de conventioneel versus digitaal vervaardigde splint

Keur, R. (Rogier) (2016) de conventioneel versus digitaal vervaardigde splint. thesis, Dentistry.

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Abstract

Aim: The occlusal splint is an appliance used to influence the signs and symptoms of temporomandibular dysfunction (TMD) and to protect the teeth from excessive wear due to bruxism. There is no consensus in the literature about the therapeutic effect of occlusal splints, however there is agreement on the behaviour changing effect. The explanation for this is that because of the patients’ anticipation on the outcome of the intervention buxism decreases. This underlines the importance of a well-fitting splint. The occlusal appliance can be manufactured in a conventional way as by digital designing and thereafter milling the splint out of acrylic resin. The aim of this study is to find out which method leads to a better result. Materials and method: This study is a doubleblind randomised pilot study. The study population was, after exclusion, a group of 34 dental students aged 20-35 years old. With these students, alginate impressions of the upper and lower arch were made, as well as a wax bite in maximal occlusion decreasing the vertical overbite with a minimum of 2,5 mm. One half of the group received a conventionally manufactured splint without button anchors and the other half received a digitally designed and milled splint. Both types of splint were of the Michigan type with canine guidance. Research was done on the stone models, during the phase in which the splints were placed and during a digital bite registration. The variables that have been measured are occlusion, articulation, fit, retention and wear comfort. The programs R and IBM SPSS were used to compare these variables in the study groups for statistical significance. In this study a 95% confidence interval was chosen. Results: A statistically significant difference between the two types of splint was found in the variables fit ((U=84,000; p=0,036) and retention (p=0,001), both measured on the stone models. In addition to that, a statistically significant difference was found in the retention judged by the study population (p=0,01346) and the number of occlusal contact points in the anterior region measured by the T-scan (U=78,000; p=0,020). All these mentioned differences were in favor of the digitally designed splints. The variable occlusion in this study is subdivided in ‘symmetrical contact between the left and the right side of the splint’, ‘the number of occlusal contact points left and right on the splint’ and ‘simultaneous and evenly contact when coming in occlusion’. The first two mentioned variables were measured with both articulating paper and the T-scan and the last one mentioned was judged by the study population. Despite the fact that no significant difference was found in the first two mentioned variables, the digitally designed splints scored better on average than the conventionally manufactured splints which shows a trend. This was also the case for the ‘wear comfort’ although both types of splint scored low. This trend was not seen in the variables ‘articulation’ and ‘distribution of the bite force measured by the T-scan’ and ‘simultaneous and evenly contact when coming in occlusion’. Discussion and conclusion: The digitally designed and manufactured occlusal splint scored, in most of the researched variables, better on average than the conventionally manufactured splint. In a couple of cases this difference was also found to be statistically significant. One can consequently say that there is a tendency in favour of the digitally designing and manufacturing way of producing an occlusal splint.

Item Type:	Thesis (Thesis)
Supervisor name:	Cune, Prof. dr. M.S. and Pelt, dr A.J. van and Droulias, drs N.
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:46
Last Modified:	25 Jun 2020 10:46
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/729

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