Dentist № 2 (41) – 2021, pp. 18-29                                                                               SCIENTIFIC PUBLICATION

The effectiveness of the use of individual occlusal splints in athletes

S.P. Rubnikovicha, I.N. Baradinab, I.V. Samujlovc, A.I. Majzetd, V.Ch. Neden’e

aMD, PhD, DMSci, Professor, Belarusian State Medical University, Belarusian Medical Academy of Postgraduate Education, Minsk, Belarus
bMD, PhD, Associate Professor, Belarusian Medical Academy of Postgraduate Education, Minsk, Belarus
cBelarusian State University of Informatics and Radioelectronics, Minsk, Belarus
dMD, PhD, Belarusian Medical Academy of Postgraduate Education, Minsk, Belarus
eME “7th City Dental Clinic”, Minsk, Belarus

https://doi.org/10.32993/dentist.2021.2(41).7

ABSTRACT
Athletes experience high emotional and physical loads during the preparation of competitive performances, as well as directly at the time of the performance itself, which lead to a premature decrease in the functional activity of the muscles, which leads to a change in the biomechanics of movements. The functional activity of the muscles is reduced by changes occurring in the dentofacial system and manifesting as occlusive disharmony, changes in the bite, a decrease or increase in the interalveolar distance, hypertonus of the muscles of the maxillofacial region (MFR), which can lead to a decrease in athletic performance. The identification of the causes that lead to a decrease in the results of their elimination requires special training, which consists of several stages, one of which is the production of an individual occlusal relaxing splint or cap, which balances the functional activity of the muscles of the maxillofacial region,as well as the subsequent production of an individual occlusal normalizing splint with the implementation of subsequent multitasking.
The aim of the study. To evaluate the effectiveness of the use of individual occlusal splints in athletes by analyzing changes in the functional state of the muscles of the maxillofacial region based on electromyography indicators, as well as changes in inter-occlusal contacts based on occludography indicators.
Objects and methods. 10 male athletes engaged in martial arts at the professional level at the age of 23-24 years took part in the study. Each athlete underwent a clinical examination, palpation and isometric tests of the muscles of the maxillofacial region and temporomandibular joints (TMJ), auscultation in the TMJ area, control of occlusion with a copy paper and a T-scan device (occludography), cone-beam tomography (CBCT) of the maxillofacial system (ZCH) and electromyography (EMG) of the muscles of the maxillofacial region. All athletes who took part in the study at the first preparatory stage were made individual occlusal relaxing tires of two types: one with a thickness of 2.0 mm soft stiffness and the second with a thickness of 3.0 mm semi-rigid. At the second preparatory stage of the study, individual occlusal normalizing tires with a thickness of 2.0 mm were made rigid. All types of individual occlusal splints were made for the lower jaw. Statistical processing of the obtained results was carried out in the Matlab R2020 environment.
Results and discussion. The use of an individual occlusal relaxing splint in athletes for a short period of 1-2 months allowed to balance the bioelectric potential of the masticatory and temporal muscles at rest to 16%, to change the symmetrical activity of the temporal muscles to the right side in the state of muscle effort during tooth compression, and the difference in activity was 19%, and for the masticatory muscles, the right side activity was 6%. When studying the EMG data, significant differences were observed in each individual athlete, which did not affect the increase in the stability of muscle activity. The use of an individual occlusal normalizing splint in athletes during the study period of 4-6 months allowed us to consolidate the obtained result of the first preparatory period and to rearrange the position of the lower jaw in space, normalizing the inter-occlusal contacts. After the conditional division of athletes into two groups with orthognathic bite without displacement and with displacement of the lower jaw position, it was found that the muscle rearrangement of both groups according to the measurements of spontaneous activity of the masticatory and temporal muscles was almost the same, there was only increased activity on the right side, which is natural, since the lower jaw in half of the group was shifted to the right at the beginning of the study. According to the measurements of functional activity, the amplitude spread over the initial stages was observed, and in the last measurement, this difference was equalized. The most pronounced type of muscle activity of the temporal and masticatory muscles in the study group is right – sided, which is most likely associated with the type of bite, displacement of the lower and/or dominant activity of the right hand, postural changes.
Conclusion. The use of individual occlusal splints in male athletes engaged in martial arts at the initial stage allowed us to identify significant changes in the functional state of the muscles of the maxillofacial region and observe positive dynamics in their normalization, as well as to align the inter-occlusal contacts.

Keywords: sports, martial arts, electromyography, occludography, masticatory muscles, temporal muscles, individual occlusal relaxing splints, individual occlusal normalizing splints, caps, temporomandibular joints

References

  1. Trezubov V.N. [et al.] Dokazatel’stva psihicheskogo geneza gipertonii zhevatel’nyh myshc: Ch. 3 [Evidence of the mental genesis of hypertension of the masticatory muscles: Part 3]. Institut stomatologii. – Institute of Dentistry. 2011, vol. 2, pp. 62–64.
  2. Dolgaljov A.A., Bragin E.A. Diagnostika pri kompleksnom lechenii pacientov s okkljuzionnymi narushenijami zubnyh rjadov, associirovannyh patologiej visochno-nizhnecheljustnogo sustava [Diagnostics in the complex treatment of patients with occlusive disorders of the dentition associated with the pathology of the temporomandibular joint]. Aktual’nye voprosy klinicheskoj stomatologii: materialy XLVI nauch.-prakt. konf. stomatologov Stavropol. kraja. M-vo zdravoohranenija Stavropol. kraja, GBOU VP StGMA, Stomatologicheskaja assoc. Stavropol. kraja; pod red. S.N. Garazhi [Actual issues of clinical dentistry: materials XLVI scientific-practical. conf. dentists Stavropol. the edges. Ministry of Healthcare Stavropol. edge, GBOU VP StGMA, Dental Assoc. Stavropol. the edges; ed. S.N. Garages]. – Stavropol, 2008. pp. 147–151.
  3. Rubnikovich S.P., Baradina I.N., Denisova Ju.L., Samujlov I.V., Davydov M.V., Kul’chickij V.A Analiz funkcional’nogo sostojanija myshc cheljustnolicevoj oblasti u stomatologicheskih pacientov s priznakami bruksizma v sochetanii s sindromom obstruktivnogo apnoje vo sne [Analysis of the functional state of the muscles of the maxillofacial region in dental patients with signs of bruxism in combination with obstructive sleep apnea syndrome]. Doklady Nacional’noj akademii nauk Belarusi. – Reports of the National Academy of Sciences of Belarus. 2020, no. 64 (3), pp. 341–349.
  4. Sjomkin V.A., Rabuhina N.A., Ljashev I.N. Osobennosti dvizhenija nizhnej cheljusti v norme i pri provedenii jendoprotezirovanija visochnonizhnecheljustnogo sustava [Features of the movement of the lower jaw in normal conditions and during endoprosthetics of the temporomandibular joint]. Majestro stomatologii. – Maestro of Dentistry. 2003, no. 2, pp. 10–13.
  5. Sjomkin V.A., Rabuhina N.A., Volkov S.I. Patologija visochno-nizhnecheljustnyh sustavov [Pathology of the temporomandibular joints]. M.: Prakt. medicine, 2011. 168 p.
  6. Semkin V.A., Rabuhina H.A. Programma obsledovanija bol’nyh s disfunkciej visochno-nizhnecheljustnyh sustavov [The program of examination of patients with dysfunction of the temporomandibular joints]. Algoritmy v luchevoj diagnostike i programmy luchevogo i kompleksnogo lechenija bol’nyh: materialy VIII Vseros. s#ezda rentgenologov i radiologov, Moskva, 31 maja – 1 ijunja 2001 g. [Algorithms in radiation diagnostics and programs for radiation and complex treatment of patients: materials of the VIII All-Russian. Congress of Radiologists and Radiologists, Moscow, May 31 – June 1, 2001]. M., 2001. 160 p.
  7. Sidorenko A.N., [et al.] Sovershenstvovanie kompleksnogo lechenija disfunkcional’nyh sindromov v sochetanii s legkovpravimym vyvihom meniska visochno-nizhnecheljustnogo sustava [Improvement of complex treatment of dysfunctional syndromes in combination with easily recoverable dislocation of the temporomandibular joint meniscus]. Fundament. issled. – Fundament. issled. 2011, no. 9, pp. 513–516.
  8. Sotnikova M.V. Diagnostika i lechenie sindroma bolevoj disfunkcii visochno-nizhnecheljustnogo sustava: avtoref. dis. kand. med. nauk: 14.00.21 [Diagnosis and treatment of the syndrome of pain dysfunction of the temporomandibular joint: author. dis. Cand. med. Sciences: 14.00.21]. Smolensk: SGMA, 2009. 19 p.

Correspondence to:  Е-mail: rubnikovichs@mail.ru