Splint Therapy Research Articles

The Effect of Arthrocentesis Treatment for Maximum Mouth Opening and Pain in Temporomandibular Joint Diseases and the Effect of Splint, Drug, and Physical Therapy on This Treatment.

Background and Purpose: Temporomandibular disorders (TMD) are a heterogeneous group of musculoskeletal and neuromuscular diseases involving the temporomandibular joint complex and the surrounding muscle and osseous structure. TMD can be classified as intra-articular or extra-articular. The aim of this study was to evaluate the effect of arthrocentesis in terms of maximum mouth opening (MMO) and pain in patients with TMD of intra-articular origin. In addition to this treatment, the effects of factors such as splints, medication, and physical therapy on arthrocentesis were examined. Material and methods: This retrospectively designed study was conducted with 79 patients who had previously undergone arthrocentesis. These patients were divided into three groups according to the Research Diagnostic Criteria for temporomandibular disorder: disc displacement (DD) with locking (Group 1), DD without locking (Group 2), and degenerative joint diseases (Group 3) groups. The maximum mouth opening (MMO) and visual analog score (VAS) values of the groups were recorded before arthrocentesis (Baseline: T0), on the third day after arthrocentesis (T1), and at the sixth month (T2) after arthrocentesis. Information about whether the patients received concurrent medical treatment, splint treatment, and physical therapy was also recorded. These data were compared between groups. Results: It was observed that the VAS scores in all three groups decreased from T1 compared to T0 (p < 0.05). Likewise, the MMO value increased in all groups at T1 compared to T0. (p < 0.05). It was observed that splint treatment, pain killer and muscle relaxant treatment, and physical therapy made no additional contribution to arthrocentesis in terms of reducing pain or increasing MMO value (p > 0.05). Conclusions: Arthrocentesis was observed to be effective in terms of pain and function in TMJ patients in this study. It was observed that splint therapy, physical therapy, and medical therapy made no additional contribution to arthrocentesis in terms of MMO or pain.

Effect of mandibular advancement splint therapy on cardiac autonomic function in obstructive sleep apnoea.

This study aimed to evaluate the effect of mandibular advancement splint (MAS) therapy on cardiac autonomic function in patients with obstructive sleep apnoea (OSA) using heart rate variability (HRV) analysis. Electrocardiograms (ECG) derived from polysomnograms (PSG) of three prospective studies were used to study HRV of patients with OSA before and after MAS treatment. HRV parameters were averaged across the entire ECG signal during N2 sleep using 2-min epochs shifted by 30s. Paired t-tests were used to compare PSG and HRV measures before and after treatment, and the percent change in HRV measures was regressed on the percent change in apnoea-hypopnea index (AHI). In 101 patients with OSA, 72% were Caucasian, 54% men, the mean age was 56±11 years, BMI 29.8±5.3 kg/m2, and treatment duration was 4.0±3.2 months. After MAS therapy, there was a significant reduction in OSA severity (AHI, - 18 ± 16 events per hour, p < 0.001) and trends towards increased low-frequency to high-frequency ratio, low-frequency power, and reduced high-frequency power (LF:HF, - 0.4 ± 1.5, p = 0.01; LF, - 3 ± 16 nu, p = 0.02, HF, 3.5 ± 13.7 nu, p = 0.01). Change in NN intervals correlated with the change in AHI (β(SE) = - 2.21 (0.01), t = - 2.85, p = 0.005). No significant changes were observed in the time-domain HRV markers with MAS treatment. The study findings suggestthat successful MAS treatment correlates with changes in HRV, specifically the lengthening of NN intervals, a marker for improved cardiac autonomic adaptability.

Three-dimensional evaluation of upper pharyngeal airway, hyoid bone, and craniocervical changes following stabilization splint therapy in adult patients with temporomandibular joint disorders and mandibular deviation: A retrospective study

ObjectiveThis study aimed primarily to analyze the three-dimensional (3D) changes in the pharyngeal airway (PA), and secondarily, the hyoid bone (HB) and the craniocervical (CC) following stabilization splint (SS) therapy in adult patients with temporomandibular joint disorders (TMD) and mandibular deviation (MD). MethodsThirty-five adult patients with TMD and MD, who were treated using SS with a mean age of 25.14 ± 6.11 years, were enrolled in this retrospective clinical study. Pre- and post-therapeutic cone-beam computed tomography (CBCT) scans were analyzed. PA dimension,nasopharyngeal, oropharyngeal, hypopharyngeal, sub-hypopharyngeal, and total pharyngeal airway spaces were measured in surface area, volume, minimum constricted area (MCA) and width, HB position, and CC posture were analyzed three-dimensionally using InVivo 6.0.3 and Dolphin 11.95 software. Wilcoxon rank-sum or Paired t-test was conducted, and P < 0.05 was considered significant. ResultsSS therapy was administered for a period of 9.49 ± 4.02 months. The oropharyngeal airway space showed a significant decrease in sagittal width. The hypopharyngeal surface area, volume, MCA, and sagittal width decreased significantly. In terms of HB, hyoid–mandibular plane (H-MP), retrognathia–third vertebra's most inferior–anterior (RGN-C3ia), and retrognathia–Sella (RGN-S) distances significantly decreased. The Nasion–Sella line and the line that passes through C2ip to the odontoid process posterior tangent (NSL-OPT) angle in CC posture also decreased significantly. ConclusionSS therapy in TMD patients with MD mainly results in narrowing of the hypopharyngeal region, no change in HB position and improvement in head posture. These results undoubtedly assist in diagnosis and treatment of clinical conditions.

Tapping the potential of rapid prototyping techniques in creating a paradigm shift in the fabrication of occlusal splints

PurposeThis study aims to cover the overall gamut of rapid prototyping processes and biomaterials used for the fabrication of occlusal splints in a comprehensive manner and elucidate the characteristics of the materials, which are essential in determining their clinical efficacy when exposed to oral surroundings.Design/methodology/approachA collective analysis of published articles covering the use of rapid prototyping technologies in the fabrication of occlusal splints, including manufacturing workflow description and essential properties (mechanical- and thermal-based) evaluation of biocompatible splinting materials, was performed.FindingsWithout advances in rapid prototyping processes and materials engineering, occlusal splints would tend to underperform clinically due to biomechanical limitations.Social implicationsThree-dimensional printing can improve the process capabilities for commercial customization of biomechanically efficient occlusal splints.Originality/valueRapid technological advancement in dentistry with the extensive utilization of rapid prototyping processes, intra-oral scanners and novel biomaterial seems to be the potential breakthrough in the fabrication of customized occlusal splints which have endorsed occlusal splint therapy (OST) as a cornerstone of orthodontic treatment.

Results of diagnosis and treatment of temporomandibular joint dysfunction in patients with malocclusion

Temporomandibular joint dysfunction in patients with malocclusion is quite a widespread problem in modern dentistry. The study included: identification of patients with signs of TMJ dysfunction and malocclusion by pre-selection; diagnosis of dysfunctions in the main group of patients; preparation of the treatment plan using splint therapy and kinesiotherapy; assessment of the effectiveness of these treatment methods. Most of the subjects had a decrease in the tone of the masticatory muscles, pain sensitivity in the masticatory muscles and the TMJ area. Splint therapy, as well as kinesiotherapy, is the best choice in the treatment of these patients.

Awake bruxism in temporomandibular disorders patients referred to tertiary care: A retrospective study on its assessment and TMD management.

Bruxism is defined as a repetitive jaw-muscle activity characterised by clenching or grinding of the teeth and/or by bracing or thrusting of the mandible. Bruxism can occur during sleep (sleep bruxism, SB) or during wakefulness (awake bruxism, AB). To date, the effect of AB on the purported negative consequences of bruxism has remained unclear. The assessment of AB, its relation to temporomandibular disorders (TMD) treatment modalities, and their possible outcomes were investigated among TMD patients resistant to treatment in primary care and referred to a tertiary care clinic. The records of 115 patients were studied. Patients were referred to the Head and Neck Centre, Department of Oral and Maxillofacial Diseases, Helsinki University Central Hospital, for TMD treatment between 2017 and 2020. The data derived from the eligible patients' records included the following: background data (age and sex), referral data (reason and previous treatment), medical background (somatic and psychiatric), clinical and possible radiological diagnoses at a tertiary care clinic, treatment modalities for masticatory muscle myalgia, bruxism assessment, its possible treatment modalities and their outcomes, and overall management outcome. We analysed the outcomes of single treatment modalities and combined groups of modalities. For the demographic data, the Chi-squared test and Fischer's Exact test were used to determine the associations between the categorical variables. A Sankey-diagram was used to describe the flow of treatment. Temporomandibular joint-pain-dysfunction syndrome (K07.60) was the most frequent single reason to refer a patient to tertiary care (17.4%). At referral, men had myalgia (M79.1) significantly more often (p = .034) than women. Similarly, men had depression (p = .002) more often and other psychiatric diagnoses (p = .034). At tertiary care, the presence of AB was assessed in 53.9%, and self-reported AB was recorded in 48.7%. In patients with possible AB, those who were prescribed neuropathic pain medication showed significantly less improvement in symptoms (p = .021) than those who underwent splint therapy (p = .009). Overall, half of the patients showed overall improvement in their TMD symptoms from the treatment combinations. Despite several treatment modalities, only half of the patients showed improvement in their symptoms in the present study. A standardised assessment method encompassing all factors contributing to bruxism behaviours and their consequences is suggested.

The effectiveness of combining ultrasound therapy with splinting and exercise therapy for patients with carpal tunnel syndrome

Background: Carpal tunnel syndrome (CTS) can cause patients to experience negative symptoms that can significantly affect their ability to use their hands to perform daily activities. This study aimed to compare the effectiveness of a combination of splinting and exercise therapy with or without ultrasound therapy in improving CTS symptoms and the functional status of patients.&#x0D; Methods: This randomized pre and post-test control group design study was conducted in private physiotherapy practices in the Denpasar area from August to September 2022. Twenty-four subjects with unilateral CTS were randomly divided into an Intervention Group (n=12; splinting, exercise therapy, and ultrasound therapy) and a Control Group (n=12; splinting and exercise therapy only). Splinting was used all day and night for four weeks. Exercise therapy was given three times per week for four weeks. Ultrasound therapy was given once a day, three times per week, for four weeks. The subject's symptoms and functional status before and after treatment were evaluated using the Boston Carpal Tunnel Syndrome Questionnaire (BCTSQ), which consists of the Symptom Severity Scale (SSS) and the Functional Status Scale (FSS).&#x0D; Results: Significant improvements were found in SSS and FSS in Group 1 (SSS: p=0.000; FSS: p=0.000) and Group 2 (SSS: p=0.000; FSS: p=0.000), and a significant between-group difference was found in SSS (p=0.000) and FSS (p=0.001).&#x0D; Conclusion: The addition of ultrasound therapy to splinting and exercise therapy is more effective than that in improving the symptoms and functional status of patients with CTS.

Materials and manufacturing techniques for occlusal splints: A literature review.

To review the materials and fabrications methods of occlusal splints with their advantages and shortcomings and to clarify the indications for each. Temporomandibular joint disorders (TMDs) encompass a range of conditions affecting the masticatory system. Occlusal splints are currently recognized as a viable option for the management of TMDs when they are adopted in conjunction with additional approaches varying from conservative procedures (counseling, biofeedback, physical therapy, pharmacotherapy) to irreversible and less conservative ones (occlusal adjustments, orthodontics, arthroscopy, and surgery). These splints can vary in design, function, and material. The components used to fabricate the splints must withstand occlusal forces, be aesthetically pleasing, comfortable, and minimally interfering with function and phonetics. Traditional methods for fabricating splints include sprinkle-on, thermoforming, and lost wax techniques. However, with the advancement of CAD/CAM technology, additive (3D printing) and subtractive (milling) manufacturing methods expand the range of possibilities by introducing novel solutions for elaborating splints. An electronic search was conducted on PubMed using the following keywords: "occlusal splint", "guard and "materials", and "manufacturing". Thirteen in vitro publications were screened and they consisted of four clinical studies, nine reviews (three of them were systematic reviews), and five case reports. The choice of material is crucial for the success of splint therapy. Factors such as biocompatibility, ease of fabrication, adjustability, cost, and patient preference should be considered. Newer materials and techniques are emerging because of advancements in material science and manufacturing techniques. However, it should be noted that most of the evidence is based on in vitro studies with different methodologies, limiting their validity in daily practice.

RA.DI.CA. Splint Therapy in the Management of Temporomandibular Joint Displacement without Reduction.

The purpose of this study is to report clinical and instrumental changes after RA.DI.CA splint therapy for temporomandibular joint disc displacement without reduction. Subjects affected by disc dislocation without reduction were recruited between July 2020 and May 2022 based on inclusion and exclusion criteria and treated with RA.DI.CA. splints over a period of 6 months. Clinical data were collected at each phase of the study (T0, T1, T2). Magnetic resonance imaging and electrognathography data were recorded at the beginning (T0) and at the end (T2) of the study. ANOVA with post-hoc contrasts was performed to assess differences in outcome measures over time. The Wilcoxon test was used to evaluate changes in disc-condyle angle between before- and after-treatment MRI. A two-tailed value of p < 0.05 was regarded as significant. Ten patients completed the study. There were statistically significant differences over time for arthralgia, headache, neck pain, and mouth opening. Disc recapture and an improved quality of mandibular movement were recorded in 70% of subjects. The clinical and instrumental improvements are probably due to the orthopedic action of RA.DI.CA splint treatment, which allows for a greater degree of joint mobilization. The purpose of this therapy is to recover the disc position if possible and achieve an adequate joint functional adaptation that avoids the progression of the structural damage and the recurrence of symptoms.

Haglund's Disease with Clinical and Radiological Findings: 3 Case Reports

Objective: Haglund's Deformity is a variation of the posterosuperior region enlargement of the Os Calcaneus (OC) in the form of exostosis. It is associated with Haglund's Disease (HD), which encompasses Achilles tendinitis, retrocalcaneal bursitis, supra calcaneal bursitis, and inflammation of the Kager fat pad. Diagnosis is based on clinical findings and radiological methods, such as lateral ankle radiographs, Computed Tomography (CT), and Magnetic Resonance Imaging (MRI). This study aims to present three cases of ankle pain diagnosed with HD using radiological imaging. The mean age of our cases was 44.6 years, with two females and one male. Patients commonly present with complaints of pain and swelling behind the heel. Results: Physical examination revealed pain and tenderness upon palpation over the left OC and Achilles tendon insertion. Radiological examination showed osseous protrusion in the posterosuperior part of the OC, indicating Haglund's Deformity. Edema was observed at the bony prominence of the posterosuperior OC, Kager fat pad, and heel area. The treatment plan for all three patients included leg rest splint, anti-inflammatory medication, and physical therapy. Conclusion: In cases of heel pain where traumatic events such as acute fractures are ruled out, MRI should be performed, and Haglund's Syndrome should be investigated if osseous protrusion in the posterosuperior calcaneus is observed on radiographs, along with other findings suggestive of HS.

Efficacy of Arthrocentesis and Anterior Repositioning Splints in Treatment of Internal Derangement of TMJ: A Prospective Clinical Study.

The aim of this study is to assess the efficacy of double puncture arthrocentesis and anterior repositioning splints in the treatment of internal derangement of temporomandibular joint. 35 patients with mean age of 36.6 years±10.2 years diagnosed with unilateral TMD who fell into Wilkes stage 2 and disc displacement with reduction with intermittent locking described by RDC/TMD were treated with Nitzan's double puncture arthrocentesis and were given a anterior repositioning hard splint. The parameters following parameters were assessed at intervals of 1 week, 2 weeks, 1 month, 3 months and 6 months: pain, maximum inter-incisal mouth opening, Joint noise/click. Statistically significant (p < 0.001) improvements were seen at all recorded intervals in all observed parameters. Simultaneous arthrocentesis and anterior repositioning splint therapy is effective in alleviating pain and improving mouth opening without discomfort in patients with unilateral painful TMD showing disc displacement with reduction with intermittent locking.

Technical approaches and clinical outcomes of the treatment of temporomandibular dysfunction with prostheses: a systematic review

Introduction: Temporomandibular joint (TMJ) replacement is usually a last resort in the surgical treatment of end-stage joint disease. For all this gear to work efficiently, occlusion, articulation, musculature, ligaments, and psychological factors must be in complete harmony. As a treatment, implantation of a total alloplastic TMJ prosthesis. Objective: It was to demonstrate, through a systematic review, the main considerations and clinical outcomes of the treatment of temporomandibular disorders with different types of prostheses. Methods: The systematic review rules of the PRISMA Platform were followed. The search was carried out from February to April 2023 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases, using articles from 2013 to 2023. Results and Conclusion: A total of 127 articles were found, 60 articles were evaluated and 31 were included and developed in this systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 12 studies with a high risk of bias and 33 studies that did not meet GRADE. Based on the results, temporomandibular disorders (TMD) treatment is diverse and depends on the type of disease, as well as the duration and subjective level of pain. Alloplastic reconstruction can be advantageous in obtaining a rapid improvement in symptoms and rapid rehabilitation of masticatory function. Treatment of functional TMD is commonly based on conservative therapy, including physical therapy, pain therapy, and splinting therapy. Depending on the severity of TMD, treatment varies according to the degree of surgical invasion. Thus, the TMJ prosthesis seems to be reserved for patients with persistent pain, bone or fibrous ankylosis, or osteomyelitis after primary closed or open treatment of mandibular condyle fractures. Quality of life, mouth opening, and daily eating improved significantly after total TMJ prosthesis.

Treatment of TMJ Osteoarthritis

Osteoarthritis (OA) is common disease that can lead to severe pain and dysfunction in any joint, including the temporomandibular joint (TMJ). The treatment strategy for TMJ OA aims at reducing pain, preventing the progression of condylar bone destruction, and restoring joint function. Conservative therapy including nonste-roidal anti-inflammatory drugs, occlusal splint, and physical therapy, and arthrocentesis are the most common treatments for TMJ OA. These therapies are effective in most cases in relieving the signs and symptoms.

FROM DIAGNOSIS TO RECOVERY:THE LATEST INNOVATIONS IN INTERNAL DERANGEMENT MANAGEMENT

Internal derangement refers to a range of pathologies that can occur within the temporomandibular joint (TMJ).Recent advances in understanding and managing internal derangement have been made in areas such as imaging modalities, surgical techniques, and non-surgical treatments. Imaging modalities such as MRI and CBCT have allowed for better diagnosis and assessment of internal derangement, while advancements in surgical techniques have improved outcomes and reduced the need for open surgery. Non-surgical treatments, such as physiotherapy and splint therapy, have also shown promising results in managing internal derangement.This article provides an overview of these recent advances in internal derangement and their implications for clinical practice

Quantitative and qualitative condylar changes following stabilization splint therapy in patients with temporomandibular joint disorders.

This study aimed to explore the quantitative and qualitative condylar changes following stabilization splint (S.S) therapy, including condylar position, morphology, and bone mineral density (BMD) in subjects with temporomandibular disorders (TMD). In this retrospective clinical study, we enrolled 40 TMD subjects (80 joints) aged 18 to 35years, for whom a S.S was used to treat TMD. The 80 TMD consists of 32 masticatory muscle disorders (myalgia) and 48 TMJ disorders (arthralgia). Cone beam computed tomography (CBCT) was used to scan the TMJs of subjects pre- and post-treatment for three-dimensional analysis (3D). Using Mimics software v.21.0, quantitative (3D condylar and joint spaces dimensions parameters were measured using linear measurements in millimeters, according to the Kamelchuk method and Ikeda method, while the assessment of anteroposterior condyle position within the glenoid fossa was based on the method of Pullinger and Hollender), and qualitative (a round bone tissue with an area of 2 mm2 in three representative areas according to the Kamelchuk method to measure condylar BMD) pre- and post-treatment. Intra- and inter-group statistical comparisons were performed using the Wilcoxon signed ranks and the Kruskal-Wallis test, respectively. The course of treatment was 6-12months, with an average of 9.1months. For the pre- and post-treatment quantitative comparisons, there was a statistically significant difference in the anterior joint space (AJS) and coronal medial space, as well as the condyle length in the myalgia group and condylar width in the arthralgia group. For qualitative measurements, a significant difference was observed in the posterior slope of the myalgia group and the arthralgia group's anterior, superior, and posterior slopes. The inter-group comparisons revealed significant differences in AJS, condylar length, and anterior slope density. In short-term follow-up, the S.S influenced patients with TMD from different origins; it changes anterior and coronal medial joint space, condyle length in myalgia, and width in arthralgia. Furthermore, it improved the condyle bone density more evidently in arthralgia. This study highlights the influence of S.S on symptomatic populations with TMD of different origins from a qualitative and quantitative perspective.

Thermo-flexible resin for the 3D printing of occlusal splints: A randomized pilot trial

ObjectivesTo compare the clinical performance of occlusal splints printed from thermo-flexible resin with milled splints. MethodsA parallel two-arm pilot trial was initiated. Forty-seven patients (n women=38) were recruited from a tertiary care center and randomized using an online tool (sealed envelope). Inclusion criterion was an indication for treatment with a centric relation occlusal splint due to bruxism or any form of painful temporomandibular disorder. Patients were excluded if they were younger than 18 years, unable to attend follow-up appointments, or required another type of splint therapy. Patients received either, a 3D-printed (intervention group, V-print splint comfort, VOCO) or a milled splint (control group, ProArt CAD splint, Ivoclar). Construction software Ceramill M-splint (AmannGirrbach), 3D-printer MAX UV 385 (Asiga) and milling unit PrograMill PM7 (Ivoclar) were used. Follow-up assessments were conducted after 2 weeks and 3 months. Outcome measures were survival, adherence, technical complications, patient satisfaction on a 10-point Likert scale, and maximum wear using superimposition of optical scans. ResultsAfter 3 months, 20/23 intervention group and 18/24 control group participants were assessed. All splints survived. Minor complications were small crack formations on 6 printed and 4 milled splints. Mean patient satisfaction was 8 (SD 1.7) for printed, and 8.1 (SD 2.3) for milled splints (r = 0.1, p = .52). Median maximum wear was highly dispersed with 153 (IQR 140) in posterior and 195 (IQR 537) in frontal segments of printed, and 96 (IQR 78) respectively, 123 (IQR 155) of milled splints, (both: r = 0.31, p = .084). ConclusionsWithin the limitations of a pilot trial, 3D-printed and milled splints performed similarly in terms of patient satisfaction, complication rates and wear behavior. Clinical significanceThermo-flexible material was proposed for 3D printing of occlusal splints to overcome mechanical weaknesses of previously available resins. This randomized pilot study provides evidence that this material is a viable alternative to milled splints for at least three months of clinical use. Further evidence on long-term use should be obtained.

Septic retrocalcaneal bursitis in a young soccer player treated with hindfoot endoscopic bursectomy: a case report

Septic retrocalcaneal bursitis (RB) is extremely rare with no reports on surgical treatment. Here, we describe a rare case of septic RB in a 14-year-old male soccer player who was treated with hindfoot endoscopic bursectomy. A 14-year-old male soccer player complained of right heel pain without trauma histories when he was playing a soccer. Based on physical examination, radiological findings and laboratory results, we diagnosed the patient with septic RB and started to treat with conservative treatment including a non-weightbearing splint and intravenous antibiotics therapy. However, his symptoms and laboratory results did not improve at 4days after starting intravenous antibiotics therapy, and so we applied hindfoot endoscopic bursectomy for him. At 4weeks after the surgery, he could return to the original sport at preinjury level without symptoms and complications. Septic RB in a 14-year-old male soccer player was successfully treated with hindfoot endoscopic bursectomy.

SPLINTS IN PROSTHODONTICS – A LITERATURE REVIEW

Occlusal splints are also called as occlusal appliances, biteguards, mouthguards, orthotics, interocclusal appliances. Occlusal splint therapy is used as both diagnostic and treatment appliance for temporo-mandibular disorders and occlusion related disorders. The aim of this article is to provide an insight on various types of splints being used in the eld of prosthodontics, indications and the rationale for use.

Efficiency of occlusal splint therapy on orofacial muscle pain reduction: a systematic review

BackgroundThis systematic review aims to examine the existing original studies to determine the effectiveness of occlusal splints (OSs) in the management of orofacial myalgia and myofascial pain (MP) in comparison with no treatment or other interventions.Materials and methodsBased on the inclusion and exclusion criteria of this systematic review, randomized controlled trials were qualified, in which the effectiveness of occlusal splint therapy in the management of muscle pain was examined in comparison with no treatment or other interventions. This systematic review was conducted according to the guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020. The authors searched three databases (PubMed, CINAHL (The Cumulative Index to Nursing and Allied Health Literature) and Scopus) for English publications published between January 1, 2010, and June 1, 2022. The last database search was carried out on June 4, 2022. Data were extracted from the included studies and assessed for risk of bias using the revised Cochrane risk-of-bias tool for randomized trials.ResultsThirteen studies were identified for inclusion in this review. In total, 589 patients were diagnosed with orofacial muscle pain who underwent education and various forms of therapy including different types of OSs, light emitting diode therapy, acupuncture, low-level laser therapy, device-supported sensorimotor training, Kinesio Taping, myofunctional therapy, and physical therapy. All studies included demonstrated a high risk of bias.ConclusionsThere is insufficient evidence regarding whether OS therapy in the treatment of orofacial myalgia and MP offers an advantage over other forms of interventions or no treatment. Further reliable clinical studies in this area are needed to improve the quality of research, which should be performed with larger groups of blinded respondents and controls.Clinical relevanceDue to the large-scale nature of orofacial muscle pain, it is assumed that each dental clinician will meet patients with orofacial muscle pain repeatedly in daily practice; hence, the review of the effectiveness of OSs in the management of orofacial myalgia and MP is necessary.

Innovations in mandibular advancement splint therapy for obstructive sleep apnoea

Mandibular advancement splint (MAS) therapy emerged as an effective therapy for obstructive sleep apnoea (OSA) in the mid 1990s, and is now the leading treatment alternative for OSA. Since its inception, the field has seen a suite of revisions and advances in relation to design and customisation, fabrication, titration methods, response prediction models and the integration of data collection technology. This paper reviews these current and emerging innovations in MAS therapy and their impact upon sleep apnoea management.