Comparative evaluation of occlusal splint therapy and muscle energy technique in the management of temporomandibular disorders: A randomized controlled clinical trial.

Background: Contradicting evidence regarding the effects of occlusal splint therapy in the management of Temporomandibular disorder (TMD) and promising results shown by muscle energy technique. Aim: To determine and compare the effects of occlusal splint therapy, muscle energy technique, and combined treatment with education for self-management and counseling in the management of TMD. Study Design and Settings: Randomized clinical trial. Methodology: A total of 160 participants diagnosed with TMD according to Diagnostic Criteria/TMD axis I were randomly allocated into four treatment groups with equal allocation ratio using random numbers table. The main inclusion criteria were the presence of pain in the preauricular area, TMJ and/or muscles of mastication and maximum mouth opening <40 mm. Group A participants received muscle energy technique, Group B participants received occlusal splint therapy, Group C participants received combined treatment, and Group D participants received education for self-management and counseling (control). Control group treatment was provided to all the trial participants. Statistical Analysis: Intragroup comparison was made using Friedman test and Wilcoxon test while intergroup comparison was done using Kruskal-Wallis test and Mann-Whitney U test. Results: Intensity of pain on a visual analog scale and maximum mouth opening were measured at baseline, at 1 week, at 2 weeks, at 1 month, and after 3 months. Conclusion: Muscle energy technique, occlusal splint therapy and combined treatment significantly reduce pain compared to controls and muscle energy and combined treatment are superior to other groups for mouth opening improvements in patients with TMD.

Evaluation of three different tooth preparation techniques for metal ceramic crowns by comparing preparation depths: An in vitro study.

AIM: To determine the effect of three different tooth preparation techniques had on operator's ability to appropriately and consistently prepare teeth for metal ceramic crowns. MATERIALS AND METHODS: Ninety maxillary left central incisor typodont teeth were allocated to three equal groups (A, B and C) of thirty and mounted in standard working model one at a time. A freehand approach was used to prepare the teeth in Group A, which acted as a control. Groups B and C were prepared with the assistance of silicon index and suitable depth gauge burs, respectively. A silicon index of unprepared teeth, into which contrasting colored silicon injected to occupy the space created by tooth preparation, was sectioned in the midline. Images of sectioned index were captured with optical microscope attached to a personal computer. A calibrated image analysis software was used to measure the depth of preparation (in millimeters) at five points (labial-cervical, mid-labial, incisal, mid-palatal and palatal cervical) on two occasions. These results were pooled and averaged to give a mean labial, incisal and palatal preparation depths in mm. The data were analyzed by one-way analysis of variance and Scheffe's post-hoc statistical test. RESULTS: The mean depth of labial and incisal preparation for Groups A, B and C was 1.23 and 1.72 mm, 1.45 and 1.96 mm, 1.47 and 1.95 mm, respectively. The difference between the groups' labial preparation depth was significant as well as the difference between groups' incisal preparation depth. The mean palatal preparation was 0.46 mm for Group A, 0.54 mm for Group B and 0.59 mm for Group C. CONCLUSION: Teeth preparation for metal ceramic crowns without any assistance can lead to under-preparation of labial and incisal surface. CLINICAL SIGNIFICANCE: Whenever possible, considerable importance should be given to the use of index or depth gauge burs for preparing teeth for receiving metal ceramic crowns.