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Orofacial Pain
Published in Andrea Kohn Maikovich-Fong, Handbook of Psychosocial Interventions for Chronic Pain, 2019
John E. Schmidt, James M. Hawkins
In a recent RCT, Mora and colleagues compared a weekly eight-session biofeedback-based CBT program to occlusal splint therapy worn for eight weeks (Mora, Weber, Neff, & Rief, 2013). While both treatments resulted in a significant reduction in pain and jaw-use limitations, patients in the biofeedback group reported a significant increase in pain-coping skills. All improvements were stable at a six-month follow-up in both groups, with greater improvements in the biofeedback group.
Middle third fractures
Published in John Dudley Langdon, Mohan Francis Patel, Robert Andrew Ord, Peter Brennan, Operative Oral and Maxillofacial Surgery, 2017
Joe Mcmanners, Jeremy Mcmahon, Ian Holland
The use of arch bars and temporary intermaxillary fixation (IMF) may be very helpful in maintaining the correct reduction during application of the plates. The correct positioning of the fractured maxilla is guided by the anatomic position of the fractured bones, as well as the intercuspation of the dentition. The dental occlusion may not be easily attained if there is a pre-existing abnormal bite and/or missing teeth. Impressions and study models taken pre-operatively with fabrication of an occlusal splint help attain the correct dental bite at operation and may be very helpful.
Intermaxillary Fixation Techniques
Published in Jeffrey R. Marcus, Detlev Erdmann, Eduardo D. Rodriguez, Essentials of CRANIOMAXILLOFACIAL TRAUMA, 2014
Jeffrey R. Marcus, Mark D. Walsh
To fabricate an occlusal splint, dental impressions are taken. In some cases, this is performed with the patient under anesthesia for comfort. Dental casts are made from impressions; the models are cut at the fracture site to mimic the injury and allow optimal alignment of the segments. The model surgery is completed, and an acrylic splint is created. In the operating room, the fractures are reduced. The splint is placed, and the segments are fitted into it. The splint is then held in place with circummandibular wires.
Efficacy of occlusal splints in the treatment of temporomandibular disorders: a systematic review of randomized controlled trials
Published in Acta Odontologica Scandinavica, 2020
Si-Hui Zhang, Kai-Xun He, Chen-Jing Lin, Xiang-Dong Liu, Ling Wu, Jiang Chen, Xiaohui Rausch-Fan
An occlusal splint is a removable device affecting the relationship of the mandible to the maxillae. It is one of the most widely used therapeutic methods among the above-mentioned approaches [10], in part due to its low cost [7]. It can be used to reconstruct neuromuscular balance through stabilisation of the occlusion, release of stress from the TMJ, and repositioning of the TMJ in a reversible way [11].
Effectiveness of conservative therapeutic modalities for temporomandibular disorders-related pain: a systematic review
Published in Acta Odontologica Scandinavica, 2023
Alexandros Tournavitis, Evangelos Sandris, Anna Theocharidou, Theodora Slini, Maria Kokoti, Petros Koidis, Dimitrios Tortopidis
Consequently, due to the multiplicity of aetiological factors associated with TMD, several treatment modalities have been proposed [13]. Different therapeutic options, some conservative and reversible, other irreversible, have been clinically used for the management of TMD [8,13,14]. Conservative therapeutic modalities that can eliminate the painful symptoms in jaw muscles and TMJs may include occlusal splints, physiotherapy, medications, biofeedback, low-level laser therapy, photobiomodulation, acupuncture, self-care management, ultrasound therapy and counselling [13–15]. Systematic reviews of conducted randomized controlled trials (RCTs) evaluating the effectiveness of different conservative treatment modalities for TMD pain presented conflicting results [13,15–17]. It has been reported that biofeedback can be useful in managing the activity of the masticatory muscles, but there is not sufficient evidence to support its effectiveness in patients with painful TMD [18]. There is also some evidence supporting the use of occlusal appliances, jaw exercises, acupuncture, behavioural therapy and pharmacotherapy for the TMD pain relieving [19]. Furthermore, it has been shown that occlusal splints produced a similar reduction in TMD pain compared to physiotherapy, pharmacological, behavioural medicine and acupuncture treatments [16]. Recent studies did not find sufficient evidence to distinguish the effectiveness of exercise therapy versus occlusal splints for treating painful TMD patients [20]. In contrast to these findings, the placebo effects in alleviating pain have been found to be responsible from 10% to 75% of TMD pain reduction [17]. Additionally, the results of some studies about the efficacy of occlusal appliances demonstrated that there is moderate to very low-quality evidence confirming the effectiveness of occlusal splint therapy in the TMD management [15,19]. However, all types of occlusal splints provide more effective therapy for myogenous or/and arthrogenous TMD when compared to no treatment (untreated control patients) and non-occluding splints use for pain outcome [15].Contradictory results in the literature about the efficacy of therapeutic modalities on TMD pain may be attributable to the heterogeneity of the patient samples included, differences in patients’ psychosocial background factors, lack of strict criteria for the diagnosis of TMD and different periods of follow-up [13,14,19].