title: Implant-supported mandibular splinting affects temporomandibular joint biomechanics.
abstract: OBJECTIVE
  Mandibular functional movements lead to complex deformations of bony structures. The aim of this study was to test whether mandibular splinting influences condylar kinematics and temporomandibular joint (TMJ) loading patterns.
  
  
  METHODS
  Six subjects were analyzed by means of dynamic stereometry during jaw opening-closing with mandibles unconstrained as well as splinted transversally by a cast metal bar fixed bilaterally to two implant pairs in the (pre)molar region. Statistical analysis was performed by means of ANOVAs for repeated measurements (significance level α=0.05).
  
  
  RESULTS
  Transversal splinting reduced mandibular deformation during jaw opening-closing as measured between two implants in the (pre)molar region on each side of the mandible significantly by 54%. Furthermore, splinting significantly reduced the distance between lateral condylar poles (average displacement vector magnitude of each pole: 0.84±0.36 mm; average mediolateral displacement component: 45±28% of the magnitude) and led to a medial displacement of their trajectories as well as a mediolateral displacement of stress-field paths.
  
  
  CONCLUSIONS
  During jaw opening-closing, splinting of the mandible leads to a significant reduction of mandibular deformation and intercondylar distance and to altered stress-field paths, resulting in changed loading patterns of the TMJ structures.
authors.affiliation: Clinic of Fixed and Removable Prosthodontics and Dental Material Science, University of Zurich, Plattenstrasse 11, CH-8032 Zurich, Switzerland.
authors.forename: Balthasar
authors.initials: B
authors.lastname: Zaugg
authors.forename: Christoph H F
authors.initials: CH
authors.lastname: Hämmerle
authors.forename: Sandro
authors.initials: S
authors.lastname: Palla
authors.forename: Luigi M
authors.initials: LM
authors.lastname: Gallo
mesh_terms: D000704:Analysis of Variance; D001696:Biomechanical Phenomena; D019094:Dental Prosthesis, Implant-Supported; D005260:Female; D006801:Humans; D007574:Jaw Relation Record; D008279:Magnetic Resonance Imaging; D008297:Male; D008334:Mandible / Q000502:physiology*; D008875:Middle Aged; D009068:Movement / Q000502:physiology; D017090:Occlusal Splints; D012984:Software; D013704:Temporomandibular Joint / Q000502:physiology*