The type of splint used in each varying case will depend on the patient’s clinical needs, the requirements of the clinician, and the desired outcome.
Many different dental splints are available to dental patients. The type of splint used in each varying case will depend on the patient’s clinical needs, the requirements of the clinician, and the desired outcome. One of the most frequently-prescribed dental splints is the traditional flat-plane occlusal splint, which fits over the maxillary or mandibular arch. This splint is popular due to its ability to treat a wide variety of issues.
For many years, the material of choice was a clear or tooth-colored hard acrylic (made with methyl methacrylate), but this material held certain flaws. One major issue was polymerization shrinkage, which caused the appliance to warp during the curing process, creating a less-than-perfect fit once the appliance was seated in the mouth. Methyl methacrylate is a very rigid material that had to be kept clear of any undercuts, with ball clasps compensating for the lack of retention. Although effective, ball clasps can place pressure on the interdental papillae, potentially causing long-term damage.
These days, it’s far more common to use pressure-molded technologies, creating plastic splints that are less rigid and can capture undercuts for greater retention. Once formed, small amounts of hard, light-cured acrylic can be placed onto these bases, creating the correct occlusion to match the opposing dentition. Having a more stable occlusal plane helps to relieve jaw pain. Another advantage of these more modern materials is increased biocompatibility.
Thermoplastic materials offer even greater patient comfort, capturing even deeper undercuts that offer more retention with less chance of breaking. Thermoplastic materials are created using liquid monomer and powder polymer that is cured under pressure and heat. These materials have the ability to flex slightly when softened in warm water while still retaining the correct shape. Once inserted into the mouth, they are more easily able to conform to the contours of patient’s teeth. The hardness of these materials can be adjusted by modifying the liquid to powder ratio, allowing clinicians to customize splint fabrication to match the needs of the patient. This kind of appliance may be made from entirely thermoplastic materials, or it can have a hard, acrylic layer applied to the occlusal surfaces to create a more stable plane.
Dental-splint therapy can be utilized to treat multiple problems that include TMJ pain and severely worn dentition, often caused by bruxism. Always ensure that the occlusal schematics are accurately captured, that the splint protects the opposing dentition, and that it doesn’t feel too bulky to wear, which will increase patient comfort.
These materials allow dental splints to be modified from the traditional flat-plane occlusal splint design. Originally, dental splints were made as a full-coverage appliance from a flat table that occluded with every tooth in the opposing dentition. Using these materials, it’s possible to alter the design to improve the patient’s experience and, hopefully, patient compliance. Appliances can be designed to offer full coverage or may expose the anterior teeth. This can increase airflow, making it easier for patients to communicate and breathe comfortably. Such a design can also eliminate the discomfort and feeling of tightness sometimes experienced when wearing these appliances. Additional strength can be added in the form of lingual bars or mesh. The design may also be altered to add cuspid or anterior guidance, while the posterior occlusion can have guidance grooves or can be left smooth.
Since the dental splint was first introduced, its design has significantly evolved, leading to greater patient comfort. The techniques used to produce dental splints have also improved, requiring less chair-side time to fit them properly.
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