Occlusal Appliance Therapy Flashcards
(19 cards)
The use of ______ _______ splints for internal derangements became widespread, and several different appliance designs evolved
Anterior repositioning
Interocclusal orthopedic appliances of varied design and application have been used in the tx of ___ and ____
MPDS (Myofascial pain dysfunction syndrome)
TMD (temporomandibular disorders)
Interocclusal orthopedic appliances provide the practitioner with a ________ ________ form of intervention to manage the patients symptoms
Non-invasive reversible
What is a biomechanical problem?
Internal derangement
What is the most popular approach to internal derangements
Mechanical
Intraoral occlusal appliances or splints
2 types of appliances used for internal derangements
Stabilization splint
Repositioning splint
Stabilization appliance
Made in pts habitual arch of closure
Primary purpose = reduce pressure on pints, splint shown reduce parafunctional activity too
Maintains full contact w opposite teeth in CO, allows movement in all directions
Repositioning appliance
Main objective = recapture disc, usually combo of upper and lower appliance = for complaisance
All appliances need constant monitoring /adjustment = effective
Repositioning appliance - upper
Worn at night
Ramp behind max incisors prevent mandible from returning when the pt is reclining
Repositioning appliance = lower
Occlusal indents = guide mandible into protrusive position = worn during day
What should the tx of different options of appliance therapy be based on
The knowledge of TMJ Biomechanics
Each pt evaluated individually = specific tx objectives
Occlusal disengagement
Providing an ideal occlusion by the use of a splint reduces abnormal muscle activity
Vertical dimension
Increasing vertical dimension —> muscle correct length —> pain decreases by reducing the muscle contraction
Maxillo-mandibular realignment
Produce neuromuscular balance
Pre-existing mandibular position is incorrect = imbalance
Centric relation, determine muscle length,
TMJ repositioning theory
Condyle repositioned within glenoid fossa
Repositioning splint = tx internal derangements as temporary and therapeutic appliance- no evidence support need to restor occlusion permanently to the temporary tx position
Cognitive awareness
Applied to all splints
Having something in mouth alters behavior/ opportunity indulge in harmful muscle activity reduced
Effects in TMJ
Space in articular surface
Blood flow increases, swelling decreased and pain decreases
Recapture articular disc
Movement in TMJ - helps breaks adhesions
Effects in muscle of mastication
Occlusion with no restrictions , pain decreases
Low # of occluding teeth
Low # perio
Decreases CNS response
Decreases muscle tension
Different type of appliances
Stabilization appliance
Anterior repositioning
Flat plane appliance
Centric relation splint
Anterior bite plane
Posterior bite plane
Pivot appliance
Soft bite guard
Mandibular orthopaedic repositioning appliance (MORA)
Deprogrammed
NTI
