Occlusal Appliances Flashcards
What occlusal appliances are available for TMD?
Stabilisation appliance Anterior positioning appliance Anterior bite appliance Posterior bite appliance Pivot appliance Resilient appliance Distraction appliance Hydrostatic appliance Mouth restricting appliance
Which devices are stabilisation appliances?
Michigan splint, night guard, and bite guard
What does a stablisation appliance do?
Reduces TMD symptoms
Reduces bruxism protecting the dentition (in the long term it can get worse)
What adverse effects can arise with stabilisation appliances?
Caries
Soft tissue health (periodontal diseases)
Psychological dependence
What is the purpose of anterior positioning appliances?
Can allow taking away clicking/locking caused by disc displacement
Allows for adaptation of the retrodiscal tissues
Reduces clicking in the short term and the long term
What are the adverse effects of using anterior positioning devices?
Myostatic contraction of the inferior lateral pterygoid.
If this occurs it can be mitigated and prevented from getting worse
What is an anterior bite appliance?
Anterior bite plane causing anterior teeth to occlude during the bite.
Why are anterior bite appliances used?
No good evidence that it reduces TMD but some evidence.
Reduces headaches (New claim)
Stay away from these as often as possible
What are the adverse effects of using anterior bite appliances?
Stabilisation is better for TMD
Potential for occlusal changes (Eruption of posterior teeth -> Anterior open bite)
Potential to allow condyles to seat to a new position in the fossae creating a malocclusion
What are posterior bite appliances used for?
No real data supporting long term use but they are useful for acute disc displacement without reduction (leading to earlier callous formation)
What are pivot appliances used for?
They create a high spot on the mandible causing mandible to pivot out of the fossa.
What are the adverse effects of using a pivot appliance?
Can be bad for the opposite side TMJ
What is the resilient appliance?
Soft appliance used following orthodontic treatment to treat TMD
What are the adverse effects of using resilient appliances?
Increases nocturnal bruxism (doesn’t necessarily increase symptoms though)
Little adverse effects but can be used as a placebo
What are hydrostatic appliances used for?
Potentially useful to allow bite in even fashion to relieve discomfort.
They don’t last very long but can be used as a diagnostic tool
