A novel protocol for occlusal splint adjustment to treat TMD in sleep bruxism

Abstract

INTRODUCTION: Sleep bruxism (SB) is a stereotypical movement disorder that is characterized by rhythmic masticatory muscle activity associated with tooth grinding and occasional jaw clenching. OBJECTIVES: The aim of this study was to determine the relief time for temporomandibular disorders (TMD), cervical and otological signs and symptoms in patients with BS treated with occlusal splints (OS) for a period of 180 days. MATERIALS AND METHODS: Thirty patients, between ages 22 and 53 years old, presenting SB and TMD, including cervical and otological symptoms, were enrolled in this study. The patient’s treatment protocol consisted of using the OS applying a novel adjustment protocol. The total follow-up period was 180 days. The paired Student t-test was used to compare before and after long-term OS treatment. RESULTS: For all variables, the results were statistically significant (p < 0.001). As to the TMD symptoms, in most patients the relief of pain in masseter, temporalis, cervical and TMDs occurred in the 3rd month. Twenty percent of the patients were aware of clenching teeth while awake and reported that this parafunction decreased by the end of 6 months, and 90% reported an improvement in sleep quality as well. CONCLUSION: The use of an OS with a novel adjustment protocol was an effective treatment for TMD sign and symptoms in patients with SB.

A Case Report of Bruxism and Its Management with The Help of Occlusal Splints.

“…It was used to stabilize the TMJ and protect the teeth, relax the masseter and temporalis muscles, increase intervertebral and inter-discal space, allow the balance of bite forces, and decrease bruxism activity. 6 Occlusal therapy is the art and science of establishing neurovascular harmony in the masticatory system by forming mechanical lockage for the parafunctional forces with the help of removable appliances. 3 Previous studies have shown many signs and symptoms treated with occlusal splints.…”

“…In our case, there was a marked decrease of the joint noises using the occlusal splint, considering that this sign disappeared. 6 The various types of occlusal splints available are permissive, nonpermissive, hydrostatic and silicon splints. Splints distribute the forces across the masticatory system.…”

“…Some theories were put forward to explain its mechanism like: as alteration or improvement of the occlusal condition, alteration or raising in the vertical dimension, change in peripheral (motor or afferent) impulses to the central nervous system, alteration of the TMJ condylar position, placebo effects and increase in the cognitive awareness. 6 The occlusal splints also function for the providing diagnostic information in various ways. The dental practitioner can determine potential neutral zone impingements, the envelope of function, anterior guide requirements, and parafunctional habits and can also obtain information about the vertical dimension of the patients wearing occlusal splints.…”