Splints Are Not Just for TMJ Therapy Part II: Fabrication Technique
Occlusal splints have been generally recommended for temporomandibular disorder (TMD) therapy and to mitigate the occlusal effects of bruxism. During bruxism, if posterior interferences (ie, protrusive, working, and balancing contacts) are present, the maxillary muscles exhibit significantly greater contractile force than when disclusion is guided by a single canine or maxillary central incisors during protrusion, whether it is a normal functional or a parafunctional movement. When only the canine or the incisors contact in lateral movement, there is a neurologic feedback mechanism that prevents excessive muscular contraction (the more teeth that contact the greater the possible contractile stress and thus muscular overload). Also, because the anterior teeth are farther from the fulcrum (the temporomandibular joint in this instance), there is a mechanical disadvantage relative to molars. This means the same contractile force in the maxillary muscles exerts proportionally less stress with respect to farther-anterior tooth contact.