Maixner W, Diatchenko L, Dubner R Orofacial pain prospective evaluation and risk assessment study – the OPPERA study. J Pain. 2011; 12:T4-11.e1-2 https://doi.org/10.1016/j.jpain.2011.08.002
Aggarwal VR, Joughin A, Zakrzewska J Dentists' preferences for diagnosis, management and referral of chronic oro-facial pain: Results from a national survey. Health Educ J. 2012; 71:662-669
Spagnuolo G, De Vito D, Rengo S, Tatullo M. COVID-19 outbreak: an overview on dentistry. Int J Environ Res Public Health. 2020; 17 https://doi.org/10.3390/ijerph17062094
Wassell RW, Verhees L, Lawrence K Over-the-counter (OTC) bruxism splints available on the Internet. Br Dent. 2014; 216 https://doi.org/10.1038/sj.bdj.2014.452
Bereznicki T, Barry E, Wilson NHF. Unintended changes to the occlusion following the provision of night guards. Br Dent J. 2018; 225:715-722 https://doi.org/10.1038/sj.bdj.2018.869
Chate RA, Falconer DT. Dental appliances with inadequate occlusal coverage: a case report. Br Dent J. 2011; 210:109-110 https://doi.org/10.1038/sj.bdj.2011.46
Steele JG, Nohl FS, Wassell RW. Crowns and other extra-coronal restorations: occlusal considerations and articulator selection. Br Dent J. 2002; 192:377-387 https://doi.org/10.1038/sj.bdj.4801380
An unusual appliance: detrimental occlusal consequences of a lack of clinical monitoring Philip J Radford R James Spencer Dental Update 2024 50:7, 707-709.
Authors
Philip JRadford
BDS (Hons), MFDS RCPS (Glasg)
Specialty Trainee in Orthodontics, University Dental Hospital of Manchester
Removable appliances of various designs have been advocated for the treatment of temporomandibular disorders and bruxism. The COVID-19 pandemic decreased the number of clinical examinations undertaken by dentists worldwide, leading to patients seeking solutions to orofacial pain independently of clinicians. Unexpected complications can arise when the design of an appliance does not carefully consider potential occlusal changes that could occur, particularly when there is a lack of clinical monitoring undertaken.
CPD/Clinical Relevance: Poorly designed removable appliances can have an impact on a patient's occlusion, especially without regular monitoring.
Article
Temporomandibular disorders (TMDs) are the most common cause of chronic pain in the orofacial region.1 TMDs are musculoskeletal disorders predominantly affecting females, and reach a peak incidence in the second and third decades of life.2 Guidelines recommend that the firstline management of TMDs should consist of ‘reversible and non-invasive’ interventions of which education regarding self-management is the cornerstone.1 In 2012, it was reported the treatment preference of UK-based general dental practitioners (GDPs) was for ‘occlusal splint therapy’.3
Occlusal splints have both diagnostic and therapeutic purposes and are removable appliances designed to be placed over some, or all of the occlusal surfaces in the dental arch. They are prescribed for the management of TMD and to control the tooth wear effects of bruxism. They may be constructed from hard or soft acrylic and various designs have been proposed.4 The stabilization splint, as described by Moufti et al, is one example, and is a full-coverage hard-acrylic splint constructed for the upper or lower arch that provides a temporary and reversible ideal occlusion.4 The features of an ideal occlusion provided by the splint are ‘…multiple even contacts on the posterior teeth in retruded contact position…’ and ‘… canine guidance and disclusion of the posterior teeth in lateral and protrusive excursions…’.4 In providing an ideal occlusion, the appliance aims to reduce ‘abnormal muscle activity’, which can be a cause of TMD.5
Register now to continue reading
Thank you for visiting Dental Update and reading some of our resources. To read more, please register today. You’ll enjoy the following great benefits:
