Background and Objectives: The objective of our clinical trial was to determine the effectiveness of the deep dry needling technique (DDN) (neuromuscular deprogramming) as a first step in the treatment of temporomandibular disorders. Methods and Materials: The double-blind randomized clinical trial comprised 36 patients meeting the inclusion criteria who had signed the corresponding informed consent form. The participants were randomly distributed into two groups, the Experimental group (Group E) and the Control group (Group C). Group E received bilateral DDN on the masseter muscle, while Group C received a simulation of the technique (PN). All the participants were evaluated three times: pre-needling, 10 min post-needling, and through a follow-up evaluation after 15 days. These evaluations included, among other tests: pain evaluation using the Visual Analog Scale (VAS) and bilateral muscle palpation with a pressure algometer; evaluation of the opening pattern and range of the mouth, articular sounds and dental occlusion using T-scans; and electromyography, which was used to evaluate the muscle tone of the masseter muscles, in order to control changes in mandibular position. Results: Digital control of occlusion using Tec-Scan (digital occlusion analysis) showed a significant reduction both in the time of posterior disclusion and in the time needed to reach maximum force in an MI position after needling the muscle, which demonstrated that there were variations in the static position and the trajectory of the jaw. The symmetry of the arch while opening and closing the mouth was recovered in a centric relation, with an increase in the opening range of the mouth after the procedure. Conclusions: facial pain is significantly reduced and is accompanied by a notable reduction in muscle activity after needling its trigger points.
The aging population in developed countries has increased the number of edentulous patients and, therefore, the need for prosthetic rehabilitation to improve their quality of life. Complete dentures are the main treatment option in these cases. The use of CAD/CAM (Computer Aided Design/Computer Aided Manufacturing) in dentistry has improved clinical protocols and outcomes, achieving a reduction in work time and economic costs for the patients. The main objective of this review was to compare the characteristics of conventional and digital dentures, attempting to determine whether the use of new technologies represents an improvement in the properties of removable complete dentures. A bibliographic review was carried out in the PubMed/MEDLINE, Cochrane Library, Scielo, and Embase databases. With the initial search, 157 articles were obtained. After applying the inclusion and exclusion criteria, 64 publications were selected for this bibliographic review. The different conclusions of the studies consulted were compared regarding fit and retention, fracture resistance, surface roughness, biocompatibility, and aesthetics, taking into account the different methods of prostheses fabrication. In general, digital prostheses have shown better mechanical properties and, consequently, better biocompatibility and aesthetics than conventional prostheses. However, the obtained results were very heterogeneous, preventing a supported conclusion.
Due to their lack of periodontal ligaments (PLs) and the differences between dental implants and natural teeth, it is necessary to improve and generate a new occlusal scheme to prolong the life of implants and prostheses. The age and the sex of patients must be considered because of their effects on the stomatognathic system’s physiology. Operators must manage all the changes to obtain good sensations during mastication and a better occlusal scheme for implanting fixed partial prostheses. Dentists should try to protect this type of prosthesis using adjacent teeth and the PL. This is why new digital systems were created. The combination of T-Scan® (digital software for occlusal analysis) and electromyography (EMG) could allow doctors to find areas where it is necessary to act and to find suitable solutions for the problems generated by using conventional methods of occlusal analysis (such as articulating paper). In this study, a new method for establishing occlusion on fixed partial implant prostheses has been created, combining digital systems with conventional articulating paper. This method consists of asking the patient to bite down with different forces and situations in an attempt to achieve Implant-Protected Occlusion (IPO). The use of digital systems has been shown to be more effective than using only conventional systems. This new method allows a safer mode of occlusion which protects implants and prostheses, saving all the differences between them and natural teeth, and increasing the satisfaction of patients. This method also helps to overcome the changes in the stomatognathic system as age increases, adjusting the occlusion to changes in PLs with age.
About Me
Education:
- Degree in Odontology, University of Salamanca, 2018–2022.
Education:
- Degree in Odontology, University of Salamanca, 2018–2022.