BASICS OF FUNCTIONAL CLINICAL AND INSTRUMENTAL DIAGNOSTICS
AND PRETREATMENT BEFORE FINAL ORAL REHABILITATION
Figure 29. Trying on the splint
Figure 30. A few weeks after starting splint
therapy, the patient was free of headaches, TMJ
pain, and tinnitus
Figure 31. Decompression splint needs
spaceholder of 0.8 mm in the condylar boxes
of the articulator
Figure 32. The geometry of the decompression
splint follows the manipulated geometry of the
condylar boxes of the articulator
to work in a very intensive and responsible
occupation. Recently, the patient reported not
needing the splint at all during a sailing holiday
in the Mediterranean. Stachniss therefore very
appropriately termed the bite-guard splint “glasses
for the dentition”. 29
leads to a more physiological positioning of TMJ
structures with a positive, therapeutic effect. If TMJ
pain persists nonetheless, targeted, geometric
decompression of the very probably compressed
articular structures should be performed. To this
Summary
The splint therapy presented here is the most
common and recommendable standard therapy
by far, which can primarily effect muscle relaxation
and improvement of neuromuscular coordination (24).
However, successful implementation requires
that, in centric relation and therefore in the splint
position, the condyle-disc unit should be still
largely intact and the interarticular space should
not be constricted. The therapeutic approach
consists in eliminating centric and eccentric
occlusal disturbances, rebuilding lost support
zones, and changing the mandibular motion
pattern in order to improve muscle tone and
neuromuscular coordination.22 As a rule, it also
into a decompression splint by inserting an
approximately 0.8 mm space holder craniodorsally
into the condylar box of the articulator on the
side of the joint requiring decompression (also
possible bilaterally)24 (Figs. 31, 32). This yields
a corresponding vertical increase of the splint,
which in the patient can produce a ventrocaudal
decompression of the compressed articular
structures. It is strongly suggested that this
end, the splint described here can be modified
special, often helpful type of splint therapy be
conducted in association with muscle massages
and physiotherapy exercises14,27 because the jaw
relations must adapt to the premature contacts
which arise on the splint at first.
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