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Journal of Peking University(Health Sciences) ›› 2019, Vol. 51 ›› Issue (1): 105-110. doi: 10.19723/j.issn.1671-167X.2019.01.019

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Preliminary clinical application of complete digital workflow of design and manufacturing occlusal splint for sleep bruxism

Shi-min WANG1,Zheng LI1,Guan-bo WANG1,Hong-qiang YE1,Yun-song LIU1,△(),Dai TONG1,2,Wen-hui GAO2,Yong-sheng ZHOU1   

  1. 1. Department of Prosthodontics, Beijing 100081, China
    2. Dental Laboratory, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
  • Received:2018-10-09 Online:2019-02-18 Published:2019-02-26
  • Contact: Yun-song LIU E-mail:kqliuyunsong@163.com
  • Supported by:
    Supported by the Capital Health Research and Development of Special(2016-1-4101);the Project for Culturing Leading Talents in Scientific and Technological Innovation of Beijing(Z171100001117169);and the New Clinical Technology Program of Peking University Hospital and Stomatology(PKUSSNCT-17A01)

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Abstract:

Objective: To establish a complete workflow of digital design and manufacturing occlusal splint for sleep bruxism, which can be preliminarily applied in clinical use, thus observe the clinical efficacy. Methods: Twenty-four patients with sleep bruxism were recruited in the study and randomly divi-ded into two groups by using random number tables. Digital-occlusal-splint (experimental group) treatment plan and traditional-occlusal-splint (control group) treatment plan were carried out for each group, respectively. For experimental group, digital models of patients’ both dental arches and the occlusion relationship after elevation were captured using an intraoral scanner. The occlusal splint was carried out by computer aided design/computer aided manufacturing (CAD/CAM), including splint designing and milling. For control group, the traditional soft occlusal splint was fabricated by vacuum laminator. The two kinds of occlusal splints were tried in the patients from each group, and the occlusal contacts were tested respectively by T-scan analysis system, which recorded the changes of occlusal indicators in the two groups. The retention, appearance and occlusal comfort degree were evaluated by the two groups of patients. Mann-Whitney test was performed with IBM SPSS 20.0 software, and bilateral test was performed. P<0.05 was considered to be statistically significant. Results: The complete workflow of digital design and manufacturing occlusal splint was successfully established. During the clinical use, there was no statistical difference in the retention evaluation of two kinds of occlusal splints between the two groups of patients (Z=-0.538, P=0.590). The appearance score (Z=2.038, P=0.042) and the occlusal comfort score (Z=-2.579, P=0.010) of the experimental group were higher than those of the control group, with statistically significant differences. The T-scan analysis results showed that only the second molar on both sides of the traditional occlusal splint had occlusal contact in intercupsal position, while the digital occlusal splint had stable and bilaterally balanced contact between the maxillary and mandibular teeth. Furthermore, the occlusal force was uniformly distributed in the experimental group. Conclusion: The complete workflow of digital occlusal splint improves the occlusal design, greatly simplifies and optimizes the traditional process of making occlusal splint. This new method is resource-saving and environmental-friendly, and it is able to serve patients more conveniently and efficiently.

Key words: Computer-aided design, Sleep bruxism, Occlusal splints

CLC Number: 

  • R783.2

Table 1

Evaluations of retention of two occlusal splints (consideration of experimental group and control group)"

Group A B C Z value P value
Experimental group, n 6 5 1 -0.538 0.590
Control group, n 5 5 2

Table 2

Evaluations of appearance of two occlusal splints (consideration of experimental group and control group)"

Group A B C Z value P value
Experimental group, n 7 4 1 -2.038 0.042
Control group, n 2 7 3

Table 3

Evaluations of occlusal comfort degree of two occlusal splints (consideration of experimental group and control group)"

Group A B C Z value P value
Experimental group, n 9 3 0 -2.579 0.010
Control group, n 3 6 3

Figure 1

Digital design and manufacturing of occlusal splint of experimental group A, B, digital design of splint; C, final splint after milling."

Figure 2

Occlusal splint of patient No. 1 in experimental group"

Figure 3

Occlusal splint of patient No. 2 in control group"

Figure 4

T-scan results of the central occlusion of experimental group A, occlusion before try-in; B, occlusion after try-in."

Figure 5

T-scan results of the central occlusion of control group A, occlusion before try-in; B, occlusion after try-in."

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