The influence of the spring activator on the mobility of the lower jaw in traumatically injured patients

Abstract

For functional rehabilitation and improvement of mandibular mobility, 14 patients with dislocated collum or collum fracture dislocations were treated with a spring activator after surgical-conservative treatment. With an interincisal distance of < 12 mm, therapy was started with a loop spring. The average age of the patients was 26.6 years. Eight patients showed additional traumatic injuries, 2 patients were seriously polytraumatically injured. The clinical investigations referring to the maximum mouth opening and maximal interincisal distance resulted in a good to very good functional rehabilitation in all cases. The average maximal interincisal distance of 31.7 mm at the beginning of the spring activator therapy could be increased to 47.3 mm. The largest increase of the maximal interincisal distance was observed after 4 weeks of therapy. The type of reaction, however, differed interindividually. Three patients showed a spontaneous improvement of the interincisal distance within the first 2 to 3 weeks of removal of intermaxillary fixation, whereas 7 patients showed no improvement or only slightly improved values until insertion of the spring activator. An enlargement of the interincisal distance could be achieved in almost every patient within a relatively short period of time despite a drastically reduced mouth opening. Consequently, because of its mode of action in the form of a neuromuscular influence, the spring activator is especially suitable for the functional rehabilitation of patients with fractures of the condylar process.

Functional Orthodontic Treatment of Mandibular Condyle Fractures in Children and Adolescent Patients: An MRI Follow-Up

“…Functional orthodontic appliances used for the treatment of condylar fractures have been well-described in the literature [ 11 , 13 , 14 , 16 , 18 , 19 , 20 , 23 , 49 , 50 ]. However, the spring activator appliance used in this study could be particularly suitable compared with other rigid or elastic appliances [ 23 ].…”

“…To enable mobilization, as soon as a painless mouth opening of more than 20 mm was possible, a maxillary and mandibular impression and bite registration were taken for the fabrication of a functional orthodontic appliance (a spring activator). The spring activator consisted of two plastic parts connected by loop springs, which determined the position of the upper and lower jaw in a clinically defined target position ( Figure 2 ) [ 23 , 32 , 33 ]. Biomechanically, the spring elements of the device cause controlled mobility in the sense of a functional load on the temporomandibular joint whilst stabilizing the jaw relation and compensating for a loss of vertical height and tilting of the occlusal plane [ 23 ].…”

“…The spring activator consisted of two plastic parts connected by loop springs, which determined the position of the upper and lower jaw in a clinically defined target position ( Figure 2 ) [ 23 , 32 , 33 ]. Biomechanically, the spring elements of the device cause controlled mobility in the sense of a functional load on the temporomandibular joint whilst stabilizing the jaw relation and compensating for a loss of vertical height and tilting of the occlusal plane [ 23 ]. In addition, a soft diet for 10 weeks and daily wear of at least 16 h per day were prescribed to prevent the compression of the articular tissues [ 11 , 34 ].…”

“…If the remodeling capacity is overestimated and a conservative treatment is chosen, this may result in facial asymmetry, functional disorders, or the need for subsequent dysgnathic surgery [ 3 , 4 , 22 ]. In contrast, a primary surgical treatment carries the risk of facial nerve damage, scarring, growth disturbance, and other procedure-related as well as anesthesiological complications [ 21 , 23 , 24 ].…”

Patients’ perceptions on temporomandibular disorder treatment with hydrostatic oral splints - a pilot study

“…Patients with restricted mouth opening (72.0%) reported an improvement of their complaints mostly rated as a 60% reduction. Pain reduction, relaxation of the associated muscles, influence on neuromuscular activity and subsequent joint relief could have led to the improvement [ 46 , 47 ]. In contrast to other subjective symptoms like pain and headache, the assessment of the mouth opening can be objectified by determining the distance between incisal edges.…”