S2 - Occlusal Splints

Question 1

What is needed to send to lab for occlusal splint?

Answer 1

impression plus occlusal records

splints can have canine rise but generally ask for flat occlusal plane

Question 2

Impression (material, tray, opposing, how to remove, what to check for in impression?)

Answer 2

• impression in 100hr stable alginate (e.g. chromatic alginate)
• use metal Rim-Lok tray for arch splint is going on (DONT use adhesive)
• use plastic disposable tray for opposing arch (use adhesive)
• use SNAP REMOVAL
• check for no pulling away of impression from tray

Question 3

Occlusal records (material, what to do/what not to do and why?)

Answer 3

• use PVS bite reg
  DO NOT get pt to bite together, place a cotton role anteriorly or on canines bilaterally so that there is 3-4mm gap between upper and lower teeth then squirt material in (idea is to record registration without teeth contacting)
  WHY? splint is atleast 3-4mm thick and you are allowing for this thickness

Question 4

What is Clearsplint™ ?

Answer 4

slightly flexible and not completely hard like acrylic splint

Question 5

Instructions for Clearsplint™ insertion and storage

Answer 5

place in WARM water for 30seconds before inserting

NOT to be stored in water as will turn milky, use just toothbrush and toothpaste and shake dry

Question 6

When should you do md splint instead of mx and why?

Answer 6

deep 100% overbite (lower anteriors occluding with soft tissues of palate)

no room because material of mx would be so thick that the patient would feel their mouth is ‘propped open’ too far

Question 7

Why should you use metal tray over plastic?

Answer 7

dont cause as much distortion of impression material as plastic tray

Question 8

After inserting splint, pt has AOB. Is this normal? what to do?

Answer 8

You DONT want this
grind away till normal, then polish (need a highly polished surface for teeth to glide over)

Question 9

Do you have to take occlusal record for splint?

Answer 9

not rly unless several teeth missing or malocclusion

Question 10

Why do you need to use snap removal for alginate?

Answer 10

due to visco-elastic property of alginate - slow removal causes distortion, need fast snap removal

Question 11

Why might a pt have trismus after md 3rd molar exo?

Answer 11

damage to insertion of masseter

Question 12

How does an occlusal splint help muscles of face when clenching?

Answer 12

spams in temporalis occur during overclosure (clenching), splint opens occlusion causing stretching of temporalis

Question 13

What is a pro and con of bilaminar splint?

Answer 13

ease of fitting splint to teeth w/o adjustment

however soft material can be snug fitting and pt may complain about tightness (cannot adjust w acrylic burs like hard splint)

Question 14

If a tooth is supra-erupted, how should a splint be made?

Answer 14

splint must be made like this too

Question 15

T or F patient w implant therapy must wear a splint?

Answer 15

T

Question 16

How to make splint for denture patient?

Answer 16

take impression over top of denture, otherwise splint may have overclosure (even if pt doesnt wear denture at night, the splint will still fit)

Question 17

Condition when TMJ muscle spasms cause earache?

Answer 17

Costen’s syndrome