Quantitative Polygraphic Controlled Study on Efficacy and Safety of Oral Splint Devices in Tooth-grinding Subjects

Abstract

The efficacy of occlusal splints in diminishing muscle activity and tooth-grinding damage remains controversial. The objective of this study was to compare the efficacy and safety of an occlusal splint (OS) vs. a palatal control device (PCD). Nine subjects with sleep bruxism (SB) participated in this randomized study. Sleep laboratory recordings were made on the second night to establish baseline data. Patients then wore each of the splints in the sleep laboratory for recording nights three and four, two weeks apart, according to a crossover design. A statistically significant reduction in the number of SB episodes per hour (decrease of 41%, p = 0.05) and SB bursts per hour (decrease of 40%, p < 0.05) was observed with the two devices. Both oral devices also showed 50% fewer episodes with grinding noise (p = 0.06). No difference was observed between the devices. Moreover, no changes in respiratory variables were observed. Both devices reduced muscle activity associated with SB.

Choice of biomaterials—Do soft occlusal splints influence jaw-muscle activity during sleep? A preliminary report

“…Interestingly, we also demonstrated that the inhibitory effect of the hard-type OS was more pronounced when combined with a novel feedback device, i.e., contingent electrical stimulation (CES). This temporary (short-term) inhibitory effect on temporalis muscle activity during sleep is in agreement with previous studies [12,14,15]. Another important finding from this study was the observation that the soft-material OS seemed to be associated with higher night-to-night variation in jaw-muscle activity when compared to baseline values.…”

“…The specific hypothesis was that the soft-material OS has an inhibitory effect on jaw muscle activity during sleep. This would be in agreement with previous studies that OS with or without direct effects on the occlusion have temporal inhibitory effects on SB [14,15].…”

“…However, OS therapy remains so far the first option for the management of SB because the treatment is reversible and can be performed with lesser costs [13]. Previous studies have investigated the effect of an OS on SB activity compared to a control OS which does not change the occlusion -a so called "palatal control device" [14,15]. These authors reported that the use of a hard-type OS as well as the palatal control device had an inhibitory effect on SB activity and suggested that the change in occlusal contacts between the maxillary and mandibular dental arches due to the OS might not be the primary factor for a reduction of SB and EMG activity.…”

Splint Therapy in Temporomandibular Joint Disorders: Review

“…37 Splintlerin bruksizmi tedavi edip etmediğine dair farklı bilgiler mevcuttur. 18,38,39 Splint kullanımı bruksizmle meydana gelen diş aşınmalarını azaltmada etkilidir. 38,40 Stabilizasyon splintlerinin aralıklı kullanımı uyku bruksizmini sürekli kullanıma kıyasla daha uzun süreli olarak azaltmaktadır.…”

“…41 Literatürde splint tedavisi; gevşeme tedavisi, psikolojik tedavi, düşük lazer tedavisi, akupunktur, ısırma plakları, stres yönetimi, çene egzersizleri, plasebo splintleri ile karşılaştırılmıştır. 39,40,[42][43][44][45][46] Kapsamlı bir derleme çalışmasında; stabilizasyon splintinin ağız açıklığını artırma ve kas ağrısını azaltmadaki etkinliği; kontrol grubu, plasebo splinti, akupunktur, ısırma plağı ve çene egzersizi uygulamaları ile karşılaştırılmış, aralarında anlamlı bir fark bulunmadığı sonucuna varılmıştır. 42 Oklü-zal splint tedavisi ile yumuşak splint, plasebo splinti, fizik tedavi ve akupunkturun temporomandibuler bozukluklardaki etkisinin değerlendirildiği bir çalışmada, stabilizasyon splintinin diğer yön-temlerden daha etkin olduğuna dair yeterli bir kanıtın bulunmadığı bildirilmiştir.…”