Craniomandibular disorders

Question 1

What splits are there for management of CMDs

Answer 1

• Soft splints
• Full coverage hard splints
• Repositioning splints

Question 2

describe soft splint

Answer 2

• Maxillary or mandibular
• Thermoformed
• Quick + easy to make
• “Relaxation” splint
• No occlusal adjustment
• Wears - especially with nocturnal bruxists

Question 3

describe stabilisation splints

Answer 3

• Hard splint
• Stable occlusal contacts
• Aim: RCP same as ICP
• Ideal occlusion
• Michigan splint (upper splint, stabiliser)
  Maxillary arch
  Ramps to create:
• Canine guidance on lateral excursions
• Anterior guidance on protrusion
• Posterior disclusion on excursion

Question 4

Describe stabilisation splints further

Answer 4

Tanner Appliance
- Similar to Michigan splint for mandibular arch
Thermoformed splint
- Hard/soft laminate
- Can produce similar features as Michigan Splint
- Usually night time wear

Question 5

Describe repositioning splints

Answer 5

• Anterior repositioning splint
• Protrusive occlusion recorded
• Full coverage - upper or lower
• Indentations for upper and lower teeth
• Full time wear initially
• Eliminates click
• Recaptures the disc
• Gradually reduce splint use
• Need to be used with great care

Question 6

Summary

Answer 6

• Splints have a role as part of a management plan
  i.e. alongside physiotherapy type exercises etc
• Soft splints - short term only
• Stabilisation splints
  Difficult to make
  Require regular follow up
• Repositioning splints
  Rarely used
  Require regular follow up to monitor occlusion
• Do not use partial coverage splints

Question 7

Answer 7

Question 8

Answer 8

Question 9

Answer 9