A Full Digital Workflow to Design and Mill a Splint for a Patient with Temporomandibular Joint Disorder

Nota, Alessandro; Ryakhovsky, A N; Bosco, Floriana; Tecco, Simona

doi:10.3390/app11010372

Cited by 13 publications

(20 citation statements)

References 17 publications

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“…The reference points are determined repeatedly and cohesively each time in the same place, conversely to the manual measurement. Though reliable manual measurements performed by experts have been often presented in [ 19 , 44 ], an automated method should be preferred. It is also advantageous to lower the time necessary for the parameters’ determination.…”

Section: Resultsmentioning

confidence: 99%

“…Attempts were made to use CBCT for measurement of the temporomandibular joint (TMJ) parameters. The position of the TMJ head, which can be determined by analyzing the space between the TMJ head and the fossa, is recognized as being most important [19]. There has been no full agreement between researchers regarding the optimal position of the condyle [20][21][22], some also having reported dependency between the shape of the condyle and its placement [23].…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, a means of visualization and measurements of the condyle position before, during, and after the therapy is highly desirable. CBCT is considered to be one of the best techniques for that purpose [ 19 ]. However, the lack of automation of measurements of the TMJ head parameters has been observed.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

New Method for Analysis of the Temporomandibular Joint Using Cone Beam Computed Tomography

Iwaszenko¹,

Munk

Baron

et al. 2021

Sensors

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Modern dentistry commonly uses a variety of imaging methods to support diagnosis and treatment. Among them, cone beam computed tomography (CBCT) is particularly useful in presenting head structures, such as the temporomandibular joint (TMJ). The determination of the morphology of the joint is an important part of the diagnosis as well as the monitoring of the treatment results. It can be accomplished by measurement of the TMJ gap width at three selected places, taken at a specific cross-section. This study presents a new approach to these measurements. First, the CBCT images are denoised using curvilinear methods, and the volume of interest is determined. Then, the orientation of the vertical cross-section plane is computed based on segmented axial sections of the TMJ head. Finally, the cross-section plane is used to determine the standardized locations, at which the width of the gap between condyle and fossa is measured. The elaborated method was tested on selected TMJ CBCT scans with satisfactory results. The proposed solution lays the basis for the development of an autonomous method of TMJ index identification.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

New Method for Analysis of the Temporomandibular Joint Using Cone Beam Computed Tomography

Iwaszenko¹,

Munk

Baron

et al. 2021

Sensors

View full text Add to dashboard Cite

show abstract

“…[5][6][7] Innovative technologies already have an established protocol for creating splints with personal design, from different materials and by different methods. [8][9][10] Achieving a balanced occlusion requires a number of evenly distributed contacts. 11 Articulation paper is widely used in practice when registering occlusal contacts.…”

Section: Introductionmentioning

confidence: 99%

Case Report: Digital analysis of occlusion with T-Scan Novus in occlusal splint treatment for a patient with bruxism

Shopova

Bozhkova²,

Yordanova³

et al. 2021

F1000Res

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Bruxism is a disease with a multifactorial etiology. Its clinical manifestations are most often an unaesthetic smile with abraded tooth surfaces, temporomandibular disorders and muscle hyperactivity. Here we present a case of bruxism where proper articulation of the occlusal splint was performed using the T-scan Novus system. A patient with bruxism underwent treatment with stabilization splint made by 3D printer technology. Intraoral scanning was performed using Trios Color (3Shape), and the digital design was achieved using the 3Shape Dental system design - splint studio. Formlabs Form 2 printer with biocompatible resin Dental LT Clear Resin was used for printing. The T-Scan Novus system with software attached to it, version 9.1, was used for digital examination of the occlusion. A 2.7 mm thick occlusal splint was developed, and the software adapted the occlusion with antagonists. After adjustment with T-Scan Novus, a reduction in disocclusion time of the patient was achieved, which is a desired result in the treatment of bruxism. The position of the joint components was proven radiologically. The treatment of bruxism with splint therapy continues to be the main method of treatment. Using digital technology allows for more accurate constructions and precise balancing of occlusal relationships.

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“…The option to use the virtual articulator allows visualization of the movements of the lower jaw, as well as the removal of pre-contacts, if necessary. 14,15 The resulting version of the splint can be made by 3D printing or CAD/CAM milling. The technological characteristics of the objects made by cutting (CAD/CAM technology) from the monolithic block are higher and preferable than 3D printing.…”

Section: Introductionmentioning

confidence: 99%

Case Report: A digital workflow in the treatment of bruxism in a young patient

Shopova

Mladenov²

2021

F1000Res

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Bruxism is increasingly common in today's stressful world and affects mainly young patients. It is a combined disease that involves dentition and its supporting structures, muscles, ligaments and the temporomandibular joint (TMJ). Here we present a complete combined analog and digital clinical protocol in a patient with parafunction. A young patient sought help due to impaired aesthetics, as a result of abraded tooth surfaces and severe symptoms of TMJ. We implemented a therapeutic protocol of six stages: deprogramming of the muscles and determination of treatment position and digital optimization; realization of the morphological plan for the upper dentition; non-invasive repositioning of the lower jaw by splint therapy; splint placement and follow-up; morphological planning of the lower dentition and replacement of the splint with fixed prosthesis with follow-up; and completion of the case with ceramic restorations. The digitally modeled temporary constructions for the upper jaw were made of PMMA and placed in the patient's mouth together with the splint on the lower jaw, made of Ceramill Splintec. After an adaptation period, all restorations were replaced by permanent zirconia. We achieved restoration of the defects of the dental arches and hard dental tissues and recovery to normal height of the lower third of the face (vertical dimension occlusion), fixed a stable and balanced position of the lower jaw, and repaired the normal physiological position of the TMJ for the patient. Аfter a multi-stage treatment we received a result satisfying the patient, the dentist and the dental technician. Aesthetics and function were restored, and clinical symptoms were removed from the TMJ.

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A Full Digital Workflow to Design and Mill a Splint for a Patient with Temporomandibular Joint Disorder

Cited by 13 publications

References 17 publications

New Method for Analysis of the Temporomandibular Joint Using Cone Beam Computed Tomography

New Method for Analysis of the Temporomandibular Joint Using Cone Beam Computed Tomography

Case Report: Digital analysis of occlusion with T-Scan Novus in occlusal splint treatment for a patient with bruxism

Case Report: A digital workflow in the treatment of bruxism in a young patient

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