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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]

Objectives: A variety of theories on the pathogenesis of temporomandibular disorders (TMD) exists resulting in treatment approaches ranging from the fabrication of occlusal splints to alternative treatment modalities such as osteopathy. The goal of this pilot study was to investigate whether osteopathic treatment causes spatial changes in the maxilla. Method and Materials: Following ethics commission approval and informed patient consent, three patients diagnosed with TMD participated in this investigation. In addition to regular treatment, an individualized mandibular occlusal splint was fabricated and a maxillary silicone impression was made. Following osteopathic treatment, the splint was adapted intraorally and another maxillary impression was made. Before and after treatment, the splint and the impressions were scanned three-dimensionally. The resulting images were superimposed using best-fit matching algorithms. Results: Inconsistent spatial changes in the posterior areas were observed both in the maxillary impressions as well as in the mandibular splints reaching maximum absolute values of 0.50 mm. Conclusion: Based on this pilot study, it appears that osteopathic treatment may be capable of inducing spatial changes in the maxilla due to sutural movement thereby validating the fundamental principles of osteopathic treatment. Although, based on the study conducted, it cannot be concluded that osteopathy constitutes a successful treatment alternative in TMD patients, practitioners should be aware of this treatment modality. [ABSTRACT FROM AUTHOR]

DesignA single-blind randomised controlled trial was conducted in a university prosthodontics department in Germany.InterventionOnly people who presented a clear-cut clinical diagnosis of anterior disc displacement without reduction (ADDWR) were included: limited mouth opening with deflection, and limited lateral movement of the incisors and/or pain had to be found. Additionally, patients had to present at least one antagonistic molar contact on each side. The clinical finding was verified by magnetic resonance images in open and closed mouth positions. After clinical examination and imaging, centric splints or distraction splints were randomly assigned. Patients were instructed to wear the splint 18 h each day. Directions as to the care of the splint were given.Outcome measureAfter 1, 3 and 6 months of therapy, patients provided their subjective evaluation by filling out a visual analogue scale form. Any change in their pain level or functional performance level was recorded. The outcome was evaluated using the Wilcoxon signed rank test for matched pairs. Success after 6 months was defined as improvement in active mouth opening of greater than 20% and pain reduction (on chewing) of at least 50%. Success was statistically verified using a logistic regression test.ResultsA total of 74 patients (65 females and nine males) fulfilled the inclusion criteria and agreed to participate. Thirty-eight patients received a centric splint and 36 a distraction splint. The improvements in mouth opening were significant in both groups. The improvements in pain on chewing, pain during other functions, pain at rest, functional limitation on chewing and other functions were also comparable in the two groups. The logistic regression test, however, suggested that patients using centric splints were treated more successfully than the others (odds ratio, 2.88; 95% confidence interval, 1.01–8.74).ConclusionsCentric splints seem to be more effective than distraction splints. Therefore, before the surgical treatment of ADDWR, centric splints should be used instead of distraction splints.Evidence-Based Dentistry (2006) 7, 50. doi:10.1038/sj.ebd.6400404 [ABSTRACT FROM AUTHOR]