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Background: Temporomandibular Disorders (TMD) is the dysfunction of group of muscles and bones in the joint area, the main symptoms of TMD are the pain of the chewing muscles and (or) the temporomandibular joints, mandibular movement disorders and joint noise. This study was designed to explore the therapeutic effects following Individual Musculoskeletally Stable (IMS) position stabilization splint therapy for TMD patients using Fricton index, cone beam computed tomography (CBCT) and surface-Electromyogram (sEMG). Methods: In this study, we enrolled 31 TMD patients (ranging from 18 to 26 years old, including 7 males and 24 females), first Fricton index was used to evaluate the clinical curative effect of TMD with the treatment of IMS stabilization splint; then CBCT was used to observe the TMJ condylar position changes of TMD before and after the treatment of IMS stabilization splint; finally sEMG was used to observe the changes of electromyography of anterior temporalis (AT) and masseter muscles (MM) of TMD before and after the treatment of IMS stabilization splint. Results: The course of treatment was 6–8 months, with an average of 7.6 months. After the IMS stabilization splint treatment, TMD symptoms relieved, especially in pain, mandibular movement disorder, but still slightly inferior in the treatment of joint noise. And there was a statistically significant difference in the anterior and inner joint space, the condyle had the tendency of moving forward and outward. AT presented reduction significantly of EMG value at rest position after treatment. Conclusions: IMS stabilization splint is a therapeutic reversible treatment for TMD, especially for pain and mandibular movement disorder; it produces effects of forward and outward condylar movement and elimination of the masticatory muscles antagonism. [ABSTRACT FROM AUTHOR]

Background: Myogenic temporomandibular disorders (M‐TMD) commonly involve occlusal splint (OS) therapy and musculoskeletal physiotherapy (MPT). Objectives: To compare the effects of combining OS with MPT and education (EG) against OS and education (CG), in chronic M‐TMD patients. Methods: In this double‐blind randomised controlled trial, 62 participants were assigned to either EG or CG. The primary outcomes, pain levels at rest (VAS rest), maximum oral opening (VAS open) and during chewing (VAS chew), were measured by Visual Analogue Scale (VAS) in cm. The secondary outcome was the range of motion (ROM) for maximum oral opening. Both interventions lasted 3 months, with outcomes assessed at baseline (T0), post‐treatment (T1) and 3 months post‐treatment (T2). Results: Intention‐to‐treat analysis revealed significant improvements favouring EG (VAS rest = −1.50 cm [CI95%: −2.67, −0.32], p =.04; VAS open = −2.00 cm [CI95%: −3.23, −0.75], p <.01; VAS chew = −1.71 cm [CI95%: −2.90, −0.52], p =.01; ROM = 4.61 [CI95%: 0.93, 8.30], p =.04). Additionally, VAS measures were influenced by follow‐up times (VAS rest = −0.73 cm [CI95%: −1.30, −0.17], p = 0.03; VAS open = −0.97 cm [CI95%: −1.57, −0.37], p <.01; VAS chew = −1.15 cm [CI95%: −1.73, −0.58], p <.01). At T1, EG demonstrated higher number of responders compared to CG for VAS open (χ2(1) = 4.39, p =.04) and VAS chew (χ2(1) = 11.58, p <.01). Conclusion: Adding MPT to education and OS yields better outcomes in terms of pain reduction and ROM improvement, in chronic M‐TMD. Trial Registration Number: NCT03726060. [ABSTRACT FROM AUTHOR]

Background: Few studies have been conducted on treating temporomandibular disorders (TMDs) with new digital occlusal splints, which has increasingly attracted wide attention. Methods: To evaluate the clinical efficacy and quality of life (QoL) of Kovacs digital occlusal splint (KDOS) treatment in patients with TMD. Materials and methods: Eighty-nine patients with TMD who were treated using KDOS were analyzed. The patients were divided into three groups according to the Wilkes stage. The clinical symptoms and QoL scores of the patients in each group were recorded before and at least three months after treatment, and the data were statistically analyzed and compared. The relationships between the disease severity, sex, age, and level of QoL before treatment and improvement in the clinical symptoms were analyzed using binary logistic regression. Results: The mean age and follow-up period of the patients were 28.0 ± 10.4 years and 4.9 ± 2.1 months, respectively. After KDOS treatment, the improvement rates of joint noise and pain were 80.4% and 69.8%, respectively. Additionally, the patients' maximum mouth opening and global QoL mean scores significantly improved compared to those before treatment (p < 0.001). Binary logistic regression analysis revealed that the factors affecting the improvement in the clinical symptoms were disease severity and level of QoL before treatment. Conclusions: KDOS can improve the clinical symptoms and QoL of patients with TMD. Moreover, patients without osteoarthritis and with low pretreatment QoL levels are more likely to demonstrate clinical improvement. Trial registration: The trial was registered with Chinese Clinical Trial Registry (ChiCTR) (ID: ChiCTR2300076518) on 11/10/2023. [ABSTRACT FROM AUTHOR]

Background and objectives: This study analyzed and compared the distribution patterns of occlusal forces using T-Scan III before and after the hydrostatic temporary oral splint (Aqualizer Ultra) therapy in healthy subjects and subjects with temporomandibular disorders (TMDs). Materials and Methods: Fifty-one subjects were divided into groups based on anamnesis and responses to the Fonseca questionnaire. The first group, non-TMDs group (n = 19), and the second group, TMDs group (n = 32), had mild-to-severe TMDs, as identified by the Fonseca questionnaire. The non-TMDs group had an average age of 25.4 years (SD = 4.8, range 20–38) with 15 females (78.95%) and 4 males (21.05%). The TMDs group had an average age of 27.4 years (SD = 7.0, range 22–53) with 25 females (78.125%) and 7 males (21.875%). T-Scan III device was used for occlusal analysis before and after hydrostatic splint usage. Results: Significant differences were observed in the TMDs group for anterior and posterior right percentages of forces before and after hydrostatic splint usage. The analysis of force distribution per sector before and after hydrostatic splint therapy showed no significant differences in the non-TMDs group. Analysis of force distributions in the entire study population before and after hydrostatic splint therapy showed significant differences in the anterior and posterior right regions. Occlusal force increased by 32–56% in the front region and decreased in the posterior area after hydrostatic splint usage. Conclusions: Hydrostatic splint therapy is recommended as a part of full-mouth rehabilitation treatment for all patients regardless of the severity of TMDs. [ABSTRACT FROM AUTHOR]

Purpose: To analyze the success and survival of splinted and nonsplinted implants. Materials and Methods: A total of 423 patients (n = implants: 888) were included in the study. The success and survival of implants for 15 years were analyzed using a multivariable Cox regression model, and the significant effect of the splinting of prostheses and other risk factors were evaluated. Results: The cumulative success rate was 34.2%: 33.2% in nonsplinted (NS) and 34.8% in splinted implants (SP). The cumulative survival rate was 92.9% (94.1%, NS; 92.3%, SP). Whether to splint was not related to the success and survival of implants. The smaller the implant diameter, the lower the survival rate. The crown length and implant length were significantly associated only with NS implants: The longer the crown length and the shorter the implant length, the greater the risk of implant failure. The emergence angle (EA) and the emergence profile (EP) had a significant effect on only the SP implants: EA3 showed a higher risk than EA1, and EP2 and EP3 had a higher risk of implant failure. Conclusion: Crown length and implant length affected only the nonsplinted implants: The higher the crown length and the shorter the implant length, the greater the risk of implant failure. A significant effect for emergence contour was found only in SP implants: the implants restored with prostheses with EA ≥ 30 degrees on both the mesial and distal sides, and convex EP on at least one side had higher risks of failure. [ABSTRACT FROM AUTHOR]

Purpose: To analyze the biologic and mechanical complications of splinted and nonsplinted implant restorations. Materials and Methods: A total of 423 patients (n = implants: 888) were included in the study. Biologic and mechanical complications that occurred for 15 years were analyzed using the multivariable Cox regression model, and the significant effect of the splinting of prostheses and other risk factors were evaluated. Results: Biologic complications occurred in 38.7% of implants: 26.4% of nonsplinted implants (NS) and 45.4% of splinted implants (SP). Mechanical complications occurred in 49.2% of implants: 59.3% NS and 43.9% SP. Implants splinted with both mesial and distal adjacent implants (SP-mid) had the highest risk of peri-implant diseases. As the number of implants splinted increased, the risk of mechanical complications decreased. Long crown lengths increased the risk of both biologic and mechanical complications. Conclusion: Splinted implants had a higher risk of biologic complications and lower risk of mechanical complications. The implant splinted to both adjacent implants (SP-mid) had the highest risk of biologic complications. The greater the number of implants splinted, the lower the risk of mechanical complications. Long crown lengths increased the risk of both biologic and mechanical complications. [ABSTRACT FROM AUTHOR]

Purpose: To determine the effect of scanning protocol, number of implants, and implant splinting on the accuracy of digital scanning in the edentulous arch. Materials and Methods: A resin-based model of an edentulous mandible with six implants was scanned with a coordinate measurement machine as a reference and then with two intraoral scanner (IOS) systems (Trios 3 and Primescan). Ten scans were taken per IOS for three experiments, and each scan was compared to the reference data to evaluate trueness and precision. Analysis involved measurement of linear and angular discrepanices using engineering software. In experiment 1, three scanning protocols were compared (curvilinear, zigzag, and half-arch). In experiment 2, three clinical situations were simulated (6 implants, 4 implants-short arch, and 4 implants-long arch). In experiment 3, the effect of implant splinting with a suture thread was measured. Normal distribution of data was examined with Shapiro-Wilk test. Levene test was used for equality of variance (a = .05). Statistical differences in distance and angular deviations were analyzed using Student t test or ANOVA with post hoc Tukey test (a = .05). Results: The best results in terms of trueness and precision were obtained with a linear scanning protocol and six implants. The results were as follows: Trios 3: trueness = 52 µm/0.42 degrees, precision = 40 µm/0.26 degrees; Primescan: trueness = 24 µm/0.28 degrees, precision = 18 µm/0.27 degrees. The scanning protocol did not significantly affect distance or angular deviation accuracy. Trueness and precision significantly decreased with four implants using Primescan and TRIOS 3. Splinting implants negatively affected accuracy with both IOS devices. Conclusion: Both IOS devices achieved clinically satisfying accuracy for distance (< 100 µm) and angular (< 0.5 degrees) deviations with six implants and a linear scanning protocol. With four implants, angular deviations sometimes differed between implants within the same group depending on the IOS and the clinical situation. [ABSTRACT FROM AUTHOR]

Purpose: To assess (1) whether an occlusal splint (OS) or mandibular advancement splint (MAS) allowed better sleep quality and was more comfortable in individuals with sleep bruxism (SB); and (2) the relationship between sleep quality, comfort, and reduction in RMMA related to SB. Materials and Methods: Polysomnographic data from 21 SB subjects (mean ± SD age 25.6 ± 4.5 years) collected in two previous studies were compared. Morning self-reports on sleep quality and comfort of the oral device, polysomnographic data, and RMMA index data from no-device nights were compared to nights using an OS or MAS. The reduction ratio of the RMMA index was calculated for both devices. A responder to the oral device was identified when the RMMA index was less than 2 and when it showed a reduction of at least 50% from the no-device control night. Results: Self-reports for sleep quality and comfort of the oral device showed a mild advantage of the OS when compared to the MAS (r2 = 0.47, r2 = 0.32; P = .01). In responders, the MAS induced a greater reduction in the RMMA index (P = .03) than the OS. Conclusions: In the short term, the comfort of the oral device seemed to influence sleep quality in SB individuals. However, despite the slightly higher degree of comfort offered by the OS, the MAS induced a greater effect on the RMMA index. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to assess the accuracy of maxillary repositioning surgery in teaching hospitals using conventional model surgery. Materials and methods: A total of 73 patients undergoing single-piece LeFort I osteotomies in the maxilla and bilateral sagittal split osteotomies in the mandible were included in the study. Preoperative and immediate postoperative cone-beam CT were compared in computer software (Dolphin3D©). Maxillary landmarks relative to the vertical and horizontal reference lines were evaluated. The difference between the planned and achieved maxillary positions was measured. Distance error in millimeters and achievement ratio (achieved displacement/planned displacement*100) were calculated for different maxillary movements. Results: Midline correction and advancement were the most accurate movements with an overall mean distance error of 0.53 mm and 0.63 mm respectively while posterior impaction and setback were the least accurate movements with 1.38 mm and 1.76 mm mean discrepancies, respectively. A significant difference was observed only in setback movement regarding the discrepancy value (P <.05). Although setback and down-graft movements tended to under-correction, all other movements were overcorrected. As the magnitude of maxillary movements increases, the accuracy decreases. In severe displacements (≥ 8 mm), the accuracy declines significantly (P <.05). Conclusion: Classic cast surgery and manually fabricated intermediate splints in teaching hospitals yield accurate and acceptable results in the majority of cases (84.6%). The accuracy of maxillary repositioning decreases as the magnitude of displacement increases. [ABSTRACT FROM AUTHOR]

Safe delivery of care is a priority in dentistry, while basic epidemiological knowledge of patient safety incidents is still lacking. The objectives of this study were to (1) classify patient safety incidents related to primary dental care in Denmark in the period 2016–2020 and study the distribution of different types of dental treatment categories where harm occurred, (2) clarify treatment categories leading to "nerve injury" and "tooth loss" and (3) assess the financial cost of patient-harm claims. Data from the Danish Dental Compensation Act (DDCA) database was retrieved from all filed cases from 1st January 2016 until 31st December 2020 pertaining to: (1) The reason why the patient applied for treatment-related harm compensation, (2) the event that led to the alleged harm (treatment category), (3) the type of patient-harm, and (4) the financial cost of all harm compensations. A total of 9069 claims were retrieved, of which 5079 (56%) were found eligible for compensation. The three most frequent categories leading to compensation were "Root canal treatment and post preparation"(n = 2461, 48% of all approved claims), "lack of timely diagnosis and initiation of treatment" (n = 905, 18%) and "surgery" (n = 878, 17%). Damage to the root of the tooth accounted for more than half of all approved claims (54.36%), which was most frequently a result of either parietal perforation during endodontic treatment (18.54%) or instrument fracture (18.89%). Nerve injury accounted for 16.81% of the approved claims. Total cost of all compensation payments was €16,309,310, 41.1% of which was related to surgery (€6,707,430) and 20.4% (€3,322,927) to endodontic treatment. This comprehensive analysis documents that harm permeates all aspects of dentistry, especially in endodontics and surgery. Neglect or diagnostic delays contribute to 18% of claims, indicating that harm does not solely result from direct treatment. Treatment harm inflicts considerable societal costs. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this article was to introduce a method for the digital application of three‐dimensional (3D) diagnosis and treatment with a virtual articulator and 3D data. Clinical Consideration: With the use of cone‐beam computed tomography (CBCT) and intraoral and facial scans, we can create a virtual articulator and evaluate the mandibular position in maximum intercuspation and centric‐related occlusion for the patient with an unstable occlusion and temporomandibular disorders (TMD). Based on this, we treated a case using a digital mandibular position indicator (MPI) and fabricated a stabilization splint using a 3D printer. This approach eliminates the traditional impression or model mounting process and the analog face bow transfer. Furthermore, the design of the stabilization splint is accomplished using software. Conclusions: The approach outlined in this article offers the potential for a digital diagnosis and treatment process by seamlessly integrating CBCT, intraoral scans, and facial scans with a high degree of accuracy. This may enhance precision in diagnosis and treatment planning, especially for patients with complicated TMD, in addition to facilitating effective communication with orthodontic patients who require thorough attention. Clinical Significance: Utilizing a virtual articulator and digital MPI for the occlusal evaluation of patients with TMD and unstable occlusion makes it possible to diagnose and analyze the occlusal condition accurately. This approach also allows for precision and efficiency in treatment. [ABSTRACT FROM AUTHOR]

To obtain a current overview of the use of mandibular advancement splints (MAS) as a therapeutic option for obstructive sleep apnea (OSA) in the dental profession in Northern Germany. A questionnaire was mailed to 2431 dental professionals, and 8.3% responded. Descriptive data analysis was performed on each question separately. Most of the surveyed dentists (51.7%) estimated the success rate of MAS therapy to be higher than 75%. Analysis of the relationship between the number of splints prescribed annually and the dental specialization (p = 0.22), work experience (p = 0.14), estimated success rate of MAS therapy (p = 0.96), and discontinuation of MAS therapy (p = 0.57) revealed no significant correlations. Mandibular advancement splints seem to be a safe and successful therapy for OSA. There seems to be a lack of information on the patient side and a lack of education on the dentist side. [ABSTRACT FROM AUTHOR]

Background: Temporomandibular disorder (TMD) is a grouping of heterogeneous disorders with multifactorial origins. Stabilization splints (SS) have demonstrated an acceptable treatment effect in TMD. The possible changes at the skeletal, dental, and soft tissue levels need to be addressed to evaluate the benefit/risk ratio of this therapeutic procedure. Accordingly, this study aimed to three‑dimensionally evaluate skeletal, dentoalveolar and soft tissue changes after SS treatment for patients with TMD. Methods: This retrospective study included 74 adult patients with myofascial and/or intra-articular disorders (25 males and 49 females), with an average age of 22.88 ± 4.8 years, who underwent SS treatment. Pre- and post-treatment Cone beam computed tomography were analysed using Invivo 6.0.3 software. The primary outcome was the vertical skeletal and dentoalveolar changes, while the secondary outcomes were the anteroposterior skeletal, dentoalveolar and soft tissue changes. Paired t-test and Wilcoxon rank sum test were used for statistical analyses. Results: For the primary outcome; skeletally, there was a significant increase in mandibular plane inclination (difference: 0.82°±1.37), decrease facial height ratio (difference: 0.45%±1.07) and at the dentoalveolar level, the inclination of the functional (FOP-SN, FOP-FH) and bisecting (BOP-SN, BOP-FH) occlusal planes exhibited a significant increase too (difference: 0.38 ± 1.43°, 0.49 ± 1.62°, 0.44 ± 1.29° and 0.41 ± 1.17°, respectively) and also a decrease in the overbite (difference: -0.54 ± 0.83). For the secondary outcomes; there was a significant decrease in mandibular position (SNB) (difference: 1.60 ± 1.36°) and increase in the overjet (difference: 0.93 ± 1.04, p < 0.001) and a significant lower lip retrusion (difference: 0.33 ± 1.01 mm p < 0.01), was observed too. Conclusions: SS therapy resulted in significant vertical skeletal and dentoalveolar changes that were manifested mainly by facial height ratio, mandibular and occlusal plane changes, and to a lesser extent, significant anteroposterior skeletal, dentoalveolar, and soft tissue changes in the form of mandibular position, increased overjet and a more retrusive lower lip. These changes should be considered during patients' selection prior to initiating SS therapy. [ABSTRACT FROM AUTHOR]

The current study evaluated the stress distribution in a maxillary central incisor with mid‐root fracture after splinting with different intra‐radicular posts using 3D‐finite element analysis (FEA). Five 3D‐FEA models were constructed. Model 1 was an intact tooth with no fracture, Model 2: A tooth with a horizontal mid‐root fracture, with no treatment. Model 3: Same as model 2, and intraradicular splinting using fiber post. Model 4: Same as model 2 and intra‐radicular splinting using Protaper Gold file F3. Model 5: Same as model 2, and with intraradicular splinting with Ribbond. The FEA of all models was done to obtain the maximum Von‐Mises stress in the root canal space, the dentin, the periodontal ligament, and the bone. The highest Von Mises stresses for the root canal space and the dentin were found in Model 3, followed by models 4, 5, and 2, and least in Model 1. The Von Mises stress of the periodontal ligament was the least in model 1. The Von Mises stress of bone was higher in all experimental models than in the baseline model. The results suggest that in cases where intra‐radicular splinting is indicated, fiber posts and Ribbond are better alternatives to endodontic files due to the lower stresses exerted. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this study was to compare marginal bone loss (MBL) and clinical complications between surviving implants (SIs) and recently placed implants (RIs) splinted together to support a fixed partial restoration (FPR). Materials and Methods: This retrospective study employed the medical records of patients treated with implant-supported FPRs in the Maccabi-Dent Dental Clinic. Patients were included if they were over the age of 18 years, were treated with RIs adjacent to existing SIs that had previously supported FPRs for more than 1 year, and the RIs and SIs were splinted to support new FPRs. Patients who did not receive annual follow-up or whose records had nondiagnostic radiographs or lacked sufficient restorative data were excluded. MBL was assessed at the last available radiograph and compared to one taken 1 year after loading the splinted RIs and SIs together. Clinical complication data were gathered from patient records. Results: The medical records of 1,907 patients treated with a total of 7,306 implants were examined. Data from 187 implants were extracted from 46 patient records that met the inclusion criteria, with 96 RIs and 91 SIs supporting 56 FPRs. Mean followup was 39 ± 17.5 months. During the follow-up, two implants failed. The overall survival rate was 98.94% (98.96% in RIs and 98.91% in SIs), and the mean MBL in all implants was 0.41 ± 0.58 mm (0.4 ± 0.53 mm in RIs and 0.42 ± 0.45 mm in SIs). Peri-implantitis was reported in eight (4.3%) implants (four RIs and four SIs), screw loosening was reported in nine (4.8%) implants (three RIs and six SIs), ceramic chipping was reported in three (5.3%) restorations supported by four RIs and six SIs, and decementation was reported in one (1.8%) restoration supported by one RI and one SI. There was no statistically significant difference in survival rate, MBL, peri-implantitis, or screw loosening between RIs and SIs. Conclusion: There was no statistically significant difference in MBL or clinical complications between RIs and SIs. Splinting RIs and SIs for new prosthetic restoration support is a reasonable treatment choice with a high implant survival rate, low incidence of complications, and acceptable MBL. [ABSTRACT FROM AUTHOR]

Prosthetic design is a critical step in implant treatment planning that must synchronize with implant positioning to promote a state of peri-implant health. Improperly designed prostheses may not only hinder patient (or professional) hygiene measures but also impact the ability of clinicians to examine the peri-implant supporting tissues for diagnostic purposes. The purpose of this review was to discuss the current state of the evidence surrounding prosthetic factors associated with peri-implant diseases. Following the chronologic order of implant treatment, key prosthetic variables were discussed in relation to peri-implant disease pathogenesis. Specific concepts including the impact of implant spatial positioning, abutment height, residual cement, and implant splinting were found to be associated with peri-implant disease pathogenesis. Excessive occlusal forces were found to play a role in susceptibility to prosthetic complications with limited evidence to suggest a role in peri-implant disease progression. An intimate prosthetic-biologic connection exists, which must be respected to promote an environment for long-term peri-implant stability and health. [ABSTRACT FROM AUTHOR]

Background: Occlusal splints and anterior repositioning splints (ARSs) are widely accepted treatments for temporomandibular disorders (TMDs). However, there is uncertainty with regard to the most suitable amount of mandibular repositioning. The aim of this study is to evaluate the clinical and functional effects of the therapeutic position (ThP) established based on the Controlled Mandibular Repositioning (CMR) method. Methods: In this clinical trial, 20 subjects with 37 joints with disc displacement with reduction were recruited. The initial standard functional diagnostic protocol, MRI, and digital condylography were performed, and ThP was calculated with the CMR method. After a 6-month follow-up, the standard diagnostic protocol was repeated. The change in disc position was evaluated by means of MRI after 6 months of CMR therapy. Results: The MRI findings in the parasagittal plane demonstrated that out of the 37 joints presenting disc displacement, 36 discs were successfully repositioned; thus, the condyle–disc–fossa relationship was re-established. Therefore, the success rate of this pilot study was 97.3%. The mean position of the displaced discs was at 10:30 o'clock of the TMJ joint and at 12:00 o'clock after CMR therapy. Conclusions: The ThP determined using the CMR approach reduced all of the anteriorly displaced discs (except one). The CMR method allowed to define an optimum ThP of the mandible thus supporting patients' effective adaptation to treatment position. [ABSTRACT FROM AUTHOR]

Introduction: Several medical devices (MDs) are used to assist surgeons in positioning the upper dental arch (UDA) during Le Fort I osteotomies (LFIOs). Some only allow holding, others only positioning. This study aimed to assess the accuracy of a new MD (PirifixTM) coupling these two functions during LFIO on 3D-printed models. Materials and Methods: DICOM data were selected from patients who underwent surgical planning for LFIO between 27 July 2020 and 1 December 2022. Their anatomy was reproduced after segmentation, planning, and stereolithography in two models. Each model was assigned to one of two surgical groups: the control group (positioning by occlusal splint) and the PirifixTM group. Each patient's model was planned with the objective of horizontalizing and recentering the UDA. After positioning, models were digitalized using Einscan Pro 2X and compared to the planned model with CloudCompare. The statistical analysis was performed using the Wilcoxon Mann–Whitney test. The result was considered significant if the p-value was less than 0.05. Results: Twenty-one patients were selected. Forty-two anatomical models were 3D-printed. The mean difference compared to the planned and corrected positions was 0.69 mm for the control group and 0.84 mm for the PirifixTM group (p = 0.036). Conclusion: PirifixTM may be a new alternative to available MDs. Further investigations are needed to describe the relationship between the device and facial soft tissues. [ABSTRACT FROM AUTHOR]

Temporomandibular disorders (TMDs) are debilitating and can be difficult to diagnose. Internal disc derangement is one of more than 30 TMDs. Appropriate treatment and use of multiprofessional resources are critical to providing care essentials for these temporomandibular joint conditions. [ABSTRACT FROM AUTHOR]

Background/Aim: Luxation is a common traumatic dental injury treated with a wire composite (WC) splint. However, bulk‐fill flowable composite and conventional packable composite have not been compared for retaining these splints. Therefore, the objectives of this randomized controlled trial were (1) to compare retention of WC splints, and (2) to compare adhesive point dimension, application and removal time, and effect on tooth mobility between the two WC splints. Materials and Methods: In this parallel group, non‐inferiority double blind randomized controlled trial, a total of 90 patients, aged 16–50 years participated. They were randomly allocated into two groups, the packable composite group (PC) n = 45 and the bulk‐fill flowable composite group (BF‐FC) n = 45 by lottery method. Following measurements were taken at the splint application appointment. Horizontal tooth mobility measured via Periotest, splint application time, and frontal images of splinted teeth to measure the percentage composite adhesive point area. After 2 weeks, splints were visually inspected for retention, whereas mobility and removal times were also recorded. Statistically, comparisons were made using independent samples sample T‐test, Fisher's exact test, and Mann–Whitney U at p ≤.05. Results: A total of 88 patients with 156 luxated teeth completed the trial, as two patients were lost to follow‐up. Two patients in the PC group reported with completely de‐bonded splints while none de‐bonded in the BF‐FC group. Both groups were similar in terms of splint retention (p =.352), reduction of mobility (p =.426), and splint removal times (p =.372). The BF‐FC group performed significantly better in adhesive point dimension percentages (p <.001) and splint application time (p <.001). Conclusion: Both groups were comparable in most parameters of the study. However, for BF‐FC group application time and adhesive point dimension were significantly less. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the impact of occlusal splint plus laser therapy (OS + LT) compared with OS alone on the patient‐reported outcomes and clinical parameters of patients with temporomandibular disorders (TMDs). Methods: Twenty‐three patients with TMDs were randomly assigned to two treatment approaches: OS and OS + LT (multiwave locked system). The two outcomes were clinical parameters (mouth‐opening distances, number of muscles and TMJs with pain) and patient‐reported outcomes (pain score and oral health‐related quality of life [OHRQoL] determined using the 14‐item oral health impact profile [OHIP‐14]). The outcomes were measured at four time points: baseline, 2 weeks, 1 and 3 months after treatment. According to DC/TMD Axis I classification, the participants were diagnosed as having pain only and pain with intraarticular joint disorder. Adjusting for age and sex, the outcome changes were analysed using generalized estimating models at a 5% significance level. Results: The pain‐free mouth‐opening distance of the patients who received OS + LT continuously increased from 2 weeks to 3 months. However, the value was significantly increased at 3 months in patients who received OS alone. The unassisted mouth‐opening distance significantly increased after 3 months in both groups. In both treatment approaches, the number of muscles and TMJs with pain, as well as the pain and OHIP‐14 scores gradually decreased from baseline to 3 months. Conclusions: The patients who received OS and OS + LT demonstrated better OHRQoL and clinical parameters during 3 months after treatment. An improvement in the pain‐free mouth‐opening distance at 2 weeks was found only in OS plus LT group; however, this difference may not be clinically significant. [ABSTRACT FROM AUTHOR]

To compare the short-term clinical results between disc repositioning by open surgery (DROS) and stabilization splint (SS) for the treatment of temporomandibular joint (TMJ) anterior disc displacement without reduction (ADDwoR). Patients diagnosed with ADDwoR by magnetic resonance imaging (MRI) and treated by either DROS or SS from June 2020 to January 2022 were reviewed. They were selected to match the baseline data before each treatment and then to compare the clinical results including maximum interincisal opening (MIO), protrusion and lateral excursion distances, visual analogue scale (VAS) scores of pain, diet, and quality of life (QoL) and their effective rates, total satisfaction rate after 3 and 6 months of the treatment, and between the 2 treatment methods. SPSS software was used to analyze the statistical differences. A total of 175 patients were included in the study. There were 95 patients in the DROS group and 80 patients in the SS group. MIO and VAS scores were significantly improved after each treatment at 3 and 6 months (p < 0.05). DROS improved more at 6 months than 3 months (p < 0.001), whereas SS had no significant changes (p > 0.05). DROS had significantly better MIO, VAS score and effect rates than SS (p < 0.001). The total satisfaction rate was 94.73% in DROS and 86.25% in SS. The protrusion and lateral excursions decreased after DROS at 3 months (p < 0.001) but improved at 6 months to better than before the surgery (p = 0.03, p = 0.10). There were no significant changes in protrusion and lateral excursions after SS (p > 0.05, p > 0.05). DROS had better short-term clinical results than SS in the treatment of ADDwoR. • Through VAS evaluation and mouth opening measurement, DROS obtained better results than OS for the treatment of ADDwoR. [ABSTRACT FROM AUTHOR]

Objectives: To compare implant placement accuracy and patient‐centered results between the dynamic computer‐assisted implant surgeries (d‐CAISs) using marker‐based and marker‐free registration methods. Materials and Methods: A double‐armed, single‐blinded randomized controlled trial was conducted, in which 34 patients requiring single implant placement at the esthetic zone were randomly assigned to the marker‐based (n = 17) or marker‐free (n = 17) groups. The marker‐based registration was performed using a splint containing radiopaque markers, while the marker‐free registration used natural teeth. The primary outcome assessed implant positioning accuracy via angular and linear deviations between preoperative and postoperative implant positions in CBCT. Patients were also surveyed about the intraoperative experience and oral health impact profile (OHIP). Results: The global linear deviations at the implant platform (0.82 ± 0.28 and 0.85 ± 0.41 mm) and apex (1.28 ± 0.34 and 0.85 (IQR: 0.64–1.50) mm) for the marker‐based and marker‐free groups respectively showed no significant difference. However, the angular deviation of the marker‐free group (2.77 ± 0.92°) was significantly lower than the marker‐based group (4.28 ± 1.58°). There was no significant difference in the mean postoperative OHIP scores between the two groups (p =.758), with scores of 2.74 ± 1.21 for marker‐based and 2.93 ± 2.18 for marker‐free groups, indicating mild oral health‐related impairment in both. Notably, patients in the marker‐free group showed significantly higher satisfaction (p =.031) with the treatment procedures. Conclusions: D‐CAIS with a marker‐free registration method for single implantation in the anterior maxilla has advantages in improving implant placement accuracy and patients' satisfaction, without generating a significant increase in clinical time and expenses. [ABSTRACT FROM AUTHOR]

Objective: In many esthetic treatments, clinicians may consider the option to modify the maxillo mandibular position. A raise of the vertical dimension of occlusion (VDO) may help restore esthetics, increase the space for dental materials, and reduce the invasiveness of dental procedures. Traditionally, VDO increases are done by using the centric relation (CR) position. Despite a long history of use, the neuromuscular effects of different maxillo mandibular relations are not fully studied. The aim of this study was to investigate the effect of alterations of maxillo‐mandibular relation from maximal intercuspal position (MIP) to a raised VDO CR position on jaw‐elevator muscle activity. Materials and Methods: Fifteen healthy individuals were asked to carry out maximal voluntary clenching (MVC) in MIP and in CR on individual splints. Electromyographic (EMG) activity of the masseter and anterior temporalis muscles was assessed in μV as the root mean square of the amplitude. Specific indexes and ratios were also computed. Data analyzed in MIP and CR were compared by paired student's t‐tests. Results: MVC levels were not negatively affected by a VDO increase in CR position. On the contrary masseter muscles showed a statistically significant increase (p < 0.005). No significant effect on the anterior temporalis was observed. Conclusion: These results suggest that no immediate negative effect on maximum voluntary clenching was induced by a VDO increase in CR position. A slight increase observed in EMG clenching levels could be explained by the increase in VDO when clenching on the splint. Clinical Implications: The results of this study support the use of CR position as a pragmatic reference position due to the absence of relevant or negative changes in neuromuscular function. [ABSTRACT FROM AUTHOR]

A 25-year-old man with a hip dislocation and Pipkin II type femoral head fracture, whose surgical treatment was postponed for 15 days due to Covid 19 pandemic, is described. For 2 months after surgery, treatment was supported by therapy in a hyperbaric chamber and with a continuous passive motion (CPM) splint. Four months after surgery, bone fusion of the femoral head fracture was achieved with its normal revascularization. Two years after the operation, the patient was moving efficiently and had no complaints of hip pain. Delayed open reduction and internal fixation of the femoral head fracture resulted in a very good functional and radiological outcome. [ABSTRACT FROM AUTHOR]

Background and Objective: This review paper focuses on sleep bruxism (SB) in children and adolescents. It aims to assess the landscape of knowledge published in the last 20 years. Methods: A total of 144 relevant publications from 386 previously identified through Medline were included, of which 83 were on possible SB, 37 on probable SB, 20 on definite SB and 4 were non‐applicable. The review places emphasis on the recent evidence on prevalence, pathophysiology, diagnosis and management of SB in children and adolescents, with special focus on probable and definitive SB. Results: The prevalence ranges from 5% to 50% depending on the age range and on the SB diagnosis (possible, probable or definitive). The pathophysiology is multifactorial, arousal associated and with behavioural problems and sleep disorders (obstructive sleep apnoea, snoring, nightmares) as risk factors, as well as respiratory conditions (allergies, oral breathing). Screening should include questionnaires and dental assessment. Instrumental recording is helpful to confirm diagnosis although more studies are needed to validate this approach in children. SB management includes controlling orofacial and dental consequences and assessing for any other comorbidity. Management options include occlusal splints, oral appliances (advancement mandibular), rapid maxillary expansion and some medications, although this last option is supported by limited evidences in children. Conclusion: Suggestions of future topics in research are delivered to better understand comorbidities, diagnosis and management with improved outcomes compared to what is currently available. [ABSTRACT FROM AUTHOR]

Background: 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. Objectives: 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. Methods: 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. Results: 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. Conclusion: 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. [ABSTRACT FROM AUTHOR]

Purpose: Temporomandibular disorders (TMDs) are frequent stomatological disorders. However, their treatment is controversial. Therefore, we compared the efficacy of combination therapy (splint therapy along with physiotherapy, manual therapy, and counseling) with physiotherapy, manual therapy, and counseling alone. The extent of mouth opening and pain perception were the outcomes. Study selection: Systematic searches for English publications were performed using four major literature databases (Cochrane Library, EMBASE, PubMed, and Web of Science). We included randomized controlled trials. We calculated mean differences with 95% confidence interval (CI) for pain perception and maximum mouth opening (MMO) for the two groups. The Hartung-Knapp adjustment was used for cases comprising at least five studies. Results: Six articles were included in the pain perception category, and four were reviewed for MMO at baseline. Four articles assessed pain perception, and two assessed MMO at 1 month. Five articles were analyzed upon comparing pain perception at baseline and 1-month follow-up. The mean difference was -2.54 [95% CI: -3.38; to -1.70] in the intervention group and -2.33 [95% CI: -4.06; to -0.61] in the control group. Two articles were analyzed upon comparing MMO at baseline and 1-month follow-up. The mean difference in the intervention group was 3.69 [95% CI: -0.34; 7.72], whereas that in the control group was 3.62 [95% CI: -3.43; 10.67]. Conclusions: Both therapies can be used in the management of myogenic TMD. Due to the marginal differences between the baseline and 1-month values, our results could not confirm the efficacy of combination therapy. [ABSTRACT FROM AUTHOR]

There is currently no consensus on the best treatment for painful temporomandibular disc displacement with reduction (DDwR), and no network meta-analysis of randomized clinical trials (RCTs) comparing all types of treatment for this condition has been conducted. The objective of this study was to compare and rank all treatments for DDwR, including conservative treatments, occlusal splints, low-level laser therapy (LLLT), manual therapy, no treatment (control), arthrocentesis (Arthro) alone, Arthro plus intra-articular injection of platelet-rich plasma (Arthro–PRP) or hyaluronic acid (Arthro–HA), and Arthro plus occlusal splint. Predictor variables were pain intensity and maximum mouth opening (MMO). The mean difference with 95% confidence interval was estimated using Stata software. The GRADE system was used to assess the certainty of the evidence. Twenty RCTs reporting 1107 patients were identified in the literature search; 980 of these patients were included in the network meta-analysis. Direct meta-analysis showed that Arthro–PRP significantly reduced pain intensity compared to Arthro alone, while occlusal splint and manual therapy were superior to conservative treatment (all very low quality evidence). Arthro with intra-articular injection of PRP/HA ranked as the most effective treatment in terms of pain reduction, whereas LLLT ranked the best choice for increasing MMO for patients with DDwR. However, it is important to note that the evidence for the superiority of these treatments is generally of very low quality. Therefore, further high-quality research is needed to confirm these findings and provide more reliable recommendations for the treatment of DDwR. [ABSTRACT FROM AUTHOR]

Background: Sleep bruxism is a prevalent condition in dentistry practice, characterized by involuntary grinding or clenching of the teeth during sleep. Several therapies, including occlusal splints, have been used to manage sleep bruxism and temporomandibular disorders, including occlusal splints. This study aimed to compare the effectiveness of different occlusal splints in managing sleep bruxism. Methods: The PICO framework encompasses the characterization of the population, intervention, comparison, and pertinent outcomes. A comprehensive and systematic literature review was conducted on PubMed, Scopus, and Google Scholar to identify grey literature. The search specifically targeted scientific studies published before September 20, 2023. The Cochrane Collaboration Risk of Bias Tool assessed the accuracy of the included Randomized Control Trials (RCTs). The modified Newcastle–Ottawa Scale assessed non-randomized studies. Data were systematically extracted, synthesized, and reported thematically. Results: Out of the total of 808 articles that were evaluated, only 15 articles were found to meet the specified inclusion criteria. Adjustable splints, such as full-occlusion biofeedback splints, were more effective in reducing sleep bruxism episodes, improving patient-reported symptoms, and enhancing overall well-being. The impact of different occlusal sprints on electromyographic activity varies, and potential adverse effects should be considered individually. Conclusions: This review provides valuable insights into the effectiveness of occlusal splints in managing sleep bruxism. The results of this study indicate that occlusal splint therapy is a viable treatment approach for sleep bruxism. [ABSTRACT FROM AUTHOR]

This article explores the use of 3D printing technology in the creation of occlusal splints for the treatment of bruxism. The study demonstrates that digital technology and 3D printing can be reliable and effective in producing occlusal splints. The article discusses the advantages and disadvantages of different manufacturing techniques and materials used in the process. Overall, the use of 3D printing for occlusal splints shows promise, but further research is needed to assess long-term use. Additionally, a list of references is provided for further exploration of the topic, covering various aspects of occlusal splints and their fabrication. [Extracted from the article]

Purpose: To evaluate the effects of vertical compressive cyclic load on abutment screws and the stability of screw-retained splinted fixed dental prostheses supported by bone-level nonengaging and partially engaging abutments. Materials and Methods: Ten standardized two-unit prostheses integrated with nonengaging and partially engaging abutments were 3D-printed and cast in nonprecious metal and attached to two implant analogs with conical connections angled 15 degrees toward the vertical axis in a resin bock. The common path of insertion for the prosthesis with partially engaging abutments to angled implant analogs was created by selectively reducing the abutment surface that obstructed the implant housing. A 500-N average load was applied to each sample while oscillating 30 degrees from the vertical axis at 60 Hz to failure. Prosthesis stability was measured by deflection from the initial position using a linear displacement measuring device. Sample groups were assessed using the independent-samples t test and one-way repeated-measures analysis of variance (ANOVA) with post hoc tests. Results: The mean cycles to failure for nonengaging and partially engaging abutment groups were 27,180 ± 29,420 and 457,890 ± 265,734, respectively. Failed nonengaging samples had 9 out of 10 abutment screws fracture inside the implant housing but with minimal wear to the top of the implant analog. For partially engaging samples, 8 out of 10 implant housings and 7 out of 10 abutment screws fractured at test endpoints. There was no difference in initial deflections between groups. Prostheses supported by nonengaging abutments failed before deflection measurements could be taken after loading. Prosthesis displacement of partially engaged abutments decreased significantly from the initial position after 300,000 load cycles. Conclusion: Under the experimental conditions, screw-retained splinted fixed dental prostheses supported by partially engaging abutments are 17 times more stable than prostheses supported by nonengaging abutments. Abutment screw fractures are the most prevalent mode of failure for nonengaging abutments at significantly lower cycles with minimal wear on implant analogs. Partially engaging abutment groups failed from implant housing and abutment screw fractures at higher cycles. Loading appears to concentrate preferentially on the medial side on all angled implant components. Selective removal of the abutment obstruction allows a common path of insertion for multiple implants and partial engagement to implant housings. [ABSTRACT FROM AUTHOR]

Wearing an intraoral jaw-protruding splint could enhance respiratory function in clinical settings and eventually exercise performance. Purpose: The authors studied the acute effect of wearing a lower-jaw-forwarding splint at different protruding percentages (30% and 50%) across a wide range of running exercise intensities. Methods: A case study was undertaken with a highly trained and experienced 27-year-old female triathlete. She performed the same incremental intermittent treadmill running protocol on 3 occasions wearing 3 different intraoral devices (30% and 50% maximum range and a control device) to assess running physiological and kinematic variables. Results: Both the 30% and 50% protruding splints decreased oxygen uptake and carbon dioxide production (by 4%–12% and 1%–10%, respectively) and increased ventilation and respiratory frequency (by 7%–12% and 5%–16%, respectively) along the studied running intensities. Exercise energy expenditure (approximately 1%–14%) and cost (7.8, 7.4, and 8.0 J·kg−1·m−1 for 30%, 50%, and placebo devices, respectively) were also decreased when using the jaw-protruding splints. The triathlete's lower limbs' running pattern changed by wearing the forwarding splints, decreasing the contact time and stride length by approximately 4% and increasing the stride rate by approximately 4%. Conclusions: Wearing a jaw-protruding splint can have a positive biophysical effect on running-performance-related parameters. [ABSTRACT FROM AUTHOR]

Purpose: To assess the effect of stabilization splint (SS) thickness on temporomandibular disorders (TMDs).Materials and Methods: Participants were selected from patients who applied to the clinic with a complaint of temporomandibular disorders (TMDs). Symptoms were evaluated with the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). Regarding the treatment plan, patients were divided into two groups: the 2-mm-thick splint group (2-mm TSG) and the 4-mm-thick splint group (4-mm TSG). They used SSs at night (8 hours) and were recalled 1, 2, 3, and 6 months after splint insertion. At the end of the study, 72 patients (2-mm TSG = 39, 4-mm TSG = 33) had completed the 6-month follow-up. The SPSS program was used for statistical analysis. The results of the analysis were evaluated at a significance level of .05.Results: Pain in the muscles decreased significantly in the muscle disorders and combined groups (both 2- and 4-mm TSG) after 6 months of treatment (P < .05). In the combined group, TMJ sounds significantly decreased after 6 months of treatment, and there was a statistically significant difference between the 2-mm TSG and the 4-mm TSG (P = .045). Also, in the combined group, maximum unassisted opening (MUO) values of patients treated with 2-mm-thick splints decreased after 6 months of treatment (P = .022).Conclusion: Both 2-mm-thick and 4-mm-thick splints were effective in the treatment of muscle disorders and disc displacements, especially in muscle-related pain and TMJ sound symptoms. [ABSTRACT FROM AUTHOR]

Objective: Occlusal stabilization splints (OSSs) are first-line therapy for temporomandibular disorder (TMD) and sleep-related-bruxism (SRB). The main goal of this study was to quantify adherence rates to OSS therapy in TMD patients and among non-painful conditions such as clenching and bruxism. It was hypothesized that adherence rates would be similar to those for other chronic conditions. Method and materials: Medical records of 99 patients seen in the Orofacial Pain Clinic between 2006 and 2014 were reviewed. Patients meeting the inclusion criteria were interviewed over the telephone regarding OSS adherence. Results: Of the 99 patients interviewed, 80 had chronic orofacial pain related to TMD and 19 received OSS due to (non-painful) SRB. Patients were divided according to usage; the USER group (58 patients, 58.6%) used their OSS for more than 1 year; the NUSE group was the remaining 41 (41.4%) patients who used their device for less than 1 year. Of the patients with pain as the reason for OSS use, 50 (62.5%) were in the USER group and 30 (37.5%) were in the NUSE group. The most common diagnosis was masticatory muscle disorders (MMD) with a 71.4% adherence rate, representing 60.3% of the USER group, which was significantly higher than those with SRB and other facial pain (P = .039). The most common reasons for non-adherence were sleep difficulties with OSS (31.6%) and resolution of the problem (25%). Conclusions: Patients reporting mild to major pain reduction had higher adherence rates than those with complete pain relief or none at all. Patients with MMD exhibited higher adherence rates than those with other facial pain types and SRB. [ABSTRACT FROM AUTHOR]

Purpose: Investigate the effects of three different complete-arch digital implant scanning techniques used with a combined healing abutment–scan body (CHA-SB) system on the accuracy (trueness and precision) and scan time. Materials and Methods: A poly(methyl methacrylate) master model simulating an edentulous maxilla was fabricated with four parallelly inserted dental implants. A CHA-SB system was attached to each implant. The model surface was scanned using a structured blue light industrial extraoral scanner to achieve a reference model standard tessellation language file (MRM-STL). Three different scanning techniques—(1) conventional technique with unmodified master model, (2) scan body splinting technique using orthodontic elastic ligatures and plastic splint materials, and (3) land-marking technique using pyramid-shaped glass-ceramic markers—were performed. Fourteen consecutive digital scans were made by using an intraoral scanner (IOS) for each technique, converted to an STL file, and superimposed on the MRM-STL. Trueness and precision were calculated for each technique. The scan time was also recorded. The data were analyzed with one-way analysis of variance (ANOVA) and Tukey honest significant difference (HSD) tests (α = .05). Results: Effects of different scanning techniques on the trueness (distance and angular deviations; P < .001) and scan time (P = .002) were statistically significant. For precision, different scanning techniques had only a significant effect on the distance deviation (P < .001). Conclusion: Regarding trueness and precision, none of the scanning techniques was superior to others. The scan body splinting technique led to significantly less scan time. [ABSTRACT FROM AUTHOR]

Background: The term "temporomandibular disorders" (TMDs) refers to a group of painful conditions that affect both the hard and soft orofacial anatomical structures. The primary objectives of TMD treatment are to lessen pain and enhance mandibular movements, re-establishing proper functioning. One of the widely used treatment options for TMDs pathology is the occlusal splint. This non-invasive intraoral device, determines both the muscle relaxation and reversibly repositions the temporomandibular joint structures. The study aimed to compare the efficacy of different occlusal splint designs or materials in managing TMD symptoms. Methods: Twenty-six patients, nineteen of whom were female and seven of whom were male, ranging in age from twenty to seventy, met the criteria needed participate in this study. Two different questionnaires were formulated: a patient-focused and a clinician-focused questionnaire. The patient's data encompassed general health status and TMD signs and symptoms, whereas the clinician's questions addressed assessment and treatment alternatives, including the particularities of occlusal splint therapy. Results: The majority of the patients were diagnosed with disc displacement with reduction (61.5%), followed by myalgia (26.9%). The only form of treatment preferred by physicians was the Michigan occlusal splint, which was mainly used on the maxillary dental arch (84,6%). After the splint therapy was completed and the intended results were obtained, the treatment plan was finished using selective grinding, prosthetic dental restorations, orthodontic therapy, or a combination of these procedures. The patient was required to continue physical therapy (7,7%), wear a full-arch night guard (42.3%), and undergo rigorous periodic control sessions (34.6%) to maintain the final aesthetic and functional results. Conclusions: Occlusal splints are an efficient and reliable initial therapy preference for patients with temporomandibular disorders. In addition to improving symptoms in the temporomandibular joint, occlusal splints may determine mandibular repositioning, which also implies a variety of treatment approaches, ranging from the minimally invasive to the most complex, to achieve a functional occlusal status. [ABSTRACT FROM AUTHOR]

Genioplasty is performed for the orthognathic surgical correction of dentofacial deformities. This article reports a safe and accurate method for genioplasty combining a novel three-dimensional (3D) device with mixed reality (MR)-assisted surgery using a registration marker and a head-mounted display. Four types of devices were designed based on the virtual operation: a surgical splint with a connector; an osteotomy device; a repositioning device; and a registration marker. Microsoft HoloLens 2 and Holoeyes MD were used to project holograms created using computed tomography (CT) data onto the surgical field to improve the accuracy of the computer-aided designed and manufactured (CAD/CAM) surgical guides. After making an incision on the oral vestibule, the splint was fitted on the teeth and the osteotomy device was mounted at the junction site, placed directly on the exposed mandible bone surface. Temporary screws were fixed into the screw hole. An ultrasonic cutting instrument was used for the osteotomy. After separating the bone, a repositioning device was connected to the splint junction and bone segment, and repositioning was performed. At the time of repositioning, the registration marker was connected to the splint junction, and mandible repositioning was confirmed three-dimensionally through HoloLens 2 into the position specified in the virtual surgery. The rate of overlay error between the preoperative virtual operation and one-month postoperative CT data within 2 mm was 100%. CAD/CAM combined with MR enabled accurate genioplasty. [ABSTRACT FROM AUTHOR]

Ear keloids are challenging lesions to treat due to high recurrence rates postexcision. Conservative compression techniques as adjunct treatment have been reported to be effective. An innovative technique of using computer-aided design/computed-aided manufacturing to print a customized auricular splint improves efficiency and comfort level for patients compared with conventional methods. The ear is scanned using an intraoral scanning 2 weeks postsurgery. A two-piece auricular splint is designed on the digital model, incorporating perforated projections for three nylon screws for retention of the splint. The splint is printed with clear acrylic material, postprocessed, and finished. The patient is taught to assemble the components of the splint and instructed to wear for at least 8 hours daily. The surgery site reviewed for any ulceration, pain, or recurrence of keloid for 6 months. During the 6-month review, the excision scar remained flat and pink. The patient also reports unrestricted daily activities. The digital workflow increases comfort for the patient and reduces the number of hours required to produce a customized auricular splint compared with conventional methods. A fully digital workflow for a printed auricular splint should be considered for adjunctive treatment to excision of ear keloids. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Impacted maxillary central incisors represent a relatively infrequent occurrence. This condition significantly impacts the patient's self‐esteem and aesthetic concerns. Effective resolution is achievable through a combined strategy involving surgical exposure, bracket attachment, and subsequent orthodontic extrusion. The Surgical orthodontic approach is the optimal strategy for addressing impacted maxillary central incisors. Central incisor is rarely impacted teeth often associated with supernumerary teeth. This case series includes three cases of central incisor impaction presented with complaints of missing teeth, unesthetic appearance, and unclear speech. All the cases were managed with surgical exposure followed by traction by orthodontic force, restoring smile aesthetics. [ABSTRACT FROM AUTHOR]

BACKGROUND: The minimally invasive endodontics could retain more peri-cervical dentin (PCD) and other important dental structures, thus realizing the minimal loss of teeth structures and preserving the strength and function of the endodontically treated tooth (ETT). The search for abnormal root canals or calcified root canals could be quite time-consuming and increase the risk of perforation. OBJECTIVE: This study introduced a novel multifunctional 3D printing guided splint inspired by the dice, which can achieve the minimally invasive access cavity preparation and canal orifice identification. METHOD: Data were collected from an outpatient with dens invaginatus. Cone-beam Computed Tomography (CBCT) revealed a type III invagination. The CBCT data of the patient were imported into a computer-aided design (CAD) software (Exocad 3.0; Exocad GmbH) for the 3D reconstruction of jaw bones and teeth. The dice-inspired 3D printing guided splint consists of the sleeve and guided splint. The sleeve with minimal invasive opening channel and orifice locating channel were designed with a reverse-engineering software (Geomagic Wrap 2021). The reconstructed models in the Standard Template Library (STL) format were imported into a CAD software. The design of the template was aided by the dental CAD software in Splint Design Mode. The sleeve and splint were exported into the STL files separately. A 3D printer (ProJet ® 3600 3D Systems) was used to separately generate the sleeve and guided splint, and was made by stereolithography and processed in a medical resin (VisiJet M3 StonePlast). RESULTS: The novel multifunctional 3D printing guided splint could be set in position. The opening side in the sleeve was selected and the sleeve was inserted in place. The minimal invasive opening was made in the crown of the tooth to access the pulp. The sleeve was draw out and turned to the orifice location side, and then inserted in place. The target orifice was located rapidly. CONCLUSION: This novel dice-inspired multifunctional 3D printing guided splint allow dental practitioners to gain accurate, conservative, and safe cavity access from teeth with anatomical malformations. Complex operations might be carried out with less reliance on the operator's experience than with conventional access preparations. This novel dice-inspired multifunctional 3D printing guided splint would have a broad application in the dental field. [ABSTRACT FROM AUTHOR]

Objective: This clinical trial aims to compare the accuracy of interocclusal registration in centric relation taken with polyvinyl siloxane and intraoral scanner (IOS) with the fabrication of occlusal devices. Methods: Thirty‐one participants were included in the trial registered at ClinicalTrials.gov (NCT05317182) receiving two different occlusal devices from two different workflows. One workflow was performed using polyvinyl siloxane impression material and the other with IOS. Every splint was scanned before and after the occlusal adjustments to compare the volumetric changes using the Root Mean Square deviation (RMS). Furthermore, three evaluators assessed the 3D comparison using color maps in a Visual Analog Scale (VAS). Results: The average values of RMS were higher for the analog approach (0.01 ± 0.067) than the digital approach (0.065 ± 0.035). However, the differences were not statistically significant (p < 0.063) between the two impression techniques. For the semiquantitative analysis performed by blinded evaluators, differences in VAS values between the impression for the digital (2.08 ± 2.4) and analog (3.80 ± 3.3) technique were statistically significant. The three evaluators agreed in more than 90% of the qualitative dichotomous evaluation. Conclusion: Digital impressions did not show inferior accuracy compared to conventional impressions when assessed using quantitative measurements. Clinical Significance: This clinical trial provided evidence on registering interocclusal relationship at increased vertical dimension with fully digital workflow for complete arch prosthesis. [ABSTRACT FROM AUTHOR]

To evaluate and compare the mechanical properties, water sorption, water solubility, and degree of double bond conversion of three different commercially available three-dimensional (3D) printing resins used for the fabrication of flexible occlusal splints. A digital printer was used to generate specimens from the evaluated splint materials (KeySplint Soft, IMPRIMO LC Splint flex, and V-Print splint comfort). The specimens were equally divided and tested either dry or after water storage at 37 °C for 30 days. A three-point bending test was used to assess flexural strength, elastic modulus, and fracture toughness. A two-body wear test was performed using a dual-axis chewing simulator. Water sorption and water solubility were measured after 30 days. The degree of double bond conversion was determined by FTIR-spectrometry. All data for the evaluated properties were collected and statistically analyzed. Both material and storage conditions had a significant effect on the flexural strength (P < 0.001), elastic modulus (P < 0.001), fracture toughness (P < 0.001), and wear (P < 0.001). The highest water sorption was noticed with IMPRIMO LC Splint flex (1.9 ± 0.0 %), while V-Print splint comfort displayed the lowest water solubility (0.2 ± 0.0 %). For the degree of conversion, it was statistically non-significant among the different materials (P = 0.087). Different flexible 3D-printed splints available in the market displayed variations in the evaluated properties and clinicians should consider these differences when choosing occlusal device materials. Among the tested flexible splint materials, KeySplint Soft had the greatest flexural strength, elastic modulus, fracture toughness, wear resistance, and degree of conversion. It also showed the lowest water sorption. [ABSTRACT FROM AUTHOR]

Three-dimensional (3D) printing has helped drive rapid and abundant growth in the field of digital dentistry and has been largely spurred on by the development of material innovation. Thermoflexible occlusal splints represent a recent innovation in this area, as they feature a remarkably elastic behavior. Now, practitioners can provide patients with a comfortable, soft, class II medical device generated through a simple digital workflow. This article presents a case report that demonstrates the management of temporomandibular joint disorders by means of a flexible 3D-printed splint. Providing the patient relative comfort while wearing the splint to prevent the negative effects of bruxism helped enhance patient acceptance and compliance. The simple, non-invasive splint fabrication described in this report can be performed by any clinicians willing to incorporate occlusal devices into their digital workflow. [ABSTRACT FROM AUTHOR]

Purpose: Surgical management of scar tissue and contractures from facial burns has systematic approaches, yet nonsurgical management continues to lack consensus regarding therapeutic approaches capable of providing stretching of the facial skin and muscles for both treating and preventing microstomia and orofacial contractures. This exploratory study introduces an intraoral splinting system designed to provide low-load, prolonged stretching of orofacial skin and musculature to treat contractures following a facial burn injury. The treatment adjunct described here has potential application across disciplines treating microstomia and orofacial contractures. Method: An 18-year-old man with full-thickness head and neck burns participated in a 5-week trial using intraoral splints to provide stretch to areas of contracture in the mid and lower face. The trial commenced 4 and a half months after his burn injury. Prescriptive placement, sizing, and time for use of the splints were provided. Changes in distance between facial landmarks were identified for 13 measurements taken for nine facial expressions. Results: Lengthening or shortening of the distances between two landmarks indicated the potential benefit from intraoral splints. For the expression "open mouth wide," increased distance between two end points was noted in 11 of 13 measurements, ranging from 1.6 to 10.8 mm. This represents a lengthening of tissue, allowing for wider oral opening. Negative measurements between two end points occurred in two of 13 measurements, demonstrating elevation of the left and right nostrils. Visual data also demonstrated the appearance of change. Conclusions: When treating microstomia and orofacial contractures, consideration should be given to the use and further exploration of a more targeted intraoral methodology that uses a low-load, prolonged stretch to improve functional and aesthetic deficits. Oral splinting using an intraoral methodology is underutilized in the burn patient population and has application in both the acute care and chronic phases of recovery. [ABSTRACT FROM AUTHOR]

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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. [ABSTRACT FROM AUTHOR]