Effect of Articular Cavity Injection Combined with Bite Splint Treatment on Anterior Disc Displacement Without Reduction

Objective:To observe the clinical effect of articular cavity injection combined with bite splint therapy for the treatment of anterior disc displacement without reduction(ADDWoR).Methods:The research subjects for this study were 30 patients with ADDWoR treated in the temporomandibular joint specialist outpatient clinic from November 2018 to November 2019,with a disease duration of 1 to 6 months.The treatment group was treated with an articular cavity injection of sodium hyaluronate+bite splint.The control group was treated with a simple articular cavity injection of sodium hyaluronate.The two groups were followed up once every 2 weeks to evaluate the treatment effect and observe the clinical efficacy of the two groups.Statistical analysis was carried out using SPSS 24.0.t-test and general linear regression analysis were carried out to compare the data of both groups,andχ^(2)-test and binary logistic regression analysis were performed for pain index comparison.Results:There was no significant difference in terms of the efficacy of the treatment received by both groups.The mouth opening and joint pain of patients in both groups were significantly improved after treatment(P<0.001).Conclusion:Articular cavity injection of sodium hyaluronate and occlusal splint therapy are both effective and safe methods for treating ADDWoR.

Difference in cortical activation during use of volar and dorsal hand splints:a functional magnetic resonance imaging study

There have been no studies reported on the difference in cortical activation during use of volar and dorsal hand splints.We attempted to investigate the difference in cortical activation in the somatosensory cortical area during use of volar and dorsal hand splints by functional magnetic resonance imaging（f MRI）.We recruited eight healthy volunteers.f MRI was performed while subjects who were fitted with volar or dorsal hand splints performed grasp-release movements.Regions of interest were placed on the primary motor cortex（M1）,primary somatosensory cortex（S1）,posterior parietal cortex（PPC）,and secondary somatosensory cortex（S2）.Results of group analysis of f MRI data showed that the total numbers of activated voxels in all ROIs were significantly higher during use of volar hand splint（3,376） compared with that（1,416） during use of dorsal hand splint.In each ROI,use of volar hand splint induced greater activation in all ROIs（M1：1,748,S1 ：1,455,PPC：23,and S2：150） compared with use of dorsal hand splint（M1：783,S1：625,PPC：0,and S2：8）.The peak activated value was also higher during use of volar hand splint（t-value：17.29） compared with that during use of dorsal hand splint（t-value：13.11）.Taken together,use of volar hand splint induced greater cortical activation relevant to somatosensory function than use of dorsal hand splint.This result would be important for the physiatrist and therapist to apply appropriate somatosensory input in patients with brain injury.

安氏Ⅱ类错牙合伴颞下颌关节紊乱病患者经RW-splint治疗前后二腹肌前腹肌电的变化

目的探讨安氏Ⅱ类错牙合畸形伴颞下颌关节紊乱病(temporomandibular disorders,TMD)患者在经RWsplint治疗1周和2个月后二腹肌前腹肌电活动的改变,为治疗此类患者提供依据。方法 RW-splint戴入成功后,采用Bio PAK系统的EMGⅡ型表面肌电测量仪分别对患者治疗前及RW-splint治疗后1周、2个月的二腹肌前腹肌电活动进行检测。结果 RW-splint治疗1周后患者的二腹肌前腹在吞咽位时肌电幅值差异均无统计学意义(P>0.05);治疗2个月后患者吞咽位时二腹肌前腹的肌电幅值均降低,差异有统计学意义(P<0.05),在下颌姿势位治疗前后差异无统计学意义(P>0.05)。结论 RW-splint必须加长戴用时间才能改变二腹肌前腹的肌电值。

An Overview of Anterior Repositioning Splint Therapy for Disc Displacement-related Temporomandibular Disorders

Anterior repositioning splint(ARS)therapy is considered one of the most effective therapies for treating disc displacement-related temporomandibular disorders(TMDs),which account for a large proportion of TMD cases.Owing to the wide application of this therapy,the exact mechanism of remission has increasingly drawn attention.Given that practitioners have different views on ARS therapy,its indications are broadened,and operating methods diverged.This review attempts to provide an overview of ARS therapy and helps practitioners establish indications and suitable operating methods.Representative views in the past 10 years were summarised,and conclusions were drawn as follows:The mechanism of ARS therapy is mainly attributed to internal derangement correction,improvement of stress distribution and recently reported joint remodeling.It has an evident effect in the short term,and the most prevalent operating methods are protruding the mandible to the edge-to-edge position and wearing the ARS for 24 hours daily for 3-6 months.However,long-term stability is not optimal,and thus indications should be selected carefully.Notably,most of the clinical studies in this field are case analyses with low-quality evidence.Well-designed RCTs are required to further validate relevant theories.

Quartz splint^(TM)高强度石英纤维牙周夹板治疗重度慢性牙周炎的效果评价

目的:观察Quartz splint^(TM)高强度石英纤维牙周夹板治疗重度慢性牙周炎的临床效果。方法:选取重度牙周炎患者48例,随机分为两组,每组24例。A组:在洁治,刮治和根面平整12周后,比较治疗前后的牙周探诊深度和牙周附着丧失情况;B组:在在洁治,刮治,根面平整和Quartz splint^(TM)高强度石英纤维牙周固定后,12周后比较治疗前后的牙周探诊深度和牙周附着丧失情况。结果:两组治疗前后的牙周探诊深度和牙周附着丧失均比治疗前有明显减少,比较有统计学意义。两组治疗后比较,B组较A组减少明显,有统计学意义。结论:对于重度慢性牙周炎,洁治、刮治和根面平整后患者牙周状况会有明显改善,对松动明显的患牙再辅以Quartz splint^(TM)高强度石英纤维牙周夹板固定,牙周状况改善更加明显。

RW-Splint对安氏Ⅱ类错伴TMD患者咀嚼肌肌电的影响

目的:探讨安氏Ⅱ类错畸形伴TMD患者经RW-Splint治疗1周和2个月后咀嚼肌肌电活动的改变。方法:采用EMGⅡ型表面肌电测量仪分别对12名患者RW-splint治疗前、治疗后1周及2个月的咀嚼肌肌电活动进行检测。结果:RW-splint治疗1周后患者的颞肌前束、咬肌在下颌姿势位、最大紧咬牙尖交错位时肌电幅值差异均无统计学意义;治疗2个月后最大紧咬牙尖交错位时颞肌前束、咬肌的肌电幅值的肌电幅值均降低,差异有统计学意义(P<0.05),且颞肌前束的肌电幅值大于咬肌的肌电幅值,差异有统计学意义(P<0.05)。但患者下颌姿势位时颞肌前束、咬肌肌电幅值差异均无统计学意义。结论:RW-splint通过戴用时间的加长能降低咀嚼肌的肌电值,但改善其对称性作用不明显,可能与RW-splint改变了患者的牙位而呈现出原本有的早接触或干扰有关。

RW-splint治疗前后患者颞下颌关节间隙的变化

目的:探讨RW-splint治疗颞下颌关节紊乱病(temporomandibular disorder,TMD)患者后颞下颌关节间隙的改变。方法:选取18例有临床症状的TMD患者,采用RW-splint进行治疗,治疗前、后用锥形束CT(CBCT)对患者双侧颞下颌关节扫描,测量颞下颌关节上、前、后、内、外侧间隙,分析髁突位置变化。结果:RW-splint治疗后患者颞下颌关节上、后、内侧间隙变宽,前、外侧间隙变窄,但以上变化差异均无统计学意义(P>0.05)。结论:RW-splint治疗使髁突发生向前、向下、向外移动趋势,改善髁突位置可能是RW-splint治疗TMD的生物学机制之一。

Quartz Splint^(TM)高强度石英纤维夹板固定前牙的效果评价

目的:评价应用新型Quartz SplintTM高强度石英纤维夹板固定前牙的临床效果,为治疗牙周炎导致的牙齿松动提供临床依据。方法:应用Quartz SplintTM高强度石英纤维夹板对32例慢性牙周炎患者Ⅱ°、Ⅲ°松动前牙进行固定,观察固定前和固定后3、6个月牙周探诊深度(PD)、牙周附着水平(AL)和牙槽骨高度的变化。结果:松牙固定后3个月,患牙的PD由(4.39±1.26)mm减至(3.16±0.37)mm,差异有统计学意义(P<0.01);AL由(3.56±1.17)mm减至(3.34±1.03)mm,差异有统计学意义(P<0.05)。固定后6个月PD为(3.21±0.25)mm,与固定前比较差异有统计学意义(P<0.01);AL为(3.36±1.31)mm,与固定前比较差异有统计学意义(P<0.05),与固定3个月比较差异无统计学意义。X线显示所有患牙均无进一步的骨吸收,临床状况改善明显。结论:应用Quartz SplintTM高强度石英纤维夹板固定前牙可获得较满意的临床效果。

Quartz Splint^(TM)高强度石英纤维夹板在前牙正畸保持中的应用

目的:评价应用新型Quartz Splint TM高强度石英纤维夹板进行前牙正畸保持的临床效果,为选择适当正畸保持方法提供依据。方法:选择62例完成正畸常规治疗后需局部加强保持者,将患者按照随访时间分为3个月组、6个月组和12个月组。应用Quartz Splint TM高强度石英纤维夹板对前牙进行固定。目视和器械检查每个组保持器有无脱落位点,牙齿间隙及扭转错位有无复发同时检查保持器区域内牙周健康状况,即检查探诊深度(PD)、出血指数(BI)和菌斑指数(PLI),评价Quartz Splint TM高强度石英纤维夹板在前牙正畸保持中的应用效果。结果:62例患者中,60例患者Quartz Splint TM高强度石英纤维夹板均固位良好,无松脱及断裂且间隙及扭转,均未复发。仅有2例纤维夹板分别在第6个月和第12个月个别位点脱落但无断裂。随访期内Quartz Splint TM高强度石英纤维夹板总完好率为96.77%,且患者牙周状况健康。结论:应用Quartz Splint TM高强度石英纤维夹板对前牙区散在间隙或者扭转牙正畸后固定保持可获得稳定的临床效果。

Biosplint固位纤维在牙周炎患者松动牙保存中的应用

目的:分析Biosplint固位纤维在牙周炎患者松动牙保存中的应用。方法:2010年9月-2013年6月,采用Biosplint固位纤维树脂夹板,对12名中重度牙周炎患者进行松牙固定,回顾性分析其临床资料。结果:固定夹板均无整体松动或脱落,牙龈无明显红肿,牙槽骨无继续吸收。1例患者术后2年出现1处继发龋,2年6个月新增2处继发龋。14颗术前建议拔除的患牙获得保存。患者满意度100%。12例患者术后6个月探诊出血率(Bop阳性率)及探诊深度(PD)较固定前降低(P<0.05),附着丧失(AL)差别无统计学意义(P>0.05)。其中7例观察期超1年患者术后6、12个月Bop阳性率,PD均较固定前低(P<0.05),AL差别无统计学意义;术后6个月与12个月比较Bop阳性率、PD、AL均无统计学差异(P>0.05)。结论:Biosplint固位纤维树脂夹板在保存牙周炎患者松动牙的应用中获得满意的短期疗效。

Efficacy of biofeedback therapy via a mini wireless device on sleep bruxism contrasted with occlusal splint:a pilot study

The putative causes of bruxism are multifactorial and there are no definite measures for bruxism management.The aim of this study was to evaluate the efficacy of biofeedback therapy on sleep bruxism,compared with occlusal splint.Twenty-four volunteers with sleep bruxism were divided into two groups：the GTB group that were treated with biofeedback therapy（n 512） and the GTO group that were treated with occlusal splint（n 512）.A mini pressure sensor integrated with a monitoring circuit by use of a maxillary biofeedback splint was fabricated.To foster the relaxation of the masticatory muscles and the nervous system,the wireless device received signals from bruxism events and vibrations alerted the bruxer when the threshold was exceeded.Total episodes and average duration of bruxism events during8 hours of sleep were analyzed with the monitoring program（TRMY1.0）.After 6 and 12 weeks,the episodes（P 50.001） and duration（P,0.05） in the GTB group declined dramatically.In contrast,there were no significant differences in the GTO group after the treatment（P.0.05）.Furthermore,the episodes had significant differences between the GTB group and the GTO group after the same period of treatment（P 5 0.000）.The results suggest that biofeedback therapy may be an effective and convenient measure for mild bruxers,when compared with occlusal splint therapy.The mini wireless biofeedback method may be of value for the diagnosis and management of bruxism in the future.

Manual reduction with traditional small splints for distal radius fracture in older patients

Objective:To investigate the effect of manual reduction with traditional small splints fixation for distal radius fractures in older patients in the emergency department.Methods:Older patients(aged at least 60 years)with distal radius fractures were enrolled in this study.The patients were randomly divided into the treatment group and the control group.The treatment group was treated with manual reduction and small splints fixation.The control group was treated with manual reduction and resin plaster fixation.Before treatment,after reduction,and 3 months after treatment,the palmar tilt angle,ulnar deviation angle,and radial length were recorded.Before treatment and 3 months after treatment,the Cooney wrist joint scores were recorded.The time of fracture healing and related adverse events during the treatment were recorded.Results:Before treatment and after reduction,there were no statistically significant differences between the two groups in palmar tilt angle,ulnar deviation angle,or radial length(P>0.05).Three months after treatment,the palmar tilt angle,ulnar deviation angle,and radial length of the treatment group were better than those of the control group(P<0.05).The Cooney wrist scores of the treatment group was significantly higher than that of the control group three months after the treatment(P<0.05).The time of fracture healing of the treatment group was shorter than that of the control group,but the difference was no statistically significant(P>0.05).Conclusions:Compared with resin plaster fixation,traditional small splints fixation for distal radius fractures in older patients have the advantages of less loss of fracture reduction and faster functional recovery.Besides,the method is simple and low cost thus,it needs to be promoted.

颞下颌关节病患者RW-Splint治疗前后上气道变化的临床研究

目的:研究RW-Splint治疗颞下颌关节紊乱病(temporomandibular joint disorders,TMD)对上气道变化的影响。方法:纳入17例有临床症状的TMD患者,采用RW-Splint进行治疗,治疗前、后在自然体位拍摄锥形束CT(CBCT)。运用Dolphin软件对上气道三维建模并测量17项相关指标,分析治疗前后上气道的变化。结果:治疗后舌咽的体积(V舌咽)、悬雍垂尖点平面矢状径(APUT)、会厌突顶点平面的横径(LRET)均减小(P<0.05)。其他检测指标变化无统计学意义(P>0.05)。结论:RW-Splint治疗后主要影响气道的舌咽段,对鼻咽腭咽影响很小。

Treatment of condylar osteophyte in temporomandibular joint osteoarthritis with muscle balance occlusal splint and long-term follow-up:A case report

BACKGROUND Condylar osteophytes,a remodeling form of temporomandibular joint osteoarthritis(TMJ OA),mainly manifest as marginal angular outgrowths of the condyle.Previous researchers have advocated surgical removal of condylar osteophytes.Reports on the effect of occlusal splint on TMJ OA patients’joints have mostly focused on treatment with this splint,which can reduce the absorption of the affected condyle and promote repair and regeneration.However,the effect of the splint on the dissolution of condylar osteophytes has not yet been reported.CASE SUMMARY A 68-year-old female patient suffered from occlusal discomfort with left facial pain for 2 years.Cone beam computed tomography showed a rare osteophyte on top of her left condyle.She was finally diagnosed with TMJ OA.The patient refused surgical treatment and received conservative treatment with a muscle balance occlusal splint.The pain experienced by the patient on the left side of her face was relieved,and her chewing ability recovered after treatment.The osteophyte dissolved,and the condylar cortex remained stable during long-term follow-up observations.CONCLUSION The muscle balance occlusal splint could be a noninvasive means of treating condylar osteophytes in TMJ OA patients.

Quartz splint^(TM)高强度石英纤维和Super-Bond C&B粘结剂固定下前牙松动牙疗效比较

目的:比较Quartz splint^(TM)高强度石英纤维和Super-Bond C&B粘结剂固定慢性牙周炎下前牙松动牙的临床效果。方法:选取下前牙松动需要做牙周夹板松牙固定患者40例,随机分为两组。A组:在洁治、刮治和根面平整后,使用Quartz splint^(TM)高强度石英纤维做牙周固定;B组:在在洁治、刮治和根面平整后,使用Super-Bond C&B粘结剂做牙周固定。两组固定后即刻让患者对于固定物做出异物感评价。固定6个月后比较治疗前后的牙周探诊深度和牙周附着丧失情况。结果:两组治疗前后的牙周探诊深度和牙周附着丧失均比治疗前有明显减少,有统计学意义。组间比较,无统计学意义。固定后即刻异物感评价,B组优于A组,有统计学意义。结论:对于下前牙松动的患者,洁治、刮治和根面平整后使用Quartz splint^(TM)高强度石英纤维和Super-Bond C&B粘结剂牙周夹板固定,均可以使牙周状况明显改善。Super-Bond C&B粘结剂牙周夹板异物感小于Quartz splint^(TM)高强度石英纤维。

Agma Splint固定夹板联合中成药对桡骨远端骨折的临床疗效分析

目的:分析Agma Splint固定夹板联合中成药对桡骨远端骨折的治疗效果。方法:选择2011年5月-2012年5月于笔者所在医院就诊的148例桡骨远端骨折患者,随机分为试验组86例和对照组62例,对照组使用小夹板固定治疗,试验组使用Agma Splint固定夹板进行治疗。观察两组患者的治愈情况。结果:试验组治愈83例,治愈率达96.5%,对照组治愈50例,治愈率达80.6%,两组患者治愈率比较差异有统计学意义(字2=9.96,P<0.05)。结论:Agma Splint固定夹板联合中成药对桡骨远端骨折具有有效、简便、治愈率高等优势,适合临床长期推广应用。

Current situation and consideration of small splint in the treatment of distal radius fracture complicated with ulnar styloid process fracture

Objective:The incidence of distal radius fracture combined with ulnar styloid process fracture is increasing,which seriously affects the quality of life of patients.Small splint therapy of Traditional Chinese Medicine is a reliable method for the treatment of such fractures.It not only has good clinical efficacy,but also has fewer complications and high safety.However,the traditional small splint fixation does not cover the styloid process of the ulna,and the fracture of the styloid process of the ulna is closely related to the stability of the wrist joint,which has an important impact on the prognosis of the fracture.Based on this,we believe that the ulnar elongation splint can better improve the wrist function,and further prospects for related issues,in order to guide clinical practice.

Long-term follow-up of a patient with venlafaxine-induced diurnal bruxism treated with an occlusal splint:A case report

BACKGROUND Bruxism is a jaw-muscle activity characterized by the clenching or grinding of teeth. It can be divided into nocturnal bruxism and diurnal bruxism(DB). DB secondary to antidepressants is rare and refractory. Reports associated with antidepressant-induced DB are mostly anecdotal without long-term follow-up.The effect of drug intervention on antidepressant-induced DB is still contested.We herein report the first case of successful treatment of venlafaxine-induced DB with an occlusal splint.CASE SUMMARY This case report describes detailed 7-year follow-up of a patient with venlafaxineinduced DB treated with an occlusal splint. The patient who complained about involuntary daytime tooth grinding after taking venlafaxine for a period of 4 mo and was diagnosed with venlafaxine-induced DB. Subsequently, an occlusal splint with modified bilateral buccal-pterygoid pads was used to treat his tooth grinding and to protect the dental structures from tooth wearing. The patient reported remission of symptoms after several months of treatment. His grinding activity was gradually and stably controlled after 2 years, with an almost complete recovery from DB after 6 years.CONCLUSION The maxillary buccal-pterygoid splint can be used as a noninvasive approach to treat venlafaxine-induced DB.

Influence of occlusal splint thickness on the position of mandible

Objective: To investigate the influence of occlusal splint thickness on mandibular movement. Methods: Stabilization occlusal splints of 3, 5 and 7 mm thickness were respectively used during clenching from light contact in intercuspal position and the movement of condyles and incisor point were recorded in 5 healthy subjects. Results:The condyles moved anteriorly and superiorly without wearing occlusal splint. When wearing the occlusal splints the condyles displaced anteriorly and inferiorly. The distance of displacement increased gradually with raising the thickness of splint, though the significant difference was just found in right condyle in superior- inferior movement. The condyles went again on a path of anterior and superior direction when subjects clenched from the displaced position. In right condyle the displacement was significantly greater at 7 mm splint than that at 3 mm splint both in anterior-posterior and inferior-superior direction, while in left condyle only in anterior-posterior direction. Meanwhile, the incisal point movement was larger at 7 mm splint than at 3 mm splint in inferior-superior direction. In tapping movement there were no significant differences in condyle movement between the different thickness of occlusal splint. However, the coefficient of variation in total cycle time was the greatest when wearing the splint of 7 mm. Conclusion: Occlusal splint of 7 mm has greater effect than that of 3 mm on condyle movement, but no obvious difference with occlusal splint of 5 mm. When occlusal splint of 7 mm is inserted, the stability of condyle might be influenced during tapping movement.

Small splints versus plate fixation for distal radius fractures: A meta- analysis and systematical analysis

Objective:Evaluate the efficacy,safety and economy of small splints and plate in the treatment of distal radius fractures(DRFs).Methods:Seven electronic databases,including PubMed,EMBASE,Cochrane Library,sinomed,CNKI,VIP and Wanfang,were searched for the original study.Literature was screened according to the inclusion and exclusion criteria,and the methodological quality of the included studies was evaluated by Cochrane risk bias assessment tool.The software Revman 5.4 was used for data analysis.Results:A total of 19 studies were included in the study.The clinical effective rate of the plate group[RR=0.96,95%CI(0.93,0.99),P=0.007],Radial inclination[MD=-1.85,95%CI(-2.93,-0.77),P=0.0008],Ulnar inclination[MD=-2.49,95%CI(-3.95,-1.04),P=0.0007],relative height of radius[MD=-1.63,95%CI(-2.40,-0.86),P<0.0001]were better than those in small splints group.There was no significant difference in fracture healing time[MD=-4.39,95%CI(-9.07,0.28),P=0.07]and complications[RR=1.57,95%CI(0.98,2.52),P=0.06]between the two groups.In terms of treatment cost[MD=-2.83,95%CI(-3.37,-2.30),P<0.00001],the small splint group was better than the plate treatment group.Conclusion:Compared with small splints therapy,plate internal fixation has advantages in clinical effective rate and imaging scores.There is no significant difference in fracture healing time and complications between the two groups.In terms of treatment cost,small splint therapy is better than plate therapy.Clinical treatment should be selected and formulated according to the individual situation,demands and clinical practice of patients.