The fabrication of a customized occlusal splint based on the merging of dynamic jaw tracking records, cone beam computed tomography, and CAD-CAM digital impression

Abstract

OBJECTIVES:The aim of this case report was to present the procedure of fabricating a customized occlusal splint, through a revolutionary software that combines cone beam computed tomography (CBCT) with jaw motion tracking (JMT) data and superimposes a digital impression.MATERIALS AND METHODS:The case report was conducted on a 46-year-old female patient diagnosed with the temporomandibular disorder. A CBCT scan and an optical impression were obtained. The range of the patient's mandibular movements was captured with a JMT device. The data were combined in the SICAT software (SICAT, Sirona, Bonn, Germany).RESULTS:The software enabled the visualization of patient-specific mandibular movements and provided a real dynamic anatomical evaluation of the condylar position in the glenoid fossa. After the assessment of the range of movements during opening, protrusion, and lateral movements all the data were sent to SICAT and a customized occlusal splint was manufactured.CONCLUSIONS:The SICAT software provides a three-dimensional real-dynamic simulation of mandibular movements relative to the patient-specific anatomy of the jaw; thus, it opens new possibilities and potentials for the management of temporomandibular disorders.

Damon technique for orthodontic treatment of a patient with temporomandibular joint dysfunction

“…[ 7 8 ] The differential diagnosis of TMD in the present study allowed us to collect a wide range of clinical manifestations (signs and symptoms) that, when compared with the rest of the population, coincide especially with muscle hypertonicity in the masseter, temporal, internal, and external pterygoids and with myalgia and obvious contractures[ 9 10 ]; this point is relevant, and because the treated patient's features were within these parafunctions, these factors were important when performing physical and clinical examinations to achieve an accurate diagnosis, thus allowing specialized care. [ 11 12 ] Traditionally, these disorders have been overlooked because they are considered only of interest to dental surgeons. [ 13 ] Within the process with the Damon system, an overexpression of the torque of the upper lateral incisors was observed, and torque control with an inversion in the direction of the bracket was required.…”

Jaw motion tracking systems – literature review

“…Additionally, SICAT software measures forces of jaw movement and include them in an overall final analysis. 42,43 Due to the publications by Kühnöl et al and Hannsen et al SICAT is the valuable tool in treating cases of TMD that require rehabilitation e.g. occlusal or repositioning splints.…”

“…Digitally designed and fabricated custom-made splint was accurate, adjustment time as well as doctor's time was reduced, and the patient reported immediate relief from TMJ symptoms. 42 In March 2019, MODJAW Tech in Motion (Modjaw, Villeurbanne, France), the latest technology for real-time jaw motion registration was presented. MODJAW's unique software merges all patient data, including 3D models, 4D movements, and CBCT and facial scans to establish the complete digital replica of the patient.…”

An Evaluation of Jaw Tracking Movements in Patients with Total Joint Replacements versus a Control Group

“…The measurement sensor technology consisted of a receiving sensor and a transmitting sensor. The SICAT JMT + system has been previously reported on and consists of a face bow a lower jaw sensor, a SICAT Fusion Bite Tray, a SICAT Fusion Bite adapter, a para-occlusa T-attachment, a SICAT JMT + basic unit, and SICAT JMT+ application software [22,23,27 (Figure 2). The face bow has a nose pad to locate the face bow and a rear headband t secure it to head.…”