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Background: Contingent vibratory feedback stimuli applied by a specially designed oral appliance (OA) have been reported to be effective in reducing sleep bruxism (SB). However, the inhibitory effects of the OA, which occur immediately after OA delivery, may have confounded this finding. Objective: This study sought to shed light on the effects of vibratory stimuli on SB after the OA adaptation period, when its inhibitory effects are diminished. Methods: Fourteen 'definite' SB patients were enrolled. A force‐based bruxism detection system was utilised to trigger a vibrator attached to the OA. Masseter electromyographic activity during sleep was recorded at home using portable polysomnography. After using the OA without vibratory stimulus for 16 nights (adaptation period), intermittent vibratory stimuli were applied every other half‐hour for four nights (intervention period). Electromyographic activity over 10% of the maximum voluntary contraction was regarded as a SB episode. The number and the total duration of SB episodes per hour of sleep were calculated for the sessions with and without stimuli separately and averaged for four intervention nights. The effects of stimuli on these two variables were evaluated. Results: The number and the total duration of the sessions without stimuli were 5.2 episodes/h and 35.3 s/h, respectively. These values significantly decreased to 3.9 episodes/h and 15.1 s/h (p <.05) for the sessions with vibratory stimuli. Conclusion: Contingent vibratory stimulus via an OA may be effective for the management of SB even after adaptation to OA. [ABSTRACT FROM AUTHOR]

Trauma to the teeth is a common reason for emergency room visits among children, with the maxillary anterior teeth being mostly affected. The majority of dental injuries involving the anterior teeth result from simple falls, accidents, sports activities or childish pranks. The aim of this study was to assess the prevalence of anterior teeth fracture among pediatric patients visiting a private dental college. A retrospective hospital based study was conducted by evaluating and analysing 5606 pediatric patient case records who had undergone treatment at Saveetha dental college and Hospitals from June 2019 - March 2020. Data such as patient age, gender, prevalence of anterior teeth fracture, tooth no. and type of anterior teeth fracture based on Ellis classification were documented. Descriptive and inferential statistics was done using IBM SPSS software. The results of this study conclude that the most common tooth involved in anterior teeth trauma was central incisors. The most prevalent type of anterior teeth fracture was Ellis class 2, followed by Ellis class 1 and Ellis class 3. There was a significant association between age, gender and anterior teeth fracture (p=0.000), with a higher prevalence among children aged between 9 to 11 years and male children. [ABSTRACT FROM AUTHOR]

Purpose: To investigate whether implant position (adjacent to teeth/implants vs most distal position in the arch) influences the clinical outcomes of short (= 6 mm) non-splinted implants. Materials and methods: A systematic electronic search of human randomised clinical trials and prospective cohort studies was performed using the PubMed, Embase and Cochrane Central Register of Controlled Trials (Central) databases. A manual search of implant-related journals was also performed. A meta-analysis was conducted to compare survival rate, marginal bone loss and prosthetic complications based on implant position. Results: Overall, 11 studies were included to give a total of 388 non-splinted short implants (269 adjacent, 119 distal) followed up over a period ranging from 12 to 120 months. No significant differences in survival were found when comparing adjacent and distal positioning for both arches, and no significant differences were found for marginal bone loss or prosthetic complications between groups regardless of position. Conclusions: Short implants supporting single crowns presented similar outcomes when placed in the most distal position in the arch or between adjacent teeth or other implants. [ABSTRACT FROM AUTHOR]

Aim: To compare the Oral Health‐Related Quality of Life (OHRQoL) of patients with mobile mandibular incisors before and after full‐mouth disinfection (FMD) with and without splinting. Material and methods: Thirty‐four periodontitis patients with ≥1 mobile mandibular incisor (degree II/III) were randomly allocated to the test or control group. All patients received FMD and the test group additional splinting of teeth 33–43. OHRQoL was assessed before (BL) and 3 months after FMD (RE) using the Oral Health Impact Profile (OHIP)‐14. Data were compared within and between the groups (Wilcoxon test/Mann–Whitney U test). Results: Twenty‐eight patients (13 test group/15 control group) were re‐evaluated. FMD led to a reduction of the mean probing pocket depth (PPD; in mm) (test group: BL‐PPD 3.89 ± 1.03, RE‐PPD 2.82 ± 0.53; control group: BL‐PPD 3.58 ± 0.66, RE‐PPD 2.77 ± 0.59; each p ≤.001), the mean clinical attachment level (CAL; in mm) (test group: BL‐CAL 5.22 ± 1.38, RE‐CAL 4.79 ± 0.85; control group: BL‐CAL 4.58 ± 1.10, RE‐CAL 4.41 ± 0.96; each p ≤.05), and the mean OHIP‐14 summary scores (test group: BL‐OHIP 21.7 ± 11.06, RE‐OHIP 9.9 ± 8.96, p =.0046; control group: BL‐OHIP 16.8 ± 8.27, RE‐OHIP 11.7 ± 8.55; p =.0217). The reduction of the OHIP‐G14 scores was considerably higher in the test group but statistically not significant (p =.080). Conclusions: The results show a positive impact of non‐surgical periodontal treatment on OHRQoL and a possible tendency for further improvement by splinting mobile mandibular incisors. [ABSTRACT FROM AUTHOR]

Background: Temporomandibular disorders (TMDs) are treated by different modalities including splints, physiotherapy, and acupuncture. Although all of these offer evidencebased benefits to the patients, avoiding overtreatment is of paramount importance. Objectives: To assess the effectiveness of muscle pain treatment with acupuncture combined with or without occlusal splints. Methods: Recruited patients were allocated to G1 (acupuncture) and G2 (acupuncture and occlusal splint) groups and treated in four consecutive weekly sessions (P1, P2, P3, and P4). The reported pain (RP) and the pressure pain threshold (PPT) of the masseter and temporalis muscles were assessed before and after each session. Results: RP decreased after each session in G1, except at P4. In G2, the RP decreased only after the first session, and the PPT did not vary. Conclusion: The assessed treatments did not influence the PPT levels of the masseter and anterior temporalis muscles in patients with temporomandibular disorders. Our findings suggest that occlusal splints may not be mandatory along with the acupuncture treatment. [ABSTRACT FROM AUTHOR]

Clinicians today favor minimal dental preparation in solving a patient's problems. This trend is even more pronounced when it comes to esthetic treatment. Patients who desire a beautiful smile without causing harm to their natural teeth usually request treatments that involve no dental preparation. One of the most conservative esthetic treatments is direct composite resin veneers, which in many cases, require no tooth preparation of any kind. In some cases, the patient has only one tooth darker than the rest. To avoid an aggressive reduction of tooth structure and mask the darker substrate, a diagnostic additive wax-up is utilized to plan the case. In this situation, direct composite resin veneers can be performed without preparing the patient's teeth, as with a less aggressive preparation on the tooth with unfavorable substrate. This article presents a device designed to allow accurate measurement of the volume of wax that has been added during the diagnostic wax-up, thereby controlling the depth of preparation on the darker tooth. This enables the reduction to be as conservative as possible and controls the layer thicknesses during the stratification of direct composite resin veneers. [ABSTRACT FROM AUTHOR]

Permanent central incisor impaction is very rare, and causes of impaction include adjacent supernumerary teeth, odontoma, and trauma. Surgical repositioning is a treatment option for teeth with ectopic eruption pathways. In this case report, an inverted developing maxillary central incisor was surgically repositioned at the initial stage of root development. Three dimensional (3D) virtual images were acquired using computed tomography, and a replica was produced by LCD-based masked stereolithography 3D printing. A resin for 3D printing was approved as a medical device and used as a 3D printing replica. Further, 3D technology has been found to be useful for successful tooth repositioning surgery. [ABSTRACT FROM AUTHOR]

• About 4.8% of US adults report pain in the temporomandibular joint (TMJ) • Vibroacoustic therapy (VAT) is noninvasive, safe, and uses low-frequency vibrations. • VAT has mechanisms of benefit but limited clinical studies to support the hypothesis. • Randomized trials are needed to adequately test the hypothesis that VAT reduces TMJ pain. • VAT may be a breakthrough or "another beautiful hypothesis slain by ugly facts". Pain in the temporomandibular joint (TMJ) affects about 4.8 % of the United States population. Pain is the most common symptom of TMJ and the chief reason patients seek care. Conventional treatments range from non-invasive therapies including physical therapy, dental guards and occlusal splints to interventions such as corticosteroid injections and surgery. At present, the most common challenge to healthcare providers in patients presenting with TMJ is the reduction of pain. Vibroacoustic therapy (VAT) is noninvasive and safe as a potential treatment for TMJ pain. VAT involves low-frequency vibrations from 30 to 120 + Hertz. Biological mechanisms to explain a beneficial effect include enhanced blood circulation, decreased swelling, and promotion of muscle relaxation. VAT also appears to have beneficial effects on skin and bone conduction as well as stimulates relaxation responses and the release of nitric oxide. Clinical studies of VAT to reduce TMJ pain are promising but limited in design and sample sizes. The most reliable design strategy to detect the most plausible small to moderate benefit of VAT on TMJ pain is a randomized trial. This trial should be of sufficient size, dose, and duration. If VAT has a favorable benefit-to-risk ratio, then it would represent a safe, noninvasive, feasible and cost-effective means to treat TMJ. [ABSTRACT FROM AUTHOR]

Background: In this study, we evaluated the effect of periodontal splints made from different materials on the stress distributions in compromised periodontal tissues and cement layers, using a computer simulation of mastication. Methods: Twenty-five 3D models were created for a segment of mandibular teeth with different periodontal splints bilaterally extended to the canines. The models were divided into five groups according to the different materials and thicknesses (mm) of the splints: the non-splinted group, PEEK 0.7 group, PEEK 1.0 group, FRC group, and titanium group. Each group was subdivided based on five bone loss levels. Tooth 41 of each model was subjected to vertical and oblique (θ = 45°) static loads of 100 N, respectively, onto the incisal edge. The von Mises stresses and maximum principal stress were analyzed using Abaqus software. Results: Oblique loading resulted in higher stresses on periodontal tissues, cement layers, and splints than those caused by vertical loading. The lower the supporting bone level, the greater the stress difference between the splinted groups and the non-splinted group. In model 133,331, with severe bone loss, the maximum von Mises stress values on the alveolar bone in tooth 41 under oblique loading dramatically decreased from 406.4 MPa in the non-splinted group to 28.62 MPa in the PEEK group and to 9.59 MPa in the titanium group. The four splinted groups presented similar stress distributions in periodontal tissues. The lowest stress level on the splint was observed in the PEEK 0.7 group, and the highest stress level was transferred to the cement layer in this group. Stress concentrations were primarily exhibited at the connectors near the load-carrying area. Conclusions: The tested splinted groups were all effective in distributing the loads on periodontal tissues around splinted teeth with similar patterns. Using splinting materials with low elastic moduli reduced the stress concentration at the splint connectors, whereas the tensile stress concentration was increased in the cement layer. Thus, the use of adhesive cement with a higher elastic modulus is recommended when applying less rigid PEEK splints.

The purpose of this study was to evaluate a modified method of interpositional arthroplasty for post-traumatic temporomandibular joint ankylosis. All patients were treated with a modified interpositional arthroplasty that included: navigation-assisted accurate bone dissection with minimal removal of only 5 mm of the ankylosed bony mass, novel application of bone wax and porcine acellular dermal matrix to prevent re-ankylosis, and a unique 3D-printed splint for occlusal stabilization and gap maintaining. The pre- and post-operative physical and radiological examinations of patients were recorded during routine follow-up visits. Postoperative follow-up visits lasted at least 12 months. Twelve patients, seven males and five females, ranging from 21 years to 59 years, were enrolled in this retrospective case series. All of the twelve patients with eighteen bony ankylosed temporomandibular joints were treated by our new method. The post-operative follow-up periods ranged from 1 year to 4 years. During the follow-up visits within at least 1 year, no one manifested re-ankylosis. The mean maximum incisor opening changed from 7.4 ± 5.3 mm (p < 0.001, before surgery) to 37.6 ± 3.9 mm (p < 0.001, last follow-up visit). No sign of post-operative infection or foreign body rejection was observed during the follow-up visits. The post-operative occlusal relationship was sound and stable. It is suggested that the modified method of interpositional arthroplasty provides favorable clinical and radiographic outcomes after a short-term follow up. [ABSTRACT FROM AUTHOR]

Background: Occlusal stress from oral parafunctional habits is one of the causes of temporomandibular disorders (TMD) and mandibular torus (MT). Although some studies have investigated the correlation between TMD and MT, understanding of the relationships between types of TMD and MT is insufficient. Therefore, we conducted this study to investigate the associations between presence of MT and TMD types. Methods: This study included 77 patients diagnosed with TMD who first visited our clinic for TMD between March 2019 and July 2020. Among them, 30 (38.9%) had MT, and 54 (70.1%) had oral parafunction. Parafunctional activity during sleep was confirmed using a temporary splint for checking bruxism (TSCB). Results: The relationship between prevalence of MT and oral parafunction in TMD patients was not statistically significant (P = 0.131), but the odds ratio was relatively high at 2.267. An analysis of TMD type revealed that Type I, which is classified as myalgia of the masticatory muscles, and MT had a significant association (P = 0.011). We fabricated a TSCB for 27 patients to wear during sleep and confirmed that 23 (85.2%) had nocturnal bruxism. The TSCB results and presence of MT showed a significant relationship (P = 0.047). Conclusion: Through the results of this study, clinicians may consider the hyperactivity of masticatory muscles in the presence of MT when treating TMD patients. In addition, TSCB has a great diagnostic value as it can be easily manufactured and be useful for discovering pre-existing oral parafunctions that patients are not aware of. [ABSTRACT FROM AUTHOR]

Introduction: Soft-tissue mallet finger occurs due to loss of terminal extensor tendon secondary to rupture of distal phalanx. Although using noninvasive splints for 6–8 weeks is the gold standard for conservative treatment of closed soft-tissue mallet injuries, patient compliance is an important factor impacting on patient outcomes. In this study, we used a single Kirschner Wire (K-W) to fix the distal interphalangeal (DIP) joint in extension in those patients failed to comply with routine splinting. Materials and methods: In this prospective study, 190 patients with Doyle type 1 closed soft-tissue mallet finger deformity were included in four groups between 2011 and 2015. These groups were determined according to treatment modalities. Patients in the first group were treated with a finger splint (n = 109). Patients in the second group first received a finger splint and then K-W was applied due to lack of adequate compliance (n = 23). Patients in the third group were treated with K-W only (n = 47), and the fourth group did not accept surgical treatment nor conservative treatment (n = 11). After 20 weeks of follow up, we evaluated the results with functional measurements according to Crawford criteria and patient satisfaction. Additionally, the mid-term outcome was assessed with a follow-up at 2 years. Results: At 20th week postoperatively, average DIP extension lag was 6 degrees (0–30) for the first group, 6.1 degrees (0–30) for the second group, 3.8 degrees (0–25) for the third group, and 17.3 degrees (7–30) for the fourth group. Total patient satisfaction was 85%, which was considered excellent or good. Swan neck deformity was observed in 11% of patients. Osteomyelitis and KW related complications were not observed. There were no statistically significant differences between short-term and mid-term results. Conclusion: Internal fixation via K-W may be a suitable treatment option compared to splint therapy for management of closed soft-tissue mallet finger in noncompliant patients. Using this treatment approach, the success rate for patients could satisfactorily be improved. [ABSTRACT FROM AUTHOR]

Background/Aim: Clinical studies evaluating the splinting time for surgically extruded teeth with crown‐root fractures are lacking. The aim of this study was to compare 2‐week splinting versus functional splinting times after surgical extrusion. Material and methods: Children aged 8‐13 years who presented with crown‐root fractures were included. Surgical extrusion was performed, and teeth were splinted either for 2 weeks or until normal Periotest values were achieved (functional splinting time). The outcome measures were tooth mobility, tooth loss, root resorption, marginal bone resorption and ankylosis. Measurements were taken at baseline, weekly after splint removal, and after 1, 3, 6 and 12 months. Results: Nineteen patients were included in the analysis. Surgically extruded teeth splinted for 2 weeks showed significantly higher mobility directly after splint removal and at 1 month after splinting compared with the functional splinting time group. The mean differences for horizontal Periotest values were 14.96 (95% confidence interval: 8.52, 21.39) and 6.63 (95% confidence interval: 0.25, 13), respectively. The vertical Periotest values were 10.47 (95% confidence interval: 1.95, 18.99) and 4.81 (95% confidence interval: −1.57, 11.18), respectively. At the 3‐, 6‐ and 12‐month follow‐up intervals, there were no statistically significant differences between the groups. One tooth in the 2‐week splinting group was lost. None of the teeth had ankylosis, marginal bone resorption or root resorption. Conclusions: Although both groups showed neither statistical nor clinically significant differences after 12 months, there was a significant difference immediately after splint removal, with greater tooth mobility in the 2‐week splinting group. Thus, a functional splinting time (4‐6 weeks) can be suggested for better healing and optimal stability to allow placement of the final restoration directly after splint removal. [ABSTRACT FROM AUTHOR]

Background/Aims: Traumatic dental injuries are highly prevalent and are considered an important health problem. The aim of this study was to evaluate the in vitro stress distribution around simulated traumatized teeth subjected to different types of splints by photoelastic analysis. Materials and Methods: For each group, five models of maxillary and mandibular arches were made in photoelastic resin using prefabricated teeth models, which were fixed and adjusted in a semi‐adjustable articulator. All splints were bonded with composite resin on the labial surfaces of the maxillary central incisors, the lateral incisors and the canine teeth, simulating trauma to the 11. The groups were divided according to the type of splint: control—without splint; rigid—brackets and 0.021 × 0.025 inch stainless steel wire; semi‐rigid—brackets and 0.016 × 0.016 inch cobalt‐chromium wire; fiber—fiberglass ribbon; and flexible—nylon thread. The groups were submitted to an occlusal force in a special device attached to a universal test machine in balanced, protrusive, and lateral occlusions. Then, the incisal edge of the 11 was ground to simulate infra‐occlusion, and the tests were performed again. Five points were analyzed around tooth 11 with a polariscope, and the data were submitted to ANOVA and Tukey tests at a 5% level of significance. Results: When centric occlusion was analyzed by comparing normal occlusion to infra‐occlusion, all groups showed high stress values in infra‐occlusion with statistical differences—except for the control group. When lateral occlusion was analyzed, the nylon splint showed lower statistical differences compared with the control, fiberglass, and rigid splint groups, which did not differ between each other. The semi‐rigid splint did not differ from any group. Conclusions: Fiberglass and semi‐rigid splints showed better stress distribution around the traumatized tooth under occlusal loads. The nylon splint showed characteristics of non‐stress distribution. [ABSTRACT FROM AUTHOR]

Backgrounds/Aims: Traumatic dental injuries with bone fractures require rigid splinting. The degree of rigidity of the wire‐composite splints can be challenging. The aim of this study was to evaluate the effect of the rigidity of different wire‐composite splints on alveolar process displacement. Material and Methods: A model was created using polystyrene resin to simulate the anterior maxilla, bovine incisors to simulate maxillary incisors, and polyether impression material to simulate the periodontal ligament. An alveolar process fracture was created, while maintaining the labial bone connection with the PDL. Four wire‐composite splints (0.3, 0.6, 0.9, and 1.2 mm in diameter) were compared with models without splints and with no fracture (n = 5). The alveolar process displacement was measured (3 times per model/per splint type) at the fractured and adjacent central incisor regions using a deflectometer (Instron) under functional cycling and static loading (100 N). Data (μm) were analyzed using RM ANOVA, followed by Tukey's HSD test (α = 0.05). Results: The displacement at the region of the adjacent incisor was not influenced by the splint during static and cycling load (P >.05). The Tukey test demonstrated that the model without splints had significantly higher alveolar process displacement at the traumatized teeth than that of all other splint models (P <.001). Increasing the wire diameter from 0.3 mm to 0.9 mm significantly reduced the alveolar process displacement (P <.001). No difference was observed between the 0.9 mm (P =.123) and 1.2 mm (P =.219) wire‐composite splints irrespective of the measured tooth regions. Conclusions: The rigidity of the wire‐composite splint significantly influenced the mobility of the fractured alveolar process. The use of at least 0.9 mm wire was effective in reducing the fractured alveolar process displacement to a level that was similar to the adjacent teeth. [ABSTRACT FROM AUTHOR]

Background: Pedicled buccal fat pad (PBFP) has been used for the reconstruction of small-sized maxillary defects but cannot be used without hard tissue support on the defect larger than 4 cm × 4 cm × 3 cm. Case presentation: A 64-year-old man had a history of squamous cell carcinoma of the left maxilla. After removal of the posterior maxilla, a complex bone defect (size, 5 cm × 4 cm × 3 cm) was immediately reconstructed using PBFP combined with a titanium mesh. A pinpoint fistula was found in the left palatal region 1 month after the surgery and was treated with a palatal sliding flap. There were no further complications during the follow-up. Conclusion: The present technique demonstrated that PBFP combined with a titanium mesh could be used for the reconstruction of complex maxillary defect (size, 5 cm × 4 cm × 3 cm) without additional bone graft. [ABSTRACT FROM AUTHOR]

The aim of this study was to analyze the distribution of occlusal stresses for splinted and nonsplinted mandibular anterior incisors and to compare different splinting materials. A mandibular model was generated from a patient's computed tomography scan using three-dimensional (3D) software. The mandibular model presented with four periodontally compromised incisors and two canines with optimal bone support (two-thirds crown-root ratio). Three different splint materials (composite resin, metal-reinforced, and fiber-reinforced) were selected. Vertical and transverse loads were applied, and stress levels around the periodontal structures and splint materials were analyzed with 3D finite element analysis. The results showed that when bone levels around teeth decreased, the stress on the canine increased. Tested splinting materials were successful in stress distribution, and metal was better than the other splinting materials at distributing the stresses. [ABSTRACT FROM AUTHOR]

Purpose: This in vitro study evaluated the accuracy of multiple-unit dental implant casts obtained from splinted or nonsplinted direct impression techniques using various splinting materials by comparing the casts to the reference models. The effect of two different impression materials on the accuracy of the implant casts was also evaluated for abutment-level impressions. Materials and Methods: A reference model with six internal-connection implant replicas placed in the completely edentulous mandibular arch and connected to multi-base abutments was fabricated from heat-curing acrylic resin. Forty impressions of the reference model were made, 20 each with polyether (PE) and polyvinylsiloxane (PVS) impression materials using the open tray technique. The PE and PVS groups were further subdivided into four subgroups of five each on the bases of splinting type: no splinting, bite registration PE, bite registration addition silicone, or autopolymerizing acrylic resin. The positional accuracy of the implant replica heads was measured on the poured casts using a coordinate measuring machine to assess linear differences in interimplant distances in all three axes. The collected data (linear and three-dimensional [3D] displacement values) were compared with the measurements calculated on the reference resin model and analyzed with nonparametric tests (Kruskal-Wallis and Mann- Whitney). Results: No significant differences were found between the various splinting groups for both PE and PVS impression materials in terms of linear and 3D distortions. However, small but significant differences were found between the two impression materials (PVS, 91 μm; PE, 103 μm) in terms of 3D discrepancies, irrespective of the splinting technique employed. Conclusions: Casts obtained from both impression materials exhibited differences from the reference model. The impression material influenced impression inaccuracy more than the splinting material for multiple-unit abutment-level impressions. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study was to examine the effectiveness of intraoral thermoformed splint with a magnet device over a period of 3 months, that is, to assess acceptability of this method of treatment using both objective and self-reported measures.Materials and Methods: This study was designed as a prospective clinical pilot trial. 22 patients with xerostomia and hyposalivation were included. Xerostomia was assessed using a 4-question xerostomia questionnaire score and a test for unstimulated salivary flow rates. Evaluations were performed before the treatment and 3 months after the treatment using a thermoformed splint with a magnet device.Results: There was a significant reduction in subjective symptoms after using a thermoformed splint with a magnet device for 3 months. For all 4 scored items, there was a statistically significant difference (P < .001) in median VAS scores before and 3 months after treatment. There was also a statistically significant difference in USFR before (0,15 ± 0,04 ml/min) and after treatment (0,24 ± 0,03 mL/min).Conclusion: Our findings indicate that the use of this device alleviated oral dryness and stimulated the function of the submandibular salivary gland. An intraoral thermoformed splint with a magnet device is safe, physiologically indifferent, useful, and effective in treating xerostomia and hyposalivation. [ABSTRACT FROM AUTHOR]

Non-surgical treatment is successful in controlling pain and preventing disease progress in treating thumb carpometacarpal arthritis. We used Optum's de-identified Clinformatics® Data Mart Databases between 2015 and 2018 to conduct a study of the patient and provider characteristics associated with three types of non-surgical treatment (hand therapy, splinting and corticosteroid injection) prior to surgery. In this population-based cohort study, we found that non-surgical providers were more likely to provide three different types of non-surgical treatments, as compared with hand surgeons. In addition, women and patients with comorbid conditions, including carpal tunnel syndrome, obesity, chronic pain and depression, were less likely to exhaust the available non-surgical management options for thumb carpometacarpal arthritis. Therefore, we suggest that these specific patient populations can potentially benefit from additional non-surgical treatments that may delay or obviate surgery for this disease. These groups are target populations for future efforts to ensure that all patients receive equitable care. Level of evidence: II [ABSTRACT FROM AUTHOR]

Background: The effectiveness of anterior crossbite treatment in preschool-aged children depends on the treatment design and patient compliance. Common early treatment appliances with steel wires and acrylic resin can bring about numerous problems, such as toothache, sore gums and mucous membrane injury. The aim of this study was to propose a new clear removable appliance to provide preschool-age children with an improved experience of early occlusal interference treatment. Methods: Appliances were designed with the help of 3-dimensional (3D) digital reconstruction oral models and fabricated using 3D printing technology and the pressed film method. Then, the mechanical properties of the original dental coping sheet and thermoformed aligners were assessed in a simulated intraoral environment. Preschool-age participants who displayed anterior crossbite were recruited in this study. Records (photographs and impressions) were taken before the treatment (T1), during the treatment (T2) and at the end of the treatment (T3). The effects of treatment were evaluated by clinical examination and questionnaires. Results: Normal degrees of overbite and overjet in the primary dentition were achieved using this new appliance. Dental and soft tissue relationships were improved. Questionnaires showed that the safety evaluation, degree of comfort and convenience grades of the appliance were all relatively high. Conclusion: This explorative study demonstrates that our new clear removable appliance is able to correct early-stage anterior crossbite in a safe, comfortable, convenient and efficient way. Thus, it is a promising method to correct a certain type of malocclusion, and its clinical use should be promoted in the future. [ABSTRACT FROM AUTHOR]

Objective: The aim of this multicenter, randomized controlled trial was to compare the clinical and radiographic outcomes of 6‐mm or 11‐mm implants, placed in the posterior maxilla and mandible, during a 5‐year follow‐up period. Materials and methods: Ninety‐five patients with adequate bone height for 11‐mm implants, were randomly allocated to a 6‐mm group (test group with short implants) or an 11‐mm group (control group with standard‐length implants). Two or three implants of the same length were placed in each patient and after 6 weeks loaded with a splinted provisional restoration. This was followed by definitive splinted restoration 6 months after implant placement. Clinical and radiographic parameters, including the occurrence of complications were recorded. Results: A total of 49 patients were enrolled to receive 6‐mm implants (n = 108) and 46 patients to receive 11‐mm implants (n = 101). Three implants (two of 6 mm and one of 11 mm in length) were lost before loading and one 6‐mm implant after 15 months of function, and one 11‐mm implant was lost during the first year of function. The 5‐year survival rates were 96.0% and 98.9% in the 6‐mm and 11‐mm group, respectively. The mean marginal bone level changes 5 years post‐loading were 0.01 ± 0.45 mm (bone gain) in the 6‐mm group and −0.12 ± 0.93 mm (bone loss) in the 11‐mm group (p =.7670). Clinical parameters, including plaque, bleeding on probing and pocket probing depth were not significantly different between the groups, and also technical complications were low. Conclusion: The clinical and radiographic outcomes of 6‐mm short and 11‐mm standard‐length implants were not different during a 5‐year evaluation period. [ABSTRACT FROM AUTHOR]

Objectives: To compare periodontal parameters of splinted posterior teeth versus control teeth over ten years of supportive periodontal therapy (SPT) and to assess the survival rate of splints., Material and Methods: Retrospective data of 372 SPT-patients was screened for splints (composite/fiberglass-reinforced composite) in the posterior (molars/premolars) which were inserted at least ten years before due to increased tooth mobility. For each splinted tooth (test), a corresponding control tooth had to be present at the first SPT-session after splint insertion (T1). Data was assessed at T1 and ten years later (T2). Possible influencing covariates for splint survival (mobility degree/Eichner class) were tested by Cox regression. The change in clinical attachment level (ΔCAL), probing pocket depth (ΔPPD) and the testing of possible influencing covariates was analyzed by using mixed linear regression., Results: Twenty-four patients (32 splints, 58 splinted teeth) were included. Ten test and two control teeth were lost. No differences were observed between ΔCAL and ΔPPD of test teeth compared to control teeth (ΔCAL -0.38 ± 1.90 vs. 0.20 ± 1.27 mm; ΔPPD -0.17 ± 1.18 vs. 0.10 ± 1.05 mm). Twenty-two splints fractured during the observation period (survival-rate: 31%). Mobility degree and Eichner class did not influence time until fracture., Conclusions: Splinting of periodontally compromised and mobile posterior teeth does not have any disadvantage regarding the clinical periodontal situation when regular SPT is applied. However, splint fractures occur very often., Clinical Relevance: Splinting of posterior teeth is a treatment option in addition to active periodontal therapy when patients are disturbed by tooth mobility but splints have a high susceptibility to fracture., (© 2024. The Author(s).)

Background/Aim: An increasing number of elderly patients with implant‐prosthodontic rehabilitation of the edentulous mandible frequently show increased life activity, and consequently, a greater number of aged patients is at risk for maxillofacial trauma. The aim of this 3‐dimensional (3D) finite element analysis (FEA) was to evaluate the biomechanical effects of the edentulous mandible (EM) with and without four splinted interforaminal implants exposed to three different trauma applications including assessment of different mandibular fracture risk areas. Materials and Methods: In a 3D‐FEA study design, EM with and without four splinted interforaminal implants were exposed to the application of 1000 N at the symphyseal, parasymphyseal, and mandibular angle region. On four pre‐defined superficial cortical mandibular areas (symphysis region, mental foramen region, angle of mandible, and mandibular neck) representing regions of interest (ROI), the von Mises stresses were measured for the three trauma applications. For all ROIs, stress values were evaluated and compared for the different force application sites as well as between EM models with and without interforaminal implants. Results: For EM with and without four splinted interformaninal implants, all traumatic loads generated the highest stress levels at the mandibular neck region. However, in the EM with four splinted interforaminal implants, an anterior symphyseal force application generated significantly (P <.01) increased stress values in the parasymphyseal (mental foramen) region than in EM without implants. For force applications at the parasymphaseal region (mental foramen) and at the angle of the mandible elevated, von Mises stress values were noted directly at the application sites without difference between edentulous mandibles with and without four interforaminal implants. Conclusion: In an edentulous mandible model with four splinted interforaminal implants, the condylar neck and the mental foramen represent the predilectional risk areas for mandibular fracture for both anterior symphyseal and lateral parasymphyseal force application. [ABSTRACT FROM AUTHOR]

Background: Stabilization of luxated, avulsed, and root-fractured teeth is a part of the dental trauma treatment. The aim of the study was to assess the power chain and its comparison with two commonly used splinting materials. Methods: The evaluated splints were a wire-composite splint (WCS) with a diameter of 0.5 mm, a titanium trauma splint (TTS), and a power chain-composite splint (PCS). The splints were all fixed to the labial surfaces of permanent maxillary incisors in 10 human volunteers. The following parameters were measured: tooth mobility with Periotest before and after the splint application and removal, Aproximal Plaque Index (API), Sulcus Bleeding Index (SBI), and time needed to apply and to remove the splint. Each volunteer was also given a visual analogue scale (VAS) questionnaire to assess his/her subjective attitudes to splint materials. Results: The PCS was the most flexible material as it had the lowest horizontal Periotest values. For the two other methods, horizontal splint effects were similar and were also low. The PCS was the fastest to apply and remove and was also the most aesthetic splint. Conclusion: In this experimental study among volunteers, all three tested materials were found suitable for splinting the PCS has some advantages worth it to be further evaluated clinically in trauma patients. [ABSTRACT FROM AUTHOR]

Aims: To investigate the effectiveness of single and concomitant treatment of migraine and temporomandibular disorders (TMD) in women with the comorbidity. Methods: Eligible female patients met International Classification of Headache Disorders, second edition (ICHD-2) criteria for migraine with or without aura and the Research Diagnostic Criteria for myofascial TMD (Grade ll or lll). After a run-in period (30 days), women with both migraine and TMD were enrolled into a four-arm, double-blind, placebocontrolled, factorial study testing the separate and joint effects of a migraine treatment (propranolol 90 mg) and a TMD treatment (stabilization splint [SS]) in four groups of patients. The four treatment groups were propranolol and SS (n = 22); propranolol placebo and SS (n = 23); propranolol and non-occlusal splint (NOS) (n = 23); and propranolol placebo and NOS (n = 21). The primary endpoint for migraine was change in headache days from baseline to the third month, and the secondary endpoint was change in days with at least moderate headache in the same period. The TMD endpoints included pain threshold and mandibular vertical range of motion. Data were analyzed using analysis of variance (ANOVA, Dunn's post-hoc test) or Kruskal-Wallis test. Results: For the primary endpoint, in intention-to-treat (ITT) analyses (n = 94), propranolol and SS were associated with a nonsignificant reduction in the number of headache days, relative to all other groups. For per-protocol (PP) Completer analyses (n = 89), differences in the number of headache days reached significance (P < .05). The propranolol and SS group was significantly superior to the other groups on all other headache endpoints and in disability, in both ITT and PP analyses. No significant differences among groups were seen for the TMD parameters. Conclusion: In women with TMD and migraine, migraine significantly improved only when both conditions were treated. The best treatment choice for TMD pain in women with migraine is yet to be defined. [ABSTRACT FROM AUTHOR]

Aims: To assess the influence of occlusal stabilization splints on sleep-related respiratory variables in obstructive sleep apnea (OSA) patients. Methods: Ten OSA patients (47.3 ± 11.7 years of age) received a stabilization splint in the maxilla. All patients underwent three polysomnographic recordings with their splint in situ, and three recordings without their splint in situ, using a randomized crossover design. Results: Repeated-measures ANOVAs did not yield statistically significant differences in the Apnea-Hypopnea Index (AHI) or in the Epworth Sleepiness Scale (ESS), neither between the three nights without the stabilization splint (AHI: F = 2.757, P = .090; ESS: F = 0.153, P = .860) nor between the nights with the splint in situ (AHI: F = 0.815, P = .458; ESS: F = 0.231, P =. 796). However, independent ANOVAs revealed that the mean AHI of the three nights with the stabilization splint in situ (17.4 ± 7.0 events/ hour) was significantly higher than that of the nights without the splint in situ (15.9 ± 6.4 events/hour) (F = 7.203, P = .025). The mean increase in AHI with the splint in situ was 1.4 ± 1.7 (95% confidence interval = -1.9-4.7). No difference in ESS was found when both conditions were compared (F = 1.000, P = .343). Conclusion: The use of an occlusal stabilization splint is associated with a risk of aggravation of OSA; however, the effect size was small, which reduces the clinical relevance of the study. [ABSTRACT FROM AUTHOR]

Purpose: The aim of this study was to evaluate the effect of splinting titanium (Ti) or zirconia (Zr) implants supporting maxillary anterior fixed prostheses on the stress levels and patterns in the implants, prostheses, and the surrounding bone; and to compare the effects of Zr and Ti implant materials on the stress distribution in splinted and nonsplinted designs via finite element modeling. Materials and Methods: Zr and Ti dental implants and the anterior maxilla were modeled. In the nonsplinted design (D1), implants were placed into the maxillary left central incisor and canine regions, and a three-unit zirconia fixed prosthesis was modeled. In the splinted design (D2), a symmetric model of D1 was generated and the two prostheses were splinted together to create a six-unit prosthesis. Loading was applied horizontally and obliquely. Von Mises, tensile, and compressive stresses were evaluated in the implants, prostheses, and surrounding bone. Results: Under both loading conditions, the stresses on the D2 implants were lower than those in the D1 implants. Stresses were concentrated on the neck of the implant and decreased through the apex. All of the stress values in cortical bone in D1 were slightly higher than in D2 for both implant materials under both loading conditions. Conclusion: When the implants were splinted together, stresses were reduced in the supporting bone and implants in both loading conditions, but increased stress was observed in the prostheses under oblique loading. Intense stress concentrations were found in the connector of the splinted prosthesis and the cervical region of the nonsplinted prosthesis. Zr and Ti implants showed very similar stress distributions in all materials. Under oblique loading, lower stresses occurred in implants and the prosthesis core material when Ti implants were used. [ABSTRACT FROM AUTHOR]

Objective: To compare the radiographic marginal bone loss and clinical parameters of splinted and non‐splinted fixed dental prostheses on short implants in the posterior region of the lower jaw 3 years after loading. Material and Methods: Twenty patients, 15 female and five males, with uni‐ or bilateral free‐end situations in the mandible participated in the study. Two short implants (7 mm) in the posterior mandible were placed and patients were randomized to receive splinted (n = 11) or non‐splinted (n = 13) cemented crowns. Marginal bone loss (MBL) was assessed on radiographs taken with customized positioning jigs at baseline, 1 and 3 years after loading. Plaque index (PI), gingival index (GI), probing depth (PD), and bleeding on probing (BOP) were measured. (ClinicalTrials.gov; identifier: NCT03558347). Results: After 3‐year survival rate of altogether 48 implants was 100% for both groups. Success rate (according to Papaspyridakos, Chen, Singh, Weber, & Gallucci, 2012) was 84.6% for non‐splinted and 86.4% for splinted implants. At restoration level survival rate was 100% for both groups. Marginal bone level changes showed mean gain of 0.3 ± 0.8 mm for non‐splinted and 0.1 ± 0.5 mm for splinted implants 3 years after loading. Statistical analysis showed no significant difference in PI, GI, PD, BOP, and marginal bone loss between both groups (p >.05). Conclusion: Within the limitations of this study it can be concluded that splinting crowns on short implants neither seems to affect the amount of marginal bone loss nor peri‐implant health 3 years after loading. [ABSTRACT FROM AUTHOR]

This systematic review aimed to assess the efficacy of occlusal splints in the treatment of temporomandibular disorders (TMDs). This systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Four databases (Medline via Pubmed, Web of Science, Embase and Scopus) were searched, the last search was conducted on April 2020. Randomised controlled trials (RCTs) employing the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) or Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) as diagnostic criteria and including occlusal splint as one of the experimental groups were included in the present study. The data from the included studies were extracted and assessed for risk of bias. Eleven studies were included. The sample size ranged from 12 to 96 subjects. The male to female ratio was 0 to 25%. The mean length of follow-up was 4 months. Occlusal splint had a positive effect on mandibular movements in all included studies. Seven studies showed a positive effect of occlusal splint on chronic pain reduction and pain intensity, while two others showed improvement of temporomandibular joint clicking sounds and locking of the jaws. Moreover, improvements in mouth opening, depression, and anxiety symptoms, were reported in four studies. An occlusal splint can be considered as a non-invasive treatment approach for patients with TMD, especially those with signs and symptoms of restriction of mandibular movement and pain. Moreover, the present findings highlighted an urgent need of a standardised consensus regarding the prognostic evaluation of TMD. [ABSTRACT FROM AUTHOR]

Purpose: To recommend an international multidisciplinary medical and surgical algorithm of treatment in nasal vasculitis, which will create a more streamlined approach. Methods: A two-centre, international retrospective analysis of granulomatosis with polyangiitis (GPA) and levamisole-associated vasculitis (LAV) cases presenting between 2005 and 2019 was carried out. Demographic data, and surgical and medical treatment were recorded. Patients' signs and symptoms were analysed, and recommended treatment strategies outlined with key surgical procedures described. Results: Forty-one GPA patients and 11 LAV patients were included in the study with a mean age of 38.6 and 38.8 years, respectively. A stepwise surgical management approach with reconstructive options is described and includes: (1) examination under general anaesthesia, biopsy, and insertion of silastic nasal splints; (2) septal perforation repair (with caution); (3) mild-to-moderate saddle nose reconstruction with costal cartilage; (4) severe saddle nose reconstruction with osseocartilaginous rib grafts; (5) soft-tissue reconstruction techniques. Conclusions: The management of nasal vasculitis is a particular challenge in facial plastic surgery. It requires a close collaborative approach with a physician skilled in the medical management of vasculitis. Surgery must be planned judiciously, with realistic patient expectations and only after a sustained period of remission. For more severe saddle deformities, the modified osseocartilaginous Andrews technique gives excellent long-term results. [ABSTRACT FROM AUTHOR]

Traditional model surgery with facebow transfer is not very accurate. We aimed to demonstrate that the Orthopilot™ Navigation System improves the accuracy of maxillary repositioning during Le Fort I osteotomy. Thirty patients underwent Le Fort I osteotomy alone or associated to sagittal split osteotomy. The maxilla positioning was done in two phases. First, the maxilla was positioned with the traditional occlusal splint, the position ("without Orthopilot™") was recorded by the Orthopilot™. In the second phase, the Orthopilot™ was used to improve positioning; and the final position ("with Orthopilot™") was recorded, after osteosynthesis. Positioning data were compared with planned data. Positioning data with and without the Orthopilot™ were also compared. Accuracy was classified in distinct classes with three major criteria (conformity, non-conformity, failure) according to the discrepancies. Conformity rate was significantly greater with the Orthopilot™ (2 without the Orthopilot™ compared with 8 with the Orthopilot™; p = 0.01). The failure rate was significantly lower with the Orthopilot™ (18 without Orthopilot™ compared with 7 with the Orthopilot™; p = 0.002). Dispersions of discrepancies were usually lower in all directions with the Orthopilot™. Navigation reduced the risk of discrepancy without cancelling it, especially when large movements are planned. The Orthopilot™ therefore improved the accuracy of traditional occlusal splint during Le Fort I osteotomy. [ABSTRACT FROM AUTHOR]

Background/aims: The diagnosis and treatment of dental trauma are developing rapidly in China. Therapeutic methods used to treat immature avulsed teeth remain a unique challenge in the clinical setting. The aim of this study was to compare the differences in the survival rate and management of avulsed teeth over two distinct periods.Materials and Methods: Forty immature permanent avulsed teeth of 34 patients (28 boys, 6 girls) were included in this study between 1 July 2008 and 30 June 2009 (group 1, 17 teeth), and 1 January 2015 and 31 December 2015 (group 2, 23 teeth). The patients' mean age was 8.8 (range 7-11) years. The follow-up period ranged from 1.5 to 10 years (group 1/group 2, 1.5-10/1.5-3 years). Variables such as extra-alveolar time and storage media, stage of root development, splinting type, splinting duration, endodontic treatment and management of complications were studied. The variables were analysed in relation to post-operative pulp outcomes and periodontal healing.Results: Pulp extirpation was performed in 36 teeth within 0-14 weeks (mean: 1.6 + 2.0). The incidence of ankylosis-related (replacement) resorption was 30.5% and that of infection-related (inflammatory) resorption was 22.5%. Pulp survival rate curves differed significantly between the two periods, indicating improvement (P < .05). Splinting type had changed between the study periods to more flexible splints. The use of storage media prior to replantation had also improved. Multivariate Cox proportional hazard regression showed a cumulative survival rate of 82.5% at 3 years and 29.4% at 10 years.Conclusion: A significant improvement was observed in the management and prognosis of avulsed teeth between 2008 and 2015. [ABSTRACT FROM AUTHOR]

Copyright of Quintessenz der Zahntechnik is the property of Quintessenz Verlags GmbH and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of International Journal of Computerized Dentistry is the property of Quintessence Publishing Company Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Splints are routinely used for occlusal force dissipation from the long axis of periodontally compromised teeth towards adjacent healthy teeth. This process causes forces generated from traumatic occlusion to be separated from underlying periodontium favouring regeneration of lost tissue. Splinting periodontally compromised teeth together causes the redistribution and redirection of functional and parafunctional forces to bring them within tolerance of the supporting tissue and to reduce mobility. However the common drawback of using splints include the lifespan of the splint without periodic modifications. The present study tries to relate the reduction of mobility in periodontitis cases from grade II to grade I using different splinting materials and the lifespan of the same. The present study was a single centered retrospective university based design, using patient records of Saveetha dental college, from 1st June 2019 till 1st March 2020 . The included patients were individuals with generalised/ localised chronic periodontitis, who had undergone non surgical periodontal therapy along with the use of provisional splints. The parameters assessed for two hundred and fifty eight patients included in the present study was longevity/lifespan of splints and the reduction in the degree of mobility. Our observations revealed that stainless steel wire composite splints were used 1.96 time more frequently than mesh reinforced composite splints, reduced grade II mobility to grade I mobility in teeth affected by periodontitis to a greater than composite resin wire mesh.(p<0.05). Within the limits of this study splints were found to reduce mobility as an adjunct to periodontal therapy from grade II mobility to grade I mobility while using stainless steel wire composite resin splints among age groups of 20-40 years with a lifespan of 6 months 24% of the time. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Craniomandibular Function is the property of Quintessence Publishing Company Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Acta Stomatologica Croatica is the property of Acta Stomatologica Croatica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: The aim of this prospective study was to evaluate the implant, prosthesis, and patient‐reported outcomes of maxillary removable prostheses retained by 4 implant‐supported study abutments after a follow‐up period of 1 year in patients with natural teeth or a fixed rehabilitation in the mandible. Materials and Methods: A total of 30 patients were included, and all received 4 implants in the upper maxilla. After 12 weeks, the prostheses were connected to the implant with unsplinted attachments. The implant and prosthodontics outcomes were assessed over a follow‐up period of 1 year. Patient‐reported outcome measures (PROMs) were evaluated with the Oral Health Impact Profile (OHIP‐20) questionnaire and an adaptation of the McGill Denture Satisfaction Instrument using a visual analogue scale (VAS). Results: A single patient dropped out. At the post‐operative 12‐week follow‐up, 79.3% (95% CI: 64.6%–94.1%) of the patients displayed peri‐implant mucosa hyperplasia and 69.0% (95% CI: 52.1%–85.8%) showed pain. After 1 year, 16 implants failed in 10 patients, leading to an implant survival rate of 86.2% (95% CI: 79.0%–92.5%), and the mean peri‐implant bone loss was 1.01 ± 0.77 mm (95% CI: 0.85–1.16 mm). The prosthesis survival rate was 96.6% (95% CI: 82.2%–99.9%). The OHIP‐20 and VAS scores both improved significantly from baseline to 1 year (p <.001). Conclusion: The implant survival rate was lower compared to the literature for the upper maxilla. Despite the encountered problems, PROMs showed significant improvement with the implant overdenture retained by 4 unsplinted implants compared to conventional dentures. [ABSTRACT FROM AUTHOR]

To evaluate the feasibility of safely managing subcondylar fractures using an original surgical procedure combining an intraoral approach, the use of a custom-made occlusal overlay splint, and intraoperative imaging. Condylar fragment was freed from surrounding soft tissues, was laterally exposed to the ramus, and a miniplate was fixed in place for osteosynthesis. An overlay splint maintaining the dental occlusion was used to facilitate reduction and stabilization during fixation. Intraoperative monitoring by cone-beam computed tomography (CBCT) was performed before completing the fixation. Between November 2018 and June 2019, 10 patients were treated using this procedure. The median length of the proximal condylar fragment was 29 mm (range 24–39 min). Five patients had an associated mandibular fracture. The median duration of the condylar fracture surgery was 54.5 min (range 38–79 min). All patients had satisfactory reduction and osteosynthesis with no complications. It is feasible to safely manage subcondylar fractures with this surgical procedure that could facilitate open reduction using intraoral approaches. Occlusal splints maintain downward pressure on the rami bilaterally and symmetrically, helping to anatomically reposition condylar process fractures. Intraoperative imaging is used to monitor this step. [ABSTRACT FROM AUTHOR]

A network meta-analysis (NMA) of randomized controlled trials (RCTs) was performed to assess the effectiveness of various types of occlusal splint in the management of temporomandibular disorders (TMDs) and to rank them according to their effectiveness. An electronic search was undertaken to identify RCTs published until August 2019. Predictor variables were control, non-occluding splint, hard stabilization splint (HSS), soft stabilization splint (SSS), prefabricated splint, mini-anterior splint, anterior repositioning splint (ARS), and counselling therapy (CT) with or without HSS. Outcome variables were pain improvement, post-treatment pain intensity, improvement in mouth opening, and disappearance of temporomandibular joint (TMJ) sounds. Forty-eight RCTs were included. There was a significant decrease in post-treatment pain intensity in arthrogenous TMDs after ARS (low quality evidence), CT + HSS (moderate quality evidence), mini-anterior splints (very low quality evidence), and HSS alone (low quality evidence), when compared to the control. There was a significant decrease in post-treatment pain intensity in myogenous TMDs with mini-anterior splints (very low quality evidence), SSS (very low quality evidence), CT alone (moderate quality evidence), CT + HSS (moderate quality evidence), and HSS alone (moderate quality evidence), when compared to control. ARS and CT were superior in decreasing TMJ clicking than control and HSS alone. The three highest-ranked treatments for post-treatment pain reduction in arthrogenous TMDs were ARS (92%, very low quality evidence), CT + HSS (67.3%, low quality evidence), and HSS alone (52.9%, moderate quality evidence). For myogenous TMDs, they were mini-anterior splints (86.8%, low quality evidence), CT + HSS (61.2%, very low quality evidence), and HSS alone (59.7%, moderate quality evidence). Based on this NMA of 48 RCTs, there is moderate to very low quality evidence confirming the effectiveness of occlusal splint therapy in the treatment of TMDs. Multimodal therapy consisting of CT + HSS may produce the maximum improvement for TMD patients. [ABSTRACT FROM AUTHOR]

Tooth mobility may be a common problem among patients seeking dental treatment. Tooth mobility is defined as an extent of horizontal and vertical tooth displacement created by external forces, trauma and periodontal disease. The aim of the present study is to evaluate the pattern of tooth mobility in patients with periodontal disease. Case sheet records of 86000 patients who had visited Saveetha Dental College and Hospitals between June 2019 and March 2020 were reviewed. 200 patients (105 males, 95 females) with periodontitis were included in the study. Age, gender and the pattern of tooth mobility with respect to region were collected. The collected data were analysed using SPSS statistical software. Descriptive statistics (percentage, mean, SD) and inferential test (Chi-square test) were performed. Tooth mobility was more common among males (52.8%) than the females (47.2%). Age between 41-50 years (42.7%) had a higher chance of tooth mobility. Tooth mobility was more commonly seen in the mandibular arch (47.4%) and in the anterior region (45%). Patients age, gender, site and region of mobile tooth were not associated with tooth mobility. Tooth mobility due to periodontal disease can occur equally in both male and females. The present study showed that 80% of the patients with periodontal disease had tooth mobility. Therefore, early diagnosis, preventive therapeutic measures and oral hygiene reinforcement is needed to prevent progression of periodontal disease leading to tooth mobility. [ABSTRACT FROM AUTHOR]

Background: This study aimed to demonstrate that the material of the occlusal splint can be chosen according to the needs of individual patients and contribute to the knowledge of the wear rate of these materials. Methods: In this study, four occlusal splint materials (Sr Ivocap Heat Cured, Valplast, SR Ivocap Elastomer and Eclipse) and three antagonists (natural tooth enamel, inCoris TZI and IPS e.max Press ceramic materials) were used. Each wear test was performed using a chewing simulator (n = 16; test load: 50 N; number of cycles: 10,000, 20,000 and 30,000; continuous rinsing with water at 30 °C for the wet condition). The Shapiro Wilk test was used for normal distribution suitability. Antagonist on average wear quantities both main effects and interactions of material, cycle and condition factors were investigated by Univariate variance analysis. Multiple comparisons were examined using the Games-Howell test. Results: There was a statistically significant effect of the difference in materials on the amount of wear (p < 0.001). Furthermore, there was a statistically significant difference among the mean values of all materials (p > 0.001). The highest mean value was obtained with Eclipse (0,318 μm3), and the lowest mean value was obtained with Valplast (0,134 μm3). Conclusion: Our study found differences in the in vitro wear rate among various occlusal splint materials. [ABSTRACT FROM AUTHOR]

Periodontal disease impairs tooth support and permits secondary trauma to occur. As a consequence, teeth may loosen, and the alveolar bone may be subjected to additional damage. One of the common causes of tooth loss is a slow, deteriorating response to periodontitis. Hence, the reduction of mobility is an important objective of periodontal therapy. In an effort to reduce tooth loss due to the weakened periodontium, various treatments have emerged to provide a possible solution. The prognosis of periodontally involved teeth depends often on the initial mobility and whether it can be altered by treatment. One of the methods to retain the mobile, periodontally affected tooth is by splinting. Splinting simply refers to a method of stabilizing and fixing the mobile teeth. However, splinting by itself does not reverse the damages caused to the periodontium but rather it is a method which maintains the periodontal status and helps healing. The aim of this article is to do a literature review the effect of splinting on periodontal health. [ABSTRACT FROM AUTHOR]

Objectives: This in vitro study aimed to compare changes in retentive force due to cyclic dislodging of three novel un‐splinted attachments. Materials and Methods: Experimental models simulating a mandibular two‐implant overdenture situation, with implants positioned with various interimplant discrepancies (0°, 20°, 40°, and 60°) were fabricated. Three attachment systems were tested, "N": a straight or 15°‐angulated stud; "L": a sole straight stud; and "C": a straight or individually angulated stud. All models underwent wet testing and were subjected to 10,000 insertion–removal cycles in a universal testing machine. The mean retentive forces were calculated for cycles 10, 100, 1,000, 5,000, and 10,000. Multiple mixed‐effects linear regression models were applied for statistical analyses (⍺ < 0.05). Results: "N" demonstrated an increasing retention until 1,000 cycles, which subsequently diminished back to its initial retention at 10,000 cycles, showing no significant loss during the entire experiment. Statistical models demonstrated no effect of implant angulation on retention, except for 60° after 10,000 cycles (p <.05). "L" showed an early peak at 100 cycles and did not significantly lose retentive force before 5,000 cycles. Angulations of 40° or higher were shown to lead to lower retentive forces (0° vs. 40° cycle 5,000: p <.05; 0° vs. 60° cycle 100: p <.05, ≥cycle 1,000: p <.001). "C" showed stable retentive forces with no significant loss only at 10,000 cycles (all angles: p <.001) or 5,000 cycles (0° vs. 60°: p <.05). Conclusions: All systems showed retentive forces promising successful clinical use in implant overdentures, even in situations with extremely angulated implants. Specific abutments compensating interimplant angulation maintain retention longer in situations with high axe divergencies. [ABSTRACT FROM AUTHOR]

In the area of human research that focuses on the interactions between occlusion and brain function this review discusses the relationship between the brain activity observed in the motor and sensory cortices and movements of the oral and maxillofacial area, such as gum chewing, tapping and clenching. It has been found that the sensorimotor cortex is also affected by slight changes in occlusion, such as those caused by occlusal interference devices, splints and implant prosthesis. However, findings such as these must be verified by evidence gathered from more subjects. Furthermore, individual variation is an important factor although it is assumed that any sensory movements in the oral and maxillofacial area are related to most regions of the cerebral cortex. In-depth research is necessary to clarify how changes in movement and sensation affect functional localisation in the brain. [ABSTRACT FROM AUTHOR]

Brief Background The personality of a person is greatly influenced by their smile. Imperfections in the appearance of anterior teeth can reduce a person's confidence and aesthetics. This case report represents the rehabilitation of a patient with severe tooth deformation in the upper and lower anterior teeth region. The tooth structure was not enough to support porcelain crowns, so Resin Composite was used to build up the tooth and it was supported using a periodontal splint. Materials and Methods Clinical examination and radiographic evaluation showed a tooth form-size discrepancy. Due to the lack of tooth structure available for crown preparation, Resin Composite material was used to build up the tooth structure. everStick by GC was used as a periodontal splint to support the structure. Discussion Resin Composite is one of the most conservative and aesthetic techniques available for restoring tooth structure. The different hues and shades available help it to provide a seemingly natural looking restoration. This helps in rehabilitation of a decrepit smile. Long term studies showed high success rates. Failure was seen in patients with paranormal muscle activity like bruxism and in bonding on pre-existing composite restorations. Marginal discolouration was seen in patients with tobacco habits (smoking and smokeless forms). Summary and Conclusions Composite build-up of teeth is a viable option for restoring tooth structure when the case demands aesthetic needs in both young and adult patients. The amount of tooth structure conserved is also much greater than with porcelain crowns. Cost of treatment is also significantly lower. [ABSTRACT FROM AUTHOR]

Dental implants have gained much popularity and acceptance in the course of a decade. Patients now prefer a treatment that does not involve the fiddling of the natural teeth adjacent to their missing spaces more so in the anterior esthetic regions. Implants are a go to treatment for rehabilitation of the teeth in the anterior region of the jaw. With proper analysis and pre-treatment planning about the end outcome, implants can be a successful mode of treatment in the esthetic regions. Implants can provide a proper emergence profile similar to that of the natural teeth and also the final shade matching plays an important role in cases where the adjacent teeth have staining as in fluorosis. This case report details the procedure of stage 1 and 2 of implant treatment for a patient with fluorosis. [ABSTRACT FROM AUTHOR]

Different treatment options for patients with arthrogenous Temporomandibular Disorders (TMDs) have been reported. However, evidence regarding the most effective intervention using network meta-analysis (NMA) has not been performed. Thus, we conducted a NMA of randomized clinical trials (RCTs) to identify the most effective treatment of arthrogenous TMDs with respect to pain reduction and improved mouth opening, and to generate a ranking according to their effectiveness. An electronic search on three major databases was undertaken to identify RCTs published before August 2019, comparing up to fourteen different treatments against control/placebo patients for arthrogenous TMDs with respect to pain reduction and improved mouth opening. The treatment variables were controls/placebo, conservative treatment (muscle exercises and occlusal splint therapy), occlusal splint therapy alone, intraarticular injection (IAI) of hyaluronic acid (HA) or corticosteroid (CS), arthrocentesis with or without HA, CS and platelet-rich plasma (PRP), arthroscopy with or without HA and PRP, open joint surgery, and physiotherapy. Frequentist NMA was performed using STATA software. Studies meeting the inclusion criteria were divided according to the length of follow-up (short-term (≤5 months) and intermediate-term (≥6 months to 4 years) and type of TMJ arthrogenous disorders; internal derangement (ID) and TMJ osteoarthritis (OA). The standardized mean differences (SMD) in post-treatment pain reduction and maximum mouth opening (MMO) were analysed. Thirty-six RCTs were identified that performed comparative outcome assessments for pain and 33 RCTs for MMO. At the short term (≤5 months), IAI-HA (SMD = −2.8, CI: −3.7 to −1.8) and IAI-CS (SMD = −2.11, CI: −2.9 to −1.2) (all very low quality evidence) achieved a substantially greater pain reduction than control/placebo. At intermediate term (≥6 months), a statistically significant decrease in posttreatment pain intensity was observed following Arthroscopy-PRP (SMD = −3.5, CI: −6.2 to −0.82), Arthrocentesis-PRP (SMD = −3.08, CI: −5.44 to −0.71), Arthroscopy-HA (SMD = −3.01, CI: −5.8 to −0.12), TMJ surgery (SMD = −3, CI: −5.7 to −0.28), IAI-HA (SMD = −2.9, CI: −4.9 to −1.09) (all very low quality evidence), Arthroscopy-alone (SMD = −2.6, CI: −5.1 to −0.07, low quality evidence) and Arthrocentesis-HA (SMD = −2.3, CI: −4.5 to −018, moderate-quality evidence) when compared to the control/placebo groups. Relative to MMO, the most effective treatments for short- and intermediate-term improvement were the arthroscopy procedures (PRP > HA > alone, all very low-quality evidence) followed by Arthrocentesis-PRP (very low-quality evidence) and Arthrocentesis-HA (moderate-quality evidence). The non-invasive procedures of occlusal splint therapy, physical therapy, conservative therapy, placebo/control provided significantly lower quality outcomes relative to pain and MMO. The results of the present meta-analysis support a paradigm shift in arthrogenous TMJ disorder treatment. There is a new evidence (though on a very low to moderate quality level) that minimally invasive procedures, particularly in combination with IAI of adjuvant pharmacological agents (PRP, HA or CS), are significantly more effective than conservative treatments for both pain reduction and improvement of MMO in both short (≤5 months) and intermediate term (6 months–4 years) periods. In contrast to traditional concepts mandating exhaustion of conservative treatment options, minimally invasive procedures, therefore, deserve to be implemented as efficient first-line treatments (e.g. IAIs and/or arthrocentesis) or should be considered rather early, i.e. as soon as patients do not show a clear benefit from an initial conservative treatment. [ABSTRACT FROM AUTHOR]