Occlusal appliance

therapy

prepared by
dr/akram alhemeary
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 Definition of occlusal appliance (splint)
Definition of occlusal appliance therapy
Uses of splints
• Diagnostic use of splint
• Therapeutic use of splint
Types of splints:
• Stabilization splint
• Anterior positioning splint
• Anterior bite plane splint
• Posterior bite plane splint
• Pivoting splint
• Soft or resilient splint
Which splint should be used?
Success of splint therapy

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An occlusal appliance is a
removable device that fits
over the occlusal and
incisal surfaces of the teeth
in one arch, creating precise
occlusal contact with the
teeth of the opposing arch

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- Commonly referred to as: splint, bite guard,
night guard, interocclusal appliance, and
orthopedic device .

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 Occlusal appliance therapy :
Used in treatment of TMD,
bruxism, and headache

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 TMD
“Umbrella term covering pain
and dysfunction of the muscles of
mastication and the
temporomandibular joints”
Difficult to diagnose, as
presenting symptoms can be
variable
Treatment is challenging for both
dentist and patient
Splint treatment is reversible and
non-invasive
Splint treatment provides
diagnostic information and relief

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 USES OF SPLINTS
To temporarily provide an
occlusal condition that allow
the TMJ to assume the most
orthopedically stable joint
position (centric relation)
To introduce an optimum
occlusal condition that
reorganises neuromuscular
reflex activity
To protect the teeth from
abnormal forces

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 CENTRIC RELATION
“the relation of the mandible to
the maxillae when the condyles
are in the uppermost and
rearmost position in the glenoid
fossae”

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 SPLINT-DIAGNOSTIC
Splints help to
determine
parafunctional habits
Splints help to
determine the causative
factor of TMD
Splints help to rule out
certain causative factors
of TMD

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Help in management of the
symptoms of many TMDs:
• Muscle relaxation
• Protecting teeth and jaws
from bruxism
• Allow condylar seating in
the most orthopedically
stable joint position (CR)

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 TYPES OF OCCLUSAL APPLIANCES
(SPLINTS)
1. Stabilization splint: also called muscle relaxation
splint
2. Anterior positioning splint: also called orthopedic
repositioning appliance
3. Anterior bite plane
4. Posterior bite plane
5. Pivoting splint
6. Soft or resilient splint
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 STABILIZATION SPLINT
Is a full arch hard acrylic splint
Generally fabricated for the
maxillary arch
Allows condylar seating in the
CR when splint is in place
Provides an optimal occlusal
relationship
Treatment goal: to eliminate any
orthopedic instability between
the occlusal position and the
joint position

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 STABILIZATION SPLINT INDICATIONS
Generally used to treat muscle pain
disorders:
1. TMD that relates to muscle
hyperactivity : Wearing stabilization
splint >>> decreases parafunctional
activity e.g. bruxism >>> muscle
relaxation and pain relief
2. Local muscle soreness
3. Chronic centrally mediated myalgia
Also helpful for treatment of
retrodiscitis secondary to trauma:
Wearing stabilization splint >>>
minimises forces to damages tissues
>>> permits more efficient healing

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 RETRODISCITIS

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 Stabilization splint maxillary versus
mandibular
Maxillary:
• More stable and covers more tissue
• More retentive and less likely to break
• More versatile (allows opposing contacts to be achieved
in all skeletal and molar relationships)
• All mandibular contacts are on flat surface (increased
stability)
• Help to locate the CR
Mandibular:
• Easier to speak with
• Less visible (more aesthetic)
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