Ozturk Gurtekin Serpila, Bal Burcub, Oral Korayb
aPrivate practice, Istanbul, Turkey
bYeditepe University, Faculty of Dentistry, Department of Prosthodontics, Istanbul, Turkey
Summary
Background/Aim: Stabilization appliances have traditionally been used for the treatment of temporomandibular disorders and bruxism. The aim of this study was to evaluate the effect of two appliances (hard and soft) with different thicknesses on the electromyographic (EMG) activities of masseter and anterior temporalis muscles. Material and Methods: 30 healthy subjects have been divided into two groups of 15, according to the appliance material used (soft, hard). For each subject in both groups, two appliances have been prepared with 3 mm and 6 mm thickness. EMG recordings of bilateral masseter and anterior temporalis muscles were taken for each appliance. Results: The results showed that, the decrease in average EMG values during maximum voluntary clenching with a 3-mm and 6-mm-thick hard appliance was statistically significant compared with the average EMG of maximum voluntary clenching in the intercuspal position. The increase in average EMG values during maximum voluntary clenching with a soft appliance of 3 mm and 6 mm thickness was statistically significant. Conclusions: The hard stabilization appliances decrease the activity of the masseter and temporalis muscles, while the soft appliances increase the activity of the masseter and temporalis muscles.
Keywords: temporomandibular disorders; hard appliance; soft appliance; electromyography
Reference
Ferreira FM, Ce’zar Simamoto-Ju’nior P, Soares CJ, Ramos AMdAM, Fernandes-Neto AJ. Effect of occlusal splints on the stress distribution on the temporomandibular joint disc. Braz Dent J, 2017;28:324-329
Roark AL, Glaros AG, O’Mahony AM. Effects of interocclusal appliances on EMG activity during parafunctional tooth contact. J Oral Rehabil, 2003;30:573-577
Pettengill CA, Growney MR Jr, Schoff R, Kenworthy CR. A pilot study comparing the efficacy of hard and soft stabilizing appliances in treating patients with temporomandibular disorders. J Prosthet Dent, 1998;79:165-168
Limchaichana N, Nilsson H, Petersson A, Ekberg E. Resilient appliance-therapy treatment outcome in patients with TMD pain correlated to MRI-determined changes in condyle position. Cranio, 2009;27:185-193
Tecco S, Quinzi V, Nota A, Giovannozzi A, Abed MR, Marzo G. Electromyography-guided adjustment of an occlusal appliance: Effect on pain perceptions related with temporomandibular disorders. A controlled clinical study. Diagnostics (Basel), 2021;11:667
Tartaglia GM, Moreira Rodrigues da Silva MA, Bottini S, Sforza C, Ferrario VF. Masticatory muscle activity during maximum voluntary clench in different research diagnostic criteria for temporomandibular disorders (RDC/TMD) groups. Man Ther, 2008;13:434-440
Visser A, Naeije M, Hansson TL. The temporal/masseter co-contraction: An electromyographic and clinical evaluation of short-term stabilization splint therapy in myogenous cmd patients. J Oral Rehabil, 1995;22:387-389
Okeson JP. Management of temporomandibular disorders. 6.ed, Mosby-Year Book, Inc., St. Louis, 2008
Savabi O, Nejatidanesh F, Khosravi S. Effect of occlusal splints on the electromyographic activities of masseter and temporal muscles during maximum clenching. Quintessence Int, 2007;38:e129-132
Akat B, Görür SA, Bayrak A, Eren H, Eres N, Erkcan Y, Kılıçarslan MA, Orhan K. Ultrasonographic and electromyographic evaluation of three types of occlusal splints on masticatory muscle activity, thickness, and length in patients with bruxism. Cranio, 2020;1-10
Wright EF, Schiffman EL. Treatment alternatives for patients with masticatory myofascial pain. J Am Dent Assoc, 1995;126:1030-1039
Ferrario VF, Sforza C, Tartaglia GM, Dellavia C. Immediate effect of a stabilization appliance on masticatory muscle activity in temporomandibular disorder patients. J Oral Rehabil, 2002;29:810-815
Cohenca N, Roges RA, Roges R. The incidence and severity of dental trauma in intercollegiate athletes. J Am Dent Assoc, 2007;138:1121-1126
Karakis D, Dogan A, Bek B. Evaluation of the effect of two different occlusal splints on maximum occlusal force in patients with sleep bruxism: a pilot study. J Adv Prosthodont 2014;6:103-108
Seifeldin SA, Elhayes KA. Soft versus hard occlusal splint therapy in the management of temporomandibular disorders (TMDs). Saudi Dent J 2015;27:208-214
Kashiwagi K, Noguchi T, Fukuda K. Effects of soft occlusal appliance therapy for patients with masticatory muscle pain. J Dent Anesth Pain Med, 2021;21:71-80
Truelove E, Huggins KH, Mancl L, Dworkin SF. The efficacy of traditional, low-cost and nonsplint therapies for temporo-mandibular disorder: a randomized controlled trial. J Am Dent Assoc, 2006;137:1099-1107
Ries LG, Alves MC, Be’rzin F. Asymmetric activation of temporalis, masseter and sternocleidomastoid muscles in temporomandibular disorder patients. Cranio, 2008;26:59-64
Dworkin SF, Turner JA, Mancl L, Wilson L, Massoth D, Huggins KH, LeResche L, Truelove E. A randomized clinical trial of tailored comprehensive care treatment program for temporomandibular disorders. J Orofac Pain, 2002;16:259-276
Tecco S, Tetè S, D’Attilio M, Perillo L, Festa F. Surface electromyographic patterns of masticatory, neck, and trunk muscles in temporomandibular joint dysfunction patients undergoing anterior repositioning splint therapy. Eur J Orthod, 2008;30:592-597
Pita MS, Ribeiro AB, Garcia AR, Pedrazzi V, Zuim PR. Effect of occlusal splint thickness on electrical masticatory muscle activity during rest and clenching. Braz Oral Res, 2011;25:506-511
Tartaglia GM, Lodetti G, Paiva G, De Felicio CM, Sforza C. Surface electromyographic assessment of patients with long lasting temporomandibular joint disorder pain. J Electromyogr Kinesiol, 2011;21:659-664
Sheikholeslam A, Holmgren K, Riise C. Therapeutic effects of the plane occlusal appliance on signs and smptoms of craniomandibular disorders in patients with nocturnal bruxism. J Oral Rehabil, 1993;20:473-482
Chung SC, Kim YK, Kim HS. Prevalence and patterns of nocturnal bruxofacets on stabilization appliances in temporomandibular disorder patients. Cranio, 2000;18:92-97
List T, Helkimo M. Acupuncture and occlusal appliance therapy in the treatment of craniomandibular disorders. II. A 1 year follow-up study. Acta Odontol Scand, 1992;50:375-385
Hiyama S, Ono T, Ishiwata Y, Kato Y, Kuroda T. First night effect of an interocclusal appliance on nocturnal masticatory muscle activity. J Oral Rehabil, 2003;30:139-145
Scopel V, Alves da Costa GS, Urias D. An electromyographic study of masseter and anterior temporalis muscles in extra-articular myogenous TMJ pain patients compared to an asymptomatic and normal population. Cranio, 2005;23:194-203
Nascimento LL, Amorim CF, Giannasi LC, Oliveira CS, Nacif SR, Silva Ade M, Nascimento DF, Marchini L, de Oliveira LV. Occlusal appliance for sleep bruxism: an electromyographic associated to Helkimo Index evaluation. Sleep Breath, 2008;12:275-280
Chandu A, Suvinen TI, Reade PC, Borromeo GL. The effect of an interocclusal appliance on bite force and masseter electromyography in asymptomatic subjects and patients with temporomandibular pain and dysfunction. J Oral Rehabil, 2004;31:530-537
Harkins S, Marteney JL, Cueva O, Cueva L. Application of soft occlusal appliances in patients suffering from clicking temporomandibular joints. Cranio, 1988; 6:71-76
Abekura H, Yokomura M, Sadamori S, Hamada T. The initial effects of occlusal splint vertical thickness on the nocturnal EMG activities of masticatory muscles in subjects with a bruxism habit. Int J Prosthodont, 2008;21:116-120
Manns A, Miralles R, Cumsille F. Influence of vertical dimension on masseter muscle electromyographic activity in patients with mandibular dysfunction. J Prosthet Dent, 1985;53:243-247
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