Orthodontic splints..

• An occlusal appliance, called a splint,
is a removable device, usually made
of hard acrylic 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. It is commonly
referred to as a bite guard, night
guard, interocclusal appliance, or
orthopedic device.
www.indiandentalacademy.com

Ideal disc - condyle complex should be
In the most antero superior area of
glenoid fossa
Against the articular eminence
Disc interposed
Normal neuromusculature
Without collateral ligament strain.

During mouth opening:
1.Superior LP stays passive
and releases contraction(- )
2.Inferior LP contracts and
pulls the condyle forward.(+)
3. Tension increases in the
retrodiskal fibers to keep it
aligned with the condyle.
During closure reverse
happens

Superior LP maintains (+) a
controlled contraction to
hold the disk forward.
The retrodiskal elastic fibers
maintain a constant tension
against the forward pull of
the muscle.
SLP muscle is attached to
the disk and condyle.
ILP is attached to the
condyle.

OCCLUSAL INTERFERENCE
PROPRIOCEPTIVE PERIODONTAL RECEPTORS
ACTIVATES PROTECTIVE REFLEX SYSTEM
TO GUARD TEETH
LPM POSITIONS THE JAW SO THAT ELEVATORS
CLOSE DIRECTLY INTO MAXIMAL OCCLUSAL
CONTACT
LPM CANNOT RELAX THE PROTECTIVE BRACING
CONTRACTION
DISPLACEMENT OF MANDIBLE TO M. I.
DISPLACEMENT OF CONDYLE DISK ASSEMBLIES

WILLIAMSONS EXPERIMENT (JPD 1983)
WILLIAMSON DEMONSTRATED THE PRECISE EFFECT
OF OCCLUSAL INTERFERNCE ON MUSCLE
COORDINATION AND NORMAL MUSCLE ACTIVITY
Using EMG procedure, he showed that interfering contacts on
the posterior teeth in any eccentric position caused hyperactivity
of the elevator muscles.
But if anterior guidance was allowed to disclude all posterior
teeth from any contact other than CR, the elevator muscles either
stopped or reduced active contraction the moment posterior teeth
were discluded.

HOW SPLINT WORKS ?
Five distinct theories explain it:

1. Occlusal disengagement theory
2. Vertical dimension theory
3. Maxillomandibular realignment
theory
4. TMJ repositioning theory
5. Cognitive awareness theory

The neuromuscular protective mechanism causes a person to
accommodate his jaw position to the intercusping of the teeth.
The purpose of an anatomic articulator is to eliminate the
patient’s neuromuscular response to his existing occlusion. This
is the basis for occlusal therapy and TMJ treatment.

The Mandibular Position Indicator (M.P.I.) procedure quantifies
the differences between the joint-dominated position and the
tooth-dominated position of maximum intercuspal position(ICP).
Delta H → Vertical increase or decrease (incisal pin)
Delta L → Protrusion or retrusive movement (incisal table)
Delta Y → Right or left transverse movement
Delta X → Protrusive (+) or (-) retrusive (Horizontal)
Delta Z → Compression (+) or (-) distraction (Vertical)

OKESONS CLASSIFICATION OF SPLINT :
1. Stabilization splints
2. Anterior repositioning splints
3. Anterior bite plane
4. Posterior bite plane
5. Pivot splint
6. Soft splint
CLASSIFICATION BY SLAVICEK (JCO 1989 FEB

1. Myopathic splint
2. Decompression splint
3. Compression splint
4. Verticalization splint
5. Anterior Repositioning splint

Another way to classify splints based on the arch for which it is
fabricated.

1. MAXILLARY SPLINTS
A. CENTRIC WITH CUSPID AND ANTERIOR GUIDE RAMP
1. BIOSTAR OR OMNIVAC BASE
WITH SELF CURE OCCLUSAL 2. HEAT PROCESSED WITH
CLASPS 3. CAST METAL - VITALLIUM OR GOLD
B. DISTRACTION OR FORWARD REPOSITIONER
1. BIOSTAR OR OMNIVAC BASE SELF CURE OCCLUSAL
2. HEAT PROCESSED WITH CLASPS
C. BITE PLATE
D. POSTERIOR BITE PLATE

2. MANDIBULAR SPLINTS
A. LOWER CENTRIC SPLINT WITH OR WITHOUR ANTERIOR
RAMP B. LOWER PIVOT SPLINT C. LOWER POSTERIOR
FORWARD POSITION SPLINT 1. PARTIAL COVERAGE 2.
FULL COVERAGE


CLASSIFICATION ACCORDING TO ALEX WILLIS (AJO 1995
MARCH)
1. Flat Plane Splint
2. Anterior Repositioning splint
3. Canine protected splint
Dawson classifies splints in two types only,

1. A permissive splint
2. A directive splint


BILATERAL MANIPULATIONwww.indiandentalacademy.com

LEAF GAUGE

MESIAL INCLINE
DISTAL INCLINE

ANTERIOR STOP IS FLAT & PERPENDICULAR TO
LONG AXIS OF MANDIBULAR INCISOR

MAXILLARY FULL ARCH STABILIZATION APPLIANCE

DURING LATEROTRUSIVE MOVEMENT MANDIBULAR CANINE
DISOCCLUDES THE POSTERIOR TEETH

DESIGN :
1.In centric relation all posterior mandibular
buccal cusps must contact on flat surfaces
with even force.
2. During protrusive movement, the
mandibular canines must contact the
appliance with even force.
3.In any lateral movement only the mandibular
canines should exhibit laterotrusive contact on
the appliance.
4.The mandibular posterior teeth must contact
the appliance only in centric relation closure.
5.In the alert feeding position, the posterior
teeth must contact the appliance more
prominently than the anterior teeth.www.indiandentalacademy.com

ANTERIOR REPOSITIONING SPLINT
Fabrication:
1. The mandible must be directed by the splint to a position that
aligns the condyle with the disk.
2.The mandible must be prevented from from closing or clenching
distally to the position of disk of alignment.
3.Both anterior and posterior segments should share anchorage for
directing the mandible forward.

Mandible assumes
forward position
Guiding ramp
Ramp shifts the mandible
forward

BITE RECORDS FOR ANTERIOR REPOSITIONING SPLINT

S SPLINT

ICP (black dot) above RCP (red dot) indicates
compression.
Rx : DECOMPRESSION SPLINT

ICP (black dot) below RCP (red dot) indicates
distraction.
Rx : COMPRESSION SPLINT

CANINE PROTECTED SPLINT
Posterior pinpoint centric stops and extreme canine rise with
tight vertical element.

ANTERIOR BITE PLANE

1. POSTERIORS ARE INTRUDED BY ELEVATOR MUSCLES
2. UPPER INCISORS STARTS TO MOVE LINGUALLY
3. LOWER INCISORS MIGHT MOVE LABIALLY & SUPRAERUPT
4. LINGUALIZED UPPER INCISOR INTERFERE WITH ARC OF
CLOSURE & FORCE THE CONDYLE TO DISTALIZE

POSTERIOR BITE PLANE & EFFECT AFTER 1 YEAR WEAR

Bite Plane anchored in headgear tubes.

Full Arch Maxillary Removable Bite Splintwww.indiandentalacademy.com

I. Inclined plane for the alignment of the upper front teeth.
II. Biting splint for the nivellisation of the compensating curve.

POSTERIOR PIVOTING APPLIANCE LOADS THE CONDYLE
IT DOESNOT DISTRACT THE CONDYLE

Four balanced points of maxillomandibular contact in centric relation:
two articular disc assemblies and
two glass ionomer pads on lower first molars.
GIC PIVOT SPLIT

Case with deep overbite and advanced attrition of incisal and cusp
tips.
Glass ionomer splint allows immediate placement of full fixed
appliances while opening bite and establishing centric relation.
GIC PIVOT SPLINT

DAWSONS CLASSIFICATION OF SPLINT
PERMISSIVE SPLINT DIRECTIVE SPLINT

FOUR TYPES OF PERMISSIVE SPLINT
A. ANTERIOR B PLANE
B. POSTERIOR B PLANE
C & D UPPER AND LOWER FULL OCCLUSAL SPLINTwww.indiandentalacademy.com

All tooth inclines are separated or covered with
smooth plastic
Occlusion is blocked because of smooth gliding surface
Neuromuscular reflex controlling the closure into
maximum intercuspation is lost
Muscles function according to their own coordinated
interaction (muscle deprogrammers )
If the condition of articular components permit condyle is
then allowed to return to their correct seated position
( centric relation ).


Orthodontic splints..

Recommended

Recommended

More Related Content

What's hot

What's hot (20)

Viewers also liked

Viewers also liked (20)

Similar to Orthodontic splints..

Similar to Orthodontic splints.. (20)

More from Indian dental academy

More from Indian dental academy (20)

Recently uploaded

Recently uploaded (20)

Orthodontic splints..