Occlusal splints – changes in the muscular activity

Mladenov²

2022

F1000Res

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.

Section: Discussionmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

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

Mladenov²

2022

F1000Res

“…1 The splints' aims are to redistribute the occlusal forces and reduce the activity of the masticatory muscles. 5 To achieve a therapeutic effect, it is necessary to wear it almost all the time. [6][7][8] In recent years, modern methods of occlusal splints' creation using CAD/CAM technology and additive manufacturing have been increasingly developed.…”

Section: Introductionmentioning

confidence: 99%

T-Scan Novus System in the Management of Splints—Pilot Study

Bozhkova

2021

Eur J Dent

The purpose of this pilot study was to demonstrate the capabilities of the T-Scan Novus system in bruxism treatment by splints. Bruxism patients underwent treatment with a splint made by additive manufacturing. Intraoral scanning was performed using Trios Color (3Shape), and digital design was performed using 3Shape Dental system design - splint studio. The biocompatible material Dental LT Clear Resin was printed using a Formlabs Form 2 printer. The T-Scan Novus system with a software attached to it, version 9.1, was used for digital examination of the occlusion. A splint with an occlusal thickness of 2.5 mm was developed and software adapted with relief to antagonists. The digitally set occlusion with even contacts turned out to be clinically unbalanced. After adjusting with T-Scan Novus, a balanced occlusion was achieved in the right and left halves. The treatment of bruxism with splint therapy continues to be the main method. Its combination with digital technologies allows more precise constructions and more accurate balancing of occlusal relationships.

“…21 Infrared thermography imaging can be used to check muscle activity, and hence the effect of splint treatment. 22 …”

Section: Introductionmentioning

confidence: 99%

3Shape Digital Design Software in Splints Creation—A Pilot Study

Yordanova

2021

Eur J Dent

Objectives Digital technologies have widened their horizons into the world of dental medicine and now further expanding to cover all branches. This new modern technology replaces traditional laboratory techniques allowing effective patient care. Patients who suffer from bruxism—the act of involuntary habitual grinding of teeth—have widely been benefited by splint treatments. The aim of this article is to display the variety of occlusal splints that can be created by the 3Shape Digital Design Software and their application in specific clinical situations. Materials and Methods Six variations in the splints were created digitally—three with uncombined designs and the remaining three with a combination of two of the main options available. During this study, 36 splints were made for patients aged 24 to 55 inclusively. Results The largest number of splints according to the clinical picture were made of “raise to antagonist cusp tips” (14 pieces) and the remaining were of combined type “raise to antagonist cusp tips + raise to antagonist plane” (12 pieces). There thickness was within the range of 1.5 and 5 mm. Conclusion 3Shape Digital Design Software—Splint Studio is a suitable system for designing and creating occlusal splints with respect to certain clinical situations. It is possible to combine the three main types in a separate section of the dental arch according to the case.