HOW OCCLUSAL SPLINTS WORK FOR MY ORTHODONTIC PRACTICE
Our treatment philosophy at Masters Orthodontics is characterised by clearly defined treatment goals. Possibly the most important of these goals is to have healthy and stable Temporomandibular joints (TMJ’s) before, during and after orthodontic treatment.
Many of our patients present signs and symptoms of TMJ problems when they come in to see us for an initial orthodontic consultation. Frequently the teeth don’t occlude properly and the joints adapt by moving the mandible into a more “comfortable”position to allow them to fit together better. In essence, there is a discrepancy between Maximum Intercuspation (MI) and Stable Condylar Position (frequently referred to as Centric Relation). Over time, this altered condylar position can unfortunately lead to temporomandibular disorders (TMD).
In my practice we first need to stabilise any articular problems before embarking on any irreversible orthodontic treatment. We scan the patient, design and 3D print a deprogramming splint which is used to reduce muscular pain and hyperactivity and to stabilise the condyles thus obtaining better occlusal stability.
In short, the important goals in orthodontic treatment (namely facial aesthetics, dental aesthetics, functional occlusion, periodontal health and TMJ health) are based on a stable and healthy joint.
There are many different types of splint shapes and designs, all of which have their own rationale and philosophy. Some are used in the upper arch whilst others in the lower.
At Masters Orthodontics we use a 3 piece FACE Functional Splint. As the name implies, it is comprised of three separate pieces, 2 posterior segments (used during the day) and one anterior segment (used at night).
The objective is to obtain equal intensity stops with anterior and canine guidance incorporated into the design. By relaxing the muscles of mastication we allow the condyles to adopt a stable position within the glenoid fossa.
It is imperative that we see the patient periodically to adjust the splint. Unfortunately the splint by itself has limited therapeutical effect if not checked and adjusted. The splint must be used 24/7 (including during meal times) and should only be removed to clean.