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Fractures: Bone Repair01:27

Fractures: Bone Repair

Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the procedure...

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Author Spotlight: Insights into an Efficient Murine Maxillary Orthodontic Model Protocol
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Optimizing Occlusal Splint Therapy: ElMohandes Protocol for Minimizing Musculoskeletal Alterations With Reduced Wear

Wael A El-Mohandes1, Mahmoud S Elariby2, Ahmed Bahaa1,3

  • 1Oral and Maxillofacial Surgery, Faculty of Dental Medicine, Al-Azhar University, Cairo, EGY.

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|August 21, 2025
PubMed
Summary

The ElMohandes protocol effectively reduced pain and improved jaw function in adults with temporomandibular disorders (TMD). This combined therapy, including splints and physiotherapy, achieved high patient satisfaction with no adverse effects.

Keywords:
educational interventionocclusal splintphysiotherapytenstmdstmj

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Area of Science:

  • Dentistry
  • Oral Rehabilitation
  • Pain Management

Background:

  • Temporomandibular disorders (TMD) encompass a range of conditions affecting the jaw joint and muscles.
  • Myogenic TMD and internal derangement are common etiologies requiring effective conservative management.
  • Current treatments often involve a combination of modalities, but optimal protocols are still under investigation.

Purpose of the Study:

  • To assess the clinical effectiveness and safety of the ElMohandes protocol for myogenic TMD and internal derangement.
  • To evaluate the protocol's impact on pain reduction, jaw function enhancement, and occlusal stability.
  • To determine patient satisfaction levels with the combined therapeutic approach.

Main Methods:

  • A single-arm case series involving 42 adult patients diagnosed with myogenic TMD or TMJ internal derangement.
  • A six-month protocol including intermittent occlusal splint therapy, thrice-weekly physiotherapy (TENS and ultrasound), and patient education.
  • Outcomes measured included pain intensity (VAS), maximal interincisal opening (MIO), muscle pain scores, and patient satisfaction at multiple timepoints.

Main Results:

  • All 42 participants completed the study with no dropouts.
  • Significant reductions in mean VAS pain scores (7.57 to 3.38) and improvements in MIO (31.87mm to 35.61mm) were observed (p<0.001).
  • High patient satisfaction (76.2% highly satisfied) and no adverse occlusal changes were reported.

Conclusions:

  • The ElMohandes protocol demonstrates rapid and substantial efficacy in managing TMD pain and improving function.
  • The integrated approach of splint therapy, physiotherapy, and education offers a promising conservative treatment strategy.
  • Further randomized controlled trials are recommended to validate long-term benefits and compliance.