomandibular Joint Disorder (TMD) is emphasised. Methods and Material: 15 patients suffering from pain in TMD region who qualify under myalgia pain in DC/TMD Axis I category were selected. Patients were divided into 3 groups; Ibuprofen, placebo and occlusal splint with 5 patients in each group. Pain assessment was done at the first visit, 7th day visit and 14th day visit using a VAS scale. Statistical Analysis Used: Friedman Test was applied to determine overall relief from pain in the three groups. Wilcoxon sign rank test evaluated pain relief between each time interval. Kruskal Wallis Test compared different groups for relief from pain at each time interval. Key Finding: Wilcoxon sign rank test showed a significant pain relief in all three groups from I day to I follow up day and I day to II follow up day. However Pain relief from I follow up to II follow up day was significant only in placebo group. Conclusions: Management of TMD myalgia requires a comprehensive understanding of physical and psychological aspect. This will aid us in formulating a treatment plan comprising pharmacotherapy, placebo or physical therapy or combination of any of these.

Survival of nonsurgically splinted mandibular anterior teeth during supportive maintenance care in periodontitis patients

Background/purposeSplinting mobile teeth is a choice to improve the patient's oral comfort. The purpose of this study was to assess the survival and stability of mobile anterior mandibular teeth after splinting in patients with periodontitis undergoing supportive periodontal therapy (SPT). Materials and methodsPatients with splinted mobile anterior mandibular teeth were assessed retrospectively. Periodontal statuses were recorded at baseline and follow-up visits. Tooth and splint survival as well as splint repairs were recorded. Multilevel Cox regression analyses were performed to evaluate patient- and tooth-related factors that might have influenced the survival rates of splints. ResultsSixty-one patients, collectively having 161 splints, were followed for an average of 5.44 years. On average, probing depth (PD) of splinted teeth decreased from 4.31 mm to 2.93 mm and clinical attachment loss (CAL) decreased from 5.02 mm to 4.58 mm. Alveolar bone was stable in the follow-up period. None of the splinted teeth were extracted, The overall survival rate of the splints was 65.2%. Splints made of composite resin alone were associated with a higher risk of breakage when compared to splints composed of composite resin with mesh grid strips. ConclusionSplinting showed long-term survival and splinting combined with periodontal supportive treatment is a feasible option to maintain mobile mandibular anterior teeth.

Exploration of Nurse Knowledge with Splints on Fracture Patients in Hospitals

Intoduction: One of the main tasks of nurses in providing nursing care is placing splints on patients with fractures. This installation mechanism and procedure requires more knowledge and experience so it is hoped that there will be no mistakes. This study aims to identify knowledge related to splinting in patients with fractures. Method: Non-experimental with a descriptive research approach with the aim of describing each variable. The population of this study was nurses who worked in the surgical inpatient room using a total sampling technique. The number of respondents in this study was 51 people. Data collection techniques using a questionnaire. Result: Respondent data showed that the majority of respondents were male (62.7%), aged 26-45 years (100%), D3 Nursing education (62.7%), worked more than 3 years (100%), position in the room the majority of nurses were implementing (80.4%). The results of this study were that most of the nurses' knowledge was good (80.4%), the majority of the splints were good (72.5%). Conclusion: The characteristics of nurses can affect the results of the knowledge of nurses who will be evaluated. Therefore, experience, education, and position can also be a benchmark in knowing a nurse's competence. Nurses need to increase competence in their respective fields so that they can improve the quality of service.

Treatment efficacy using occlusal splint for anterior disc displacement without reduction of temporomandibular joint

Management of TMDs with occlusal splint is a reversible, non- invasive modality which causes minimum damage to tissues, when compared to other irreversible treatment modalities. Objectives of this study is to assess the effectiveness of flat occlusal splint in patients with anterior disc displacement without reduction by evaluating reduction in pain and improvement in mouth opening. 35 participants with mean age 35 years who does not have any systemic diseases and not undergoing treatment for ADD without reduction were selected for study. After recording pain score on VAS scale and maximum mouth opening, flat occlusal splint was fabricated for maxillary arch. Patients were advised to wear the splint for all the time except on meal times. Maximum mouth opening and pain score were again evaluated after 3 weeks. Statistical results showed that there is highly significant reduction in pain score and increase in maximum mouth opening. Mean VAS score before treatment was 7.26±0.88. After treatment with splint therapy, VAS score was reduced to 2.94±1.41. The mean value of maximum mouth opening before treatment was 23.09±4.25. After treatment with splint therapy, it was increased to 30.37±5.43. Both parameters had p value &amp;#60;0.001, which is highly significant statistically. Significant reduction in pain score and improvement in mouth opening noted after using flat occlusal splint in patients having ADD without reduction. However, further studies are needed on a long term basis for better results.

Adjunctive treatment of chronic migraine using an oral dental device: overview and results of a randomized placebo-controlled crossover study

ObjectiveTo assess the nocioceptive input of habitual nocturnal jaw clenching that acts as a contributing factor in migraine pathogenesis.BackgroundHabitual nocturnal jaw clenching has been implicated as a trigger, particularly in those whose headaches are present upon waking or shortly thereafter. Nocturnal EMG studies of patients diagnosed with migraine show nearly twice the temporalis clenching EMG levels and double the bite force as matched asymptomatic controls, leading to the speculation that parafunctional clenching activity may have some role in headache pathogenesis. The NTI (Nociceptive Trigeminal Inhibition) oral device is a dental splint designed to reduce nocturnal jaw clenching intensity and is FDA approved for the prevention of medically diagnosed migraine pain based on open label studies. There are no prior placebo-controlled trials to assess the migraine prevention efficacy of the NTI splint. This is the first placebo-controlled cross-over study to assess the efficacy of the NTI splint in patients with Chronic Migraine.MethodA placebo controlled, single-blinded cross-over study was done with IRB oversight assessing the efficacy of the NTI splint compared to placebo using the change in the HIT-6 score as the outcome measure.Results68% of refractory chronic migraine sufferers using the NTI as measured by sequential HIT 6 scores had at least a one-category improvement (severe to substantial, or substantial to some, or some to none) compared to 12% when using a placebo device. 36% of subjects using the NTI device reported a two-category improvement in their HIT-6 score, compared to 0% when using placebo.ConclusionThe improvement in HIT-6 scores produced by the NTI device, suggests that patients with Chronic Migraine may have intense nocturnal jaw clenching as a contributing factor to their headache related disability. An NTI device is one method of assessing whether jaw-clenching is a contributing factor to ongoing migraine.Trial registrationCurrent Controlled Trials NCT04871581. 04/05/2021. Retrospectively registered.

Сплинт-терапия как отдельный подход в рамках комплексного лечения дисфункции височно-нижнечелюстного сустава с точки зрения физиологических понятий

BACKGROUND: Among the adult socially active population, one of the most common pathologies of the maxillary system is musculoskeletal dysfunction of the temporomandibular joint (TMJ). One of the modern methods of correction and treatment of TMJ dysfunction is splint therapy, which involves the use of splints and permits to consistently and selectively act on a particular level of disorders: occlusive, muscular, articular. This ultimately forms a new myostatic reflex of holding the jaw, builds physiological biomechanics and neuromuscular activity of the speech apparatus and the stomatognathic system as a whole. AIM: To prove the positive effectiveness of the use of splint therapy from the point of view of physiological concepts in optimizing the neuro- and myofunctional state of the stomatognathic system with an analysis of the effectiveness of the mode of using occlusal splints in patients with TMJ dysfunction. MATERIALS AND METHODS: The treatment was carried out in 34 patients with diagnosed TMJ dysfunction at the age from 17 to 40 years. For the treatment of patients, a relaxing therapeutic and diagnostic articular splint was used. The patients were divided into 2 groups of 17 people each: for the first group of patients, a round-the-clock mode of wearing a splint was set, for the second group, a 16-hour mode was set. The total observation period was 6 months. The criteria for achieving therapeutic goals were considered: absence/reduction of pain in the TMJ and orofacial pain, absence of pain on palpation of the masticatory muscles and in the TMJ, stable position of the lower jaw in the central occlusion, stability and uniformity of movements of the lower jaw at various functional positions, comfort when chewing and at rest, absence/reduction of hypertonicity of the masticatory muscles. RESULTS: The treatment results were evaluated 3 and 6 months after the primary stabilization of the mandible position. At the same time, among the patients of the first group, primary stabilization was achieved on average at the third visit (after 1.5 months from the start of splint therapy), in the second group of patients only at the fourth or fifth visit (after 2–2.5 months). Three months later, all patients of the first group and 8 patients from the second group noted a decrease in pain and orofacial pain, as well as the absence of pain on palpation of muscles and TMJ. Chewing discomfort was observed in 4 patients from the first group and 7 from the second. According to the results after 6 months, all patients were satisfied according to all criteria, all established objective criteria for treatment goals were achieved. CONCLUSIONS: With the correct selection of patients with symptoms indicative of muscle or occlusive dysfunction, splint therapy shows itself as an effective method that allows, with a full understanding of the biomechanics and functional physiology of the occlusal-muscular-articular complex, to effectively correct the neuromuscular state of the stomatognathic system towards it full balance.

Practical experience in using elastic bands in prosthodontics

AIM: The aim of the study was to investigate the effectiveness of combined treatment with elastic bands and splints in patients with masticatory muscle parafunction.&#x0D; &#x0D; MATERIALS AND METHODS: 52 people (15 men and 37 women), suffered from masticatory muscle parafunction, were examined. The diagnosis was made on the basis of clinical and instrumental (electromyography) methods. Pain intensity was determined by using the visual-analog scale. The control group consists of 31 healthy people aged 16 to 31 years. Preliminary treatment of the patients of the main group was carried out by the use of the proposed method (combined treatment with elastic bands and splints).&#x0D; RESULTS: It was found that the proposed method provides reliable (Z1-3 = 6.40, p1-3 = 0.01) reducing of pain intensity in masticatory muscles by the end of second week of therapy (from 8.17 0.6 to 4.54 0.5 points by the visual-analog scale). It was confirmed by reliable decrease of the bioelectric activity of masticatory muscles. The data for right masseter muscle was 5.7 0.14 mkV (Z = 6.30, p = 0.015) and for the left one was 5.8 0.21 mkV (Z = 6.29, p = 0.01); for right temporal muscle it was 4.1 0.19 mkV (Z = 6.39, p = 0.01) and for left one it was 4.3 0.18 mkV (Z = 6.28, p = 0.015).&#x0D; CONCLUSIONS: The proposed method allows to achieve reliable decrease of the pain intensity in patients with masticatory muscle parafunction.

Combined therapy with elastic bands and splints in patients with masticatory muscles hypertension

Was to investigate the effectiveness of combined treatment with elastic bands and splints in patients with masticatory muscle hypertension. 103 patients (37 men and 66 women) aged from 21 to 65 years were examined. The diagnosis was made based on clinical and instrumental (electromyography) methods. Pain intensity was determined using a visual-analog scale (VAS). Elimination of masticatory muscle hypertension in patients of the first group (51 people) was carried out using only splints while patients of the second group (52 people) had a combined therapy with elastic bands and splints. In the second group of patients reliable reducing of pain intensity was observed by day 14 from the start of therapy (4.54±0.5 points), while in the first group of patients it was discovered only by day 21 (5.08±0.6 points). Reliable changing of the bioelectrical activity of masticatory muscles in the second group of patients was observed by the beginning of second week from the start of preliminary therapy, while in the first group of patients it was discovered only by the third week. Thus, the proposed method of masticatory muscles hypertension treatment using elastic bands and splints has features, favorably distinguish it from the other methods of the therapy, because it provides sparing functioning condition for masticatory muscles.

The effects of hand splinting in patients with early-stage thumb carpometacarpal joint osteoarthritis: a randomized, controlled study

Background/aimEvidence for the effectiveness of splinting in thumb carpometacarpal osteoarthritis is limited. We aimed to evaluate the effects of a prefabricated carpometacarpal metacarpophalangeal immobilization splint on pain, hand function, and hand strength in patients with early-stage thumb carpometacarpal osteoarthritis.Materials and methodsSixty-three hands with stage 1 or 2 thumb carpometacarpal osteoarthritis were enrolled in the study. The nonsplint group received oral information about how to accommodate daily activities. The splint group was given a prefabricated carpometacarpal metacarpophalangeal immobilization splint for 6 weeks. Pain was evaluated using the Australian/Canadian Osteoarthritis Hand Index (AUSCAN). Hand functions were evaluated using the AUSCAN and the Quick Disabilities of Arm, Shoulder and Hand (Q-DASH) questionnaire. Grip and pinch strengths were measured using a hydraulic dynamometer and a hydraulic pinch gauge.ResultsThe AUSCAN pain, stiffness, function, total scores, and Q-DASH scores were significantly decreased in the splint group compared to the nonsplint group. Significant increments in grip and pinch strengths were detected in the splint group compared to the nonsplint group.ConclusionThe prefabricated carpometacarpal metacarpophalangeal immobilization splint is effective in improving pain, hand function, and hand strength in patients with thumb carpometacarpal osteoarthritis.

Phototherapy versus Occlusal Splint to control painful symptoms in Temporomandibular Disorder: controlled, randomized cost-effectiveness clinical trial

Objective: To compare the efficacy of photobiomodulation and occlusal splint in patients with TMD-associated myofascial pain. Material and methods: 23 patients were randomized into 2 groups: laser group (LG) (n = 12) and occlusal splint group (OSG) (n=11). For the LG, laser was applied to 3 points on each side of the face. Twelve applications were made, 2 sessions per week. In the OSG, patients were instructed to use the device during sleep, 8 hours per night, for a period of 6 weeks, and 12 adjustment and follow-up sessions were performed. Patients in both groups were reevaluated 30 days after the end of the treatments. Results: There was a decrease in pain intensity, according to a visual analogue scale, in both groups before and after 1 month (LG, p = 0.008 and OSG p = 0.002), but with no difference between groups. For the quality of life, both treatments had a positive impact, with this impact being higher in the LG compared to the OSG (p &lt;0.05). Regarding the cost-effectiveness analysis, laser was more cost-effective than the occlusal splint in the clinical trial. The incremental cost of the laser was $3,483.45 compared to the splint, but it had a cost ratio of $4,569.02 for controlled pain intensity while the splint showed $6,691.91 ratio for controlled pain intensity. Conclusion: The photobiomodulation was more cost-effective in controlling painful symptoms in patients with TMD and myofascial pain.

Improving accuracy of the intermediate splint in substantial intermaxillary sagittal discrepancies using an extra anterior anchorage point: technical note.

Background To describe a technical feature that increases the stability of the intermediate splint in patients where bimaxillary surgery with great maxillary/mandibular advancements are planned. Material and Methods Prospective evaluation of the intermediate splint dental vertical penetration in patients undergoing bimaxillary surgery where great sagittal discrepancy occur in the anterior sector between the upper and lower jaws when the intermediate splint is placed by adding an extra intermaxillary fixation (IMF) screw (2x9 mm) placed between the central incisors of the maxilla and fixed to the most anterior aspect of the intermediate splint following the direction of the sagittal maxillo-mandibular discrepancy from January to September 2018. Results The postoperative evaluation comparing the accuracy of conventional fixation versus fixation with an extra anterior anchorage point through photographic assessment and intraoral digital scanner demonstrated better dental penetration, and therefore improved intermediate splint precision with the latter in all cases Conclusions Our results suggest that this is a simple and safe technique that can be easily reproduced and optimizes the outcomes by increasing the accuracy of translation of the planned surgical movements to the operating room. Key words:Orthognathic surgery, intermediate splint, accuracy, intermaxillary fixation, bone screw.

Early Mobilization Versus Splinting After Surgical Management of Distal Radius Fractures.

After the surgical management of distal radius fractures (DRF) in older patients, further treatment with a splint often follows. It is unclear whether early mobilization might be superior to splinting in this group of patients, as it is in others. In this prospective, randomized, controlled trial, we attempted to determine whether early mobilization yields better outcomes. 50 patients over age 70 with DRF were included in the trial. Group A (the splint group) was treated with postoperative immobilization, group B with early mobilization. Clinical follow-up examinations were performed at 2, 6, and 12 weeks and at 6 and 12 months. X-rays were obtained preoperatively, postoperatively, at 6 weeks, and at 6 months. The primary outcome parameter was the modified Mayo Wrist Score (MMWS) at 6 weeks. At 6 weeks, the functional outcome was better to a statistically significant extent in group B (MMWS; 65/100 vs. 55/100 [q25 : 55/40 - q75 : 70/70; p = 0.025]). No difference between the two groups was demonstrable in their further clinical course. The estimated regression model revealed a statistically significant effect of the method of treatment (p = 0.023). There were no differences in hand strength or in x-ray findings. Early mobilization is associated with better wrist function on initial follow-up, without any demonstrable disadvantage with respect to secondary dislocation. The psychological benefit and protective function of wrist splinting in patients who are in danger of falling should nonetheless be investigated in further studies.

An 8-year prospective clinical investigation on the survival rate of feldspathic veneers: Influence of occlusal splint in patients with bruxism

ObjectivesThe aim of this study was to perform a 8-year prospective clinical investigation on the survival rate of feldspathic ceramic veneers, as well as analyse the influence of the occlusal splint in patients with parafunctional bruxism. MethodsThree hundred and sixty-four veneers fabricated using conventional feldspathic ceramic were provided in 64 patients. The patient sample included 40 individuals with bruxism. During the follow-up period, the effect of wearing the occlusal splint on the incidence of failure (fracture and/or debonding) in patients with bruxism was also assessed. The survival rate of veneers was determined using the Kaplan-Meier estimator. Statistical significance was set at p < 0.05 with a confidence interval of 95%. ResultsThe occurrence of fracture for the feldspathic veneers tested in this study was 7.7%, while only 1.9% of the total number of veneers debonded. The overall survival rate was 93.7% after 3 years, 91% after 5 years, and 87.1% after 8 years. Patients with bruxism using an occlusal splint showed a survival rate of 89.1% after 7 years, while the survival rate in patients with bruxism using no occlusal splint was 63.9% (p < 0.05). ConclusionThis study confirmed that feldspathic veneers may represent a suitable clinical solution for indirect aesthetic restorations. Such a treatment may be an option also for those patients affected by bruxism, as long as they regularly wear an occlusal splint. However, patients with bruxism using no occlusal splint may still present a potential high-risk of failure and/or debonding.