scholarly journals Occlusal splints in reversible occlusal therapy of craniomandibular dysfunction

2011 ◽  
Vol 58 (3) ◽  
pp. 156-162
Author(s):  
Vojkan Lazic ◽  
Igor Djordjevic ◽  
Ana Todorovic
Keyword(s):  
Mouth Opening ◽  
Medical Attention ◽  
Negative Effects ◽  
Posterior Teeth ◽  
Temporal Area ◽  
Craniomandibular Dysfunction ◽  
Occlusal Splints ◽  
Condylar Position ◽  
Surrounding Areas ◽  
Mandibular Movements

Craniomandibular dysfunction (CMD) is a set of structural and functional disorders of different etiology that affects temporomandibular joint (TMJ) and orofacial muscles. The most common etiologic factors are psychogenic, occlusal, trauma and congenital anomalies of craniofacial structures. About 75% of the examined population have mild symptoms of CMD while 3-4% have more severe symptoms which require medical attention. The main symptoms why people seek for medical attention are: facial pain which increases with chewing and irradiates in surrounding areas and pain in TMJ which irradiates in the ear canal, temporal area or neck. Painful restriction of mandible during mouth opening and eccentric movements is frequent as well as mandible deviation or deflection. Sound effects in TMJ such as popping or clicking during mouth opening are common. Initial and least invasive therapeutic procedure is reversible occlusal therapy using splints. There are two main types of occlusal splints: stabilization and relaxation. First type of splints works on condyle stabilization in orthopedically stable position; it is superoanterior condylar position in articular fossa with position of intercondylar discs between condyle and articular fossa when working cusps of the antagonists are in maximal contact with the splint. Another type of splint causes disocclussion of posterior teeth and eliminates negative effects of occlusal interference in the intercuspal position or during eccentric mandibular movements. During therapy, occlusal splint temporarily changes occlusal relationships as well as relations within TMJ, causing reduction of CMD symptoms. The best therapeutic effect for reduction of CMD symptoms is achieved by combination of physical therapy and medication.

Changes in The Temporomandibular Joint after Occlusal Deprogramming

2020 ◽  
pp. 1-21
Author(s):  
Rohit Kulshrestha ◽  
Keyword(s):  
Controlled Trial ◽  
Arthroscopic Surgery ◽  
Mandibular Condyle ◽  
Mouth Opening ◽  
Signs And Symptoms ◽  
Joint Space ◽  
Pharmacological Intervention ◽  
Occlusal Splints ◽  
Condylar Position ◽  
Surgery Education

Common signs and symptoms of TMD include masticatory muscle pain, TMJ sounds, limited mouth opening, and deviations in mandibular movements. Treatment generally involves some combination of occlusal splints, physiotherapy, relaxation therapy, pharmacological intervention, arthroscopic surgery, education, and behavioural counselling. One randomized controlled trial indicated that an occlusal deprogramming splint is more effective than other methods in treating TMD, although another study produced contradictory results. Measurements of the radiographic joint space a radiolucent area between the mandibular condyle and the temporal bone were introduced by Ricketts to describe condylar position. The clinical significance of condyle-fossa relationships in the TMJ is controversial, but several studies have suggested an association between eccentric condylar position and TMD. This chapter describes key changes in the condyle-fossa relationship after the use of an occlusal deprogramming splint in patients with TMD.

scholarly journals Mandibular movements in children with and without signs and symptoms of temporomandibular disorders

2004 ◽  
Vol 12 (1) ◽  
pp. 39-44 ◽  
Author(s):  
Leonardo Rigoldi Bonjardim ◽  
Maria Beatriz Duarte Gavião ◽  
Luciano José Pereira ◽  
Paula Midori Castelo
Keyword(s):  
Clinical Signs ◽  
Mouth Opening ◽  
Signs And Symptoms ◽  
Lateral Movement ◽  
Mandibular Movement ◽  
Group I ◽  
Group Ii ◽  
The Right ◽  
Mandibular Movements ◽  
Digital Caliper

This research aimed to evaluate mandibular movements in children with and without signs and symptoms of temporomandibular dysfunction. The sample taken consisted of 99 children aged 3 to 5 years distributed in two groups: I - Absence of signs and/or symptoms of TMD (25 girls/40 boys); II - Presence of signs and symptoms of TMD (16 girls/18 boys). The symptoms were evaluated through an anamnesis questionnaire answered by the child's parents/caretakers. The clinical signs were evaluated through intra- and extraoral examination. Maximum mouth opening and left/right lateral movements were measured using a digital caliper. The maximum protrusive movement was measured using a millimeter ruler. The means and standard deviations for maximum mouth opening in Group I and Group II were 40.82mm±4.18 and 40.46mm±6.66, respectively. The values found for the left lateral movement were 6.96mm±1.66 for Group I and 6.74mm±1.55 for Group II, while for the right lateral movement they were 6.46mm±1.53 and 6.74mm±1.77. The maximum protrusion movements were 5.67mm±1.76 and 6.12mm±1.92, in Groups I and II, respectively. The mandibular movement ranges neither differed statistically between groups nor between genders. FAPESP Process 96/0714-6.

scholarly journals A New Tridimensional Insight into Geometric and Kinematic Characteristics of Masticatory Cycles in Participants with Normal Occlusion

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Ramón Fuentes ◽  
Alain Arias ◽  
María Florencia Lezcano ◽  
Diego Saravia ◽  
Gisaku Kuramochi ◽  
...  
Keyword(s):  
Mouth Opening ◽  
Mandibular Movement ◽  
Electromagnetic Articulography ◽  
Kinematic Characteristics ◽  
Normal Occlusion ◽  
Significant Difference ◽  
Number Of Cycles ◽  
Opening And Closing ◽  
Mandibular Movements ◽  
Insight Into

The aim of this study was to analyze the general, geometric, and kinematic characteristics of the masticatory cycle’s movements in a tridimensional way, using a method developed by our study group to provide a new insight into the analysis of mandibular movements due to advancement in the potential of computational analysis. Ten individuals (20.1 ± 2.69 years), molar class I, without mandibular movement problems participated in this study. The movements of the masticatory cycles, frontal and sagittal mandibular border movements, were recorded using 3D electromagnetic articulography and processed with computational scripts developed by our research group. The number of chewing cycles, frequency (cycles/s), chewing cycle areas/mandibular border movements areas ratios, and the mouth opening and closing speeds on the 3D trajectory of the chewing cycle were compared. The cycles were divided and analyzed in thirds. The masticatory cycles showed high variation among the individuals (21.6 ± 9.4 cycles); the frequency (1.46 ± 0.21 cycles/s) revealed a moderate positive correlation (R = 0.52) with the number of cycles. The frontal area ratios between the cycle area and the mandibular border movement presented higher values in the first third (6.65%) of the masticatory cycles, and the ratios of sagittal areas were higher and more variable (first, 7.67%; second, 8.06%; and third, 10.04%) than the frontal view. The opening and closing mouth speeds were greater in the second third of the masticatory cycles (OS, 57.82 mm/s; CS, 58.34 mm/s) without a significant difference between the opening and closing movements when the same thirds were evaluated. Further studies are necessary to improve the understanding of the masticatory cycles regarding the standardization of parameters and their values.

scholarly journals Validating an infrared thermal switch as a novel access technology

2021 ◽  
Author(s):  
Negar Memarian ◽  
Anastasios Venetsanopoulos ◽  
Tom Chau
Keyword(s):  
Gold Standard ◽  
Mouth Opening ◽  
User Performance ◽  
Access Technology ◽  
Thermal Switch ◽  
Qualitative Feedback ◽  
Multiple Trials ◽  
Audiovisual Stimuli ◽  
Surrounding Areas ◽  
Opening And Closing

Background Recently, a novel single-switch access technology based on infrared thermography was proposed. The technology exploits the temperature differences between the inside and surrounding areas of the mouth as a switch trigger, thereby allowing voluntary switch activation upon mouth opening. However, for this technology to be clinically viable, it must be validated against a gold standard switch, such as a chin switch, that taps into the same voluntary motion. Methods In this study, we report an experiment designed to gauge the concurrent validity of the infrared thermal switch. Ten able-bodied adults participated in a series of 3 test sessions where they simultaneously used both an infrared thermal and conventional chin switch to perform multiple trials of a number identification task with visual, auditory and audiovisual stimuli. Participants also provided qualitative feedback about switch use. User performance with the two switches was quantified using an efficiency measure based on mutual information. Results User performance (p = 0.16) and response time (p = 0.25) with the infrared thermal switch were comparable to those of the gold standard. Users reported preference for the infrared thermal switch given its non-contact nature and robustness to changes in user posture. Conclusions Thermal infrared access technology appears to be a valid single switch alternative for individuals with disabilities who retain voluntary mouth opening and closing.

scholarly journals The use of occlusal splints in temporomandibular disorders - an overview.

2020 ◽  
Vol 3 (2) ◽  
pp. 3-8
Author(s):  
Andreea Kui ◽  
Silvia Pop ◽  
Smaranda Buduru ◽  
Marius Negucioiu
Keyword(s):  
Temporomandibular Disorders ◽  
Mouth Opening ◽  
Clinical Situation ◽  
Masticatory Muscles ◽  
The State ◽  
Common Symptom ◽  
Occlusal Splints ◽  
Temporomandibular Joints ◽  
Closed Lock ◽  
State Of Art

AbstractTemporomandibular disorders (TMD) affect the temporomandibular joints, the masticatory muscles, and surrounding tissues. Among symptoms such as jumps, joint noises, reduced mouth opening (closed lock), difficulties in closing the mouth (subluxation or open lock), pain is the most common symptom encountered among patients diagnosed with temporomandibular disorders. As literature on this topic is abundant and sometimes controversial, the authors focus on reviewing the state of art of occlusal splints indications. Therefore, the most common occlusal splints, like Lucia jig, nociceptive trigeminal inhibition (NTI), directive splints, etc., are being described, based on their design and therapeutic indications. Cases of malocclusions associated or not with parafunctions are usually manageable using the splints mentioned in this article. In case of disc displacements, occlusal appliances can be used, but as the etiology is multifactorial, there are some limitations, depending on the complexity of each clinical situation.

scholarly journals Nature of Occlusion during Eccentric Mandibular Movements in Young Adults

2012 ◽  
Vol 13 (5) ◽  
pp. 612-617 ◽  
Author(s):  
AV Sreekumar ◽  
PL Rupesh ◽  
Nishna Pradeep
Keyword(s):  
Young Adults ◽  
Common Factor ◽  
Class I ◽  
Protective Mechanism ◽  
Posterior Teeth ◽  
Occlusal Wear ◽  
Full Complement ◽  
Mandibular Movements ◽  
Centric Occlusion ◽  
The Ideal

ABSTRACT Aim The aim of this study was to find out the nature of occlusion and tooth contact during various eccentric mandibular movements in young adults with class I occlusion. Materials and methods The sample consisted of 100 young adults with class I occlusion with full complement of teeth. Anterior disclusion in centric occlusion was demonstrated using a shim stock interposed between the upper and lower anteriors. Disclusion of posteriors was ascertained during 1.5 mm straight protusion and in edge-to-edge protrusion, visually as well as using a silk floss method. Posterior disclusion was also verified during lateroprotrusion and crossover. Besides these occlusal wear of teeth also were observed. Results The results of this study showed that the anterior disclusion is seen only in one-fourth of the subjects compared to almost three-fourth showing posterior disclusion. Mutually protected occlusion was also seen only in one-fourth of the subjects. Canine protective mechanism is seen in a relatively large number of subjects, but it was not overwhelmingly predominant. No correlation could be established between cuspid wear and the type of occlusion. A relatively high percentage of subjects showed wear on posterior teeth when there was no posterior disclusion. Conclusion From the above study it is seen that posterior disclusion is acknowledged as a common factor except when a bilateral balance is present. Since bilateral balance is harmful, the ideal occlusal relationship in eccentric movements is in favor of posterior disclusion. Posterior disclusion is easily obtainable when restorations are planned. Clinical significance From the findings and results it has been possible to make some contributions on the nature of tooth contacts and disclusion during various eccentric movements and compare it with the requirements of ideal occlusion. How to cite this article Sreekumar AV, Rupesh PL, Pradeep N. Nature of Occlusion during Eccentric Mandibular Movements in Young Adults. J Contemp Dent Pract 2012;13(5):612-617.

scholarly journals The role of occlusal factor in the etiology of temporomandibular dysfunction

2009 ◽  
Vol 137 (11-12) ◽  
pp. 613-618 ◽  
Author(s):  
Slobodan Dodic ◽  
Vladimir Sinobad ◽  
Kosovka Obradovic-Djuricic ◽  
Vesna Medic
Keyword(s):  
Signs And Symptoms ◽  
Study Groups ◽  
Mean Value ◽  
Central Position ◽  
Therapeutic Effects ◽  
Posterior Teeth ◽  
Craniomandibular Dysfunction ◽  
Temporomandibular Dysfunction ◽  
The Mean

Introduction. The influence of occlusal condition at the onset of temporomandibular disorders (TMD) has been strongly debated for many years and still is the source of controversy. Up to the eighties in the last century, the occlusal factors such as the presence of uncured malocclusions, discrepancies between intercuspal position and retruded contact position greater than two millimeters, retrusive and nonworking side interferences and loss of posterior teeth were considered to be the primary causes of TMD. Objective. The aim of this study was to estimate the role of occlusal factor in the etiology of craniomandibular dysfunction and therapeutic effects of irreversible occlusal therapy (occlusal equilibration) in patients with TMD. Methods. In the investigation we studied a group of 200 men and women. The average age of the selected patients was between18 and 25 years. The purpose of TMD signs and symptoms was confirmed in every patient using a special functional analysis and evaluating the craniomandibular index (CMI) according to Fricton and Schiffman. The value of craniomandibular index was determined in the group of 15 patients with signs and symptoms of temporomandibular dysfunction. In the study groups occlusal equilibration (selective grinding) was performed according to Okeson using the central position of the mandible as the referent position in the occlusal therapy. The value of CMI was determined before and 30 days after occlusal equilibration. Results. The results of this study confirmed the significant reduction in the signs and symptoms of TMD after occlusal equilibration. The statistical elaboration of the differences between the values of CMI I (before treatment) and CMI II (30 days after treatment) revealed highly significant differences. The CMI I values in the group ranged between 0.076 and 0.346 with the mean value of 0.188?0.082.The values of CMI II ranged between 0.038 and 0.19 with the mean value of 0.038?0.053. Conclusion. The study conformed the validity of irreversible occlusal therapy (selective grinding) in patients with TMD.

Craniomandibular disorder/dysfunction. Characteristics and disorders of the masticatory organ

2015 ◽  
Vol 156 (4) ◽  
pp. 122-134 ◽  
Author(s):  
Géza Kiss ◽  
Miklós Pácz ◽  
Péter Kiss
Keyword(s):  
Treatment Options ◽  
Functional Anatomy ◽  
Mouth Opening ◽  
Diagnostic Algorithm ◽  
Early Years ◽  
Human Organism ◽  
Craniomandibular Dysfunction ◽  
Craniomandibular Disorder ◽  
And Function ◽  
Masticatory Organ

The practising physician often meets patients with pain located in different parts of the face and facial skull, mouth opening restriction or other motion disorder of the mandible. It is not always easy to identify and explain the cause. It is not widely known among doctors that most of these problems are due to masticatory dysfunction. There is a special group of patients showing functional disorders and there are some others who present a variety of different symptoms and visit several doctors. The masticatory organ, a functional unit of the human organism has a definite and separate task and function. In the early years of life it is capable of adaptation, while later on it tends to compensation. The authors outline the functional anatomy of the masticatory organ and the characteristics of multicausal pathology, the dynamics of the process of the disease and their interdisciplinary aspects. They discuss the basic elements of craniomandibular dysfunction. Based on the diagnostic algorithm, they summarize treatment options for masticatory function disorders. They emphasize the importance that physicians should offer treatment, especially an irreversible treatment, without a diagnosis. It occurs very often that the causes are identified after the patients become symptom-free due to treatment. The aim of this report is to help the general practitioners, dentists, neurologists, ear-nose-throat specialists, rheumatologists or any other specialists in the everyday practice who have patients with different symptoms such as pain in the skull, acoustic phenomenon of the joint or craniomandibular dysfunction. Orv. Hetil., 2015, 156(4), 122–134.

scholarly journals Effect of Occlusal Splints on the Temporomandibular Disorders, Dental Wear and Anxiety of Bruxist Children

2011 ◽  
Vol 05 (04) ◽  
pp. 441-450 ◽  
Author(s):  
Claudia C Restrepo ◽  
Isabel Medina ◽  
Patiñob Isabel
Keyword(s):  
Temporomandibular Disorders ◽  
Mouth Opening ◽  
Signs And Symptoms ◽  
Mixed Dentition ◽  
Control Group ◽  
Parent Rating ◽  
Dental Wear ◽  
Occlusal Splints ◽  
Significant Difference ◽  
Experimental Group

ABSTRACTObjectives: To evaluate the effectiveness of occlusal splints to reduce the signs and symptoms of temporomandibular disorders (TMD), dental wear and anxiety in a group of bruxist children. Methods: All of the subjects were 3 to 6 years old, had complete primary dentition, class I occlusion and were classified as bruxist according to the minimal criteria of the ICSD for bruxism. For each child, anxiety was evaluated with the Conners’ Parent Rating Scales (CPRS). The TMD were evaluated using the RDC/TMD. The dental wear was processed in digital format with Mat Lab® and Lab view® software to determine its size and form. The children were randomized into an experimental (n=19) and a control (n=17) group. The children in the experimental group used rigid bite plates for a two-year period, until mixed dentition. Afterwards, the CPRS and the RDC/TMD were applied again and dental casts were taken. Comparisons of the variables regarding dental wear, signs and symptoms of TMD and anxiety before and after treatment among the groups were analyzed using the t-test, the Wilcoxon rank sum test and the Mann-Whitney test. Results: The subjects in the experimental group showed no statistically significant difference regarding anxiety levels and dental wear when compared with the control group. The signs and symptoms of TMD were not reduced except for the deviation in mouth opening. Conclusions: The use of rigid occlusal bite plates was not efficient in reducing the signs of bruxism as a whole but did reduce the deviation in mouth opening. (Eur J Dent 2011;5:441-450)

Craniomandibular Dysfunction and Violin Playing: Prevalence and the Influence of Oral Splints on Head and Neck Muscles in Violinists

2006 ◽  
Vol 21 (4) ◽  
pp. 183-189
Author(s):  
A Steinmetz ◽  
P H Ridder ◽  
A Reichelt
Keyword(s):  
Head And Neck ◽  
Surface Emg ◽  
Occlusal Splint ◽  
Craniomandibular Dysfunction ◽  
Occlusal Splints ◽  
Muscular Tension ◽  
Overuse Syndromes ◽  
Muscular Load ◽  
Violin Playing ◽  
Muscles Of Mastication

Previous studies have shown a significant higher prevalence of craniomandibular dysfunction (CMD) in violin players compared with controls. CMD is related to increased muscular load in the muscles of mastication, the trapezius and sternocleidomastoid muscles, which can possibly predispose to overuse syndromes. To examine whether CMD can also cause overuse syndromes in violinists, we investigated a group of 31 violinists by questionnaire, mandibular tracking, and a clinical examination to elicit overuse and CMD symptoms. The influence of CMD on muscular tension during violin playing was assessed with surface EMG; this was performed twice on each violinist, once with and once without an occlusal splint, in order to work out the effect of CMD on the muscular load. CMD could be diagnosed in 74% of the investigated violinists. The occlusal splints significantly decreased the load in the masseter, temporalis, trapezius, and sternocleidomastoid muscles during musical performance. Occlusal splints appear to decrease the muscular load in asymptomatic violinists as well, suggesting a possible preventive and therapeutic role in overuse symptoms in the setting of preexisting CMD.

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