The splint is the most important, reversible aid to relax the chewing (masticatory) muscles and to guide the lower jaw into the centric condylar position. This sounds very simple, which it is not. We have seen many splints, but only very few could satisfy these demands. Almost all of them were inserted, not adjusted when necessary and then they were worn for months without any form of medical supervision.
Splints need to be checked and if necessary adjusted regularly until the centric stabilisation has been achieved. If this is not done, the treatment may not work, or even worse the condition deteriorates.
We usually make splints for the upper jaw.
Exceptions are free end saddles in the lower jaw, as well as the orthodontic occlusion case II/2 i.e. retroclined upper front teeth in combination with a severe deep bite.
The advantages of the upper splint are:
It is a lot more stable and we can get the anterior canine guidance flatter to reduce the stress of the temporo-mandibular system
If teeth are loose due to early contact, these are usually upper tooth. These generally become firm very quickly with a splint in the upper jaw
The disadvantages of the lower splint are:
It is often not as stable
The anterior canine guidance is steeper
The canine guidance is more difficult to adapt and because of that the upper teeth could become loose
During lateral movements the lower canine with the splint can skip over the upper canine and get caught
Adjusting - probably the most important step:
The splint is adjusted directly on the patient. A short time after issuing the splint, about 4-7 days, the splint should be checked. This is even more important if the patient is undergoing physiotherapy at the same time – this is always necessary when the entire body posture needs to be adjusted (e.g. unbalanced pelvic, differently long legs, recurrent vertebrae blockage etc.).
Exceptions:
Sometimes it is necessary to wear special splints on account of certain disorders. These are, for example, the distraction splints that are predominantly used when the joint is very compromised. Such splints have to be worn 24 hours every day without discussion.
Another special measure is physiotherapy. This is an additional therapy that is often used in combination with the splint and the results are remarkable.
Medication is only used in exceptional circumstances when the patient is in severe discomfort or suffers from extreme muscle tension. Most of the time, however, is the use of a splint sufficient to achieve rapid alleviation of the symptoms.
The splint fits:
Depending on the starting situation stable centric relation is achieved more or less quickly. If such a disorder is present, the aim is to get the lower jaw into a therapeutic centric position that is free of pain and has the freedom of movement. After that the occlusion should be reassessed and the different therapeutic measures that are necessary determined.