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      Clinical comparison of conventional and additive manufactured stabilization splints

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          Abstract

          The aim of this study was to compare conventional and digital additive manufacturing of hard occlusal stabilization splints (SS) using technical and clinical parameters. 14 subjects were subjected to DC/TMD Axis I clinical examination protocol and Axis II questionnaire. The subjects underwent treatment with splints over a period of 12 weeks. All subjects underwent both conventional alginate impression and intraoral digital scanning. Seven subjects received conventional manufactured stabilization splints (CM-SS), and seven subjects received CAD-CAM additive manufactured stabilization splints (AM-SS). 12 subjects completed the 12 weeks follow-up period. The subjects significantly preferred digital intraoral scanning compared to conventional alginate impression. There was a significant difference in VAS between CM-SS and AM-SS. The mean VAS result was 15 for AM-SS and 42 for CM-SS, 0 represented excellent comfort and 100 very uncomfortable. This was significant. Splint manufacturing method had no influence on treatment outcome. There was no significant difference in mean delta change for unassisted jaw opening from baseline to 12 weeks between the two groups, for CM-SS it was 2 mm difference and for AM-SS the difference was 3 mm. All subjects in both treatment groups showed improved oral function. In this study, the scanning procedure is more accepted by the subjects than alginate impressions, however the first procedure was more time consuming.

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          Most cited references23

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          Accuracy of medical models made by additive manufacturing (rapid manufacturing).

          Additive manufacturing (AM) is being increasingly used for producing medical models. The accuracy of these models varies between different materials, AM technologies and machine runs.
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            Management of TMD: evidence from systematic reviews and meta-analyses.

            This systematic review (SR) synthesises recent evidence and assesses the methodological quality of published SRs in the management of temporomandibular disorders (TMD). A systematic literature search was conducted in the PubMed, Cochrane Library, and Bandolier databases for 1987 to September 2009. Two investigators evaluated the methodological quality of each identified SR using two measurement tools: the assessment of multiple systematic reviews (AMSTAR) and level of research design scoring. Thirty-eight SRs met inclusion criteria and 30 were analysed: 23 qualitative SRs and seven meta-analyses. Ten SRs were related to occlusal appliances, occlusal adjustment or bruxism; eight to physical therapy; seven to pharmacologic treatment; four to TMJ and maxillofacial surgery; and six to behavioural therapy and multimodal treatment. The median AMSTAR score was 6 (range 2-11). Eighteen of the SRs were based on randomised clinical trials (RCTs), three were based on case-control studies, and nine were a mix of RCTs and case series. Most SRs had pain and clinical measures as primary outcome variables, while few SRs reported psychological status, daily activities, or quality of life. There is some evidence that the following can be effective in alleviating TMD pain: occlusal appliances, acupuncture, behavioural therapy, jaw exercises, postural training, and some pharmacological treatments. Evidence for the effect of electrophysical modalities and surgery is insufficient, and occlusal adjustment seems to have no effect. One limitation of most of the reviewed SRs was that the considerable variation in methodology between the primary studies made definitive conclusions impossible.
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              The jaw functional limitation scale: development, reliability, and validity of 8-item and 20-item versions.

              To develop the Jaw Functional Limitation Scale (JFLS), comprising 3 constructs and a global scale, based on a preliminary instrument, and to investigate content validity of the overall functional limitation construct, reliability, and generalizability. A temporomandibular disorders (TMD) patient group, compared to other diagnostic groups, was hypothesized to report further limitation in each of the 3 new proposed constructs.
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                Author and article information

                Journal
                Acta Biomater Odontol Scand
                Acta Biomater Odontol Scand
                IABO
                iabo20
                Acta Biomaterialia Odontologica Scandinavica
                Taylor & Francis
                2333-7931
                2018
                13 August 2018
                : 4
                : 1
                : 81-89
                Affiliations
                [a ]Department of Prosthodontics, Faculty of Dentistry, University of Oslo , Oslo, Norway;
                [b ]Tannlab Dental Laboratory , Oslo, Norway
                Author notes

                Supplemental data for this article can be accessed here .

                CONTACT C. Hjortsjö carl.hjortsjo@ 123456odont.uio.no Department of Prosthetics and Oral Function, Institute of Clinical Dentistry, University of Oslo , P.O. Box 1109 Blindern, 0317Oslo, Norway
                Article
                1497491
                10.1080/23337931.2018.1497491
                6095019
                30128331
                eb37fc6f-d0f9-4759-a053-c8cd7f157c7b
                © 2018 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 08 May 2018
                : 02 July 2018
                Page count
                Pages: 9, Words: 5510
                Categories
                Original Article

                digital impression,hard occlusal stabilization splint,cad-cam

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