BackgroundTo evaluate the effect of Low Level Laser (LLL) application at the points of greatest pain in patients with chronic masticatory muscle pain.MethodsA total number of 30 (21 women, 9 men, with a mean age of 39.2) were selected after the diagnosis of MPDS according to the Research Diagnostic Criteria for Temporomandibular Disorder (RDC/TMD). The patients were randomly divided into three groups; laser group I (n = 10); patients received the LLL at the point of greatest pain, laser group II (n = 10); patients received LLL at pre-established points in the effected muscles and placebo group (n = 10). LLL and placebo were applied three times per week, for a total of 12 sessions. Mandibular mobility was examined, masticator muscles tenderness were assessed and PPT values were obtained. Subjective pain levels were evaluated using VAS. The measurements performed before the treatment and after the completion of the therapy. Descriptive statistics (mean, standard deviation, and frequency) Student’s t-test, Mann–Whitney U-test and paired-sample t-tests were used for analysis.ResultsIn both laser groups, there was a statically significant reduction in PPT values of the muscles, number of muscles without any pain on palpation increased significantly, mandibular movements’ ranges were improved. Laser group I demonstrated statistically better results than the Laser group II in all of the measured values. Plasebo group did not show any statistically difference in any of the measured values.ConclusionsLLLT can be accepted as an alternative treatment modality in the management of masticatory muscle pain and direct irradiation seems to effect better.Trial registrationCurrent Controlled Trials ISRCTN31085, Date of registration 28/08/20145.
The present study was designed to compare the effects of low-level laser with occlusal splints in patients with signs and symptoms of myofascial pain (MP) dysfunction syndrome. A total of 40 (34 women and 6 men, with a mean age of 32.84 [SD, 10.70] years) were selected after the diagnosis of MP according to the Research Diagnostic Criteria for Temporomandibular Disorder. The patients were randomly divided into 2 groups: study group (n = 20) and control group (n = 20). Low-level laser was applied to patients in the study group 2 times per week, for a total of 10 sessions. Patients in the control group were instructed to wear occlusal splints 24 h/d for 3 months. The functional examination was based on Research Diagnostic Criteria for Temporomandibular Disorder and pressure pain threshold values were obtained with the aid of an algometer in both groups. Patients' self-report of pain was evaluated with visual analog scale. Comparisons were made within and between the groups before and after treatment. Vertical movements showed statistically significant improvements after the treatments in both groups (P < 0.01), but when the groups were compared with each other, there were no significant difference between the groups. In both groups, tenderness to palpation of the muscles decreased significantly. Pressure pain threshold evaluations and visual analog scale scores revealed similar results, too. This particular type of low-level laser therapy (820 nm, 3 J/cm2, 300-mW output power) is as effective as occlusal splint in pain release and mandibular movement improvement in MP.
With the development of a digital technology of computer-assisted manufacturing (CAD/CAM) and new age materials, the use of new types of occlusal splint is to consider. The aim of the present study was to evaluate the surface roughness (Ra) and wear behavior of different CAD/CAM materials against enamel antagonist through a simulated chewing test. A total of 75 specimens made from ethylene vinyl acetate (EVA), polymethyl methacrylate (PMMA), polycarbonate (PC), polyetheretherketone (PEEK), and polyethyleneterephthalate (PETG) as a control were polished to evaluate the Ra before loading by optical profilometry and further analyzed by scanning electron microscopy (SEM). Specimens of each group were subjected to thermomechanical fatigue loading in a chewing simulator (60000 cycles at 49 N with 5-55 °C thermocycling). The wear volume loss and change in Ra of each specimen after the simulated chewing were analyzed. One-way ANOVA, paired samples t test, and Pearson correlation analysis were performed for statistical analyzes. The result showed that the volume loss and Ra varied among the materials tested. EVA exhibited the greatest amount of Ra and volume loss (p < 0.001), while PEEK had the lowest values for both (p < 0.001). In terms of volume loss, there was no significant difference between PC and PMMA (p > 0.05). SEM investigations revealed different wear behaviors, especially in EVA. As PEEK showed significantly more favorable results, PEEK splints should be considered as a new therapeutic option for occlusal splint.
Background: The aim of this study was to compare the accuracy of different direct implant impression techniques for edentulous arches with multiple implants. Methods: Five experimental groups (n = 5) were assembled. Experimental models were created by a direct splinted technique (EG2 to EG5) and a non-splinted technique (EG1). In EG2 and EG3 synOcta impression copings were splinted with an acrylic resin bar, and in EG4 and EG5 with a light-curing composite resin bar. In EG3 and EG5 the resin bars were sectioned, while the other experimental groups were not. Three-dimensional discrepancies were measured by a computerized coordinate measuring machine. Distortion values among the groups were analysed using one-way repeated measures ANOVA. The post hoc Tukey's test was then performed for multiple comparisons. Results: The highest accuracy was obtained in EG2 (mean deviation: 12.70 lm). The acrylic bars demonstrated less deviation (12.70 lm and 22.71 lm) from the master model than the light-curing composite resin groups and the nonsplinted group (41.09 lm). The post hoc Tukey's test showed no significant difference among the groups when the effect of splint design on accuracy was investigated. Conclusions: For situations where impressions of multiple implants are to be made, splinting impression copings with acrylic resin demonstrate superior results than the non-splinted technique and splinting with light-curing composite.
Use of implants for removable dentures and fixed reconstructions improve occlusal contact area and bite force.
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