Oral Splints: Diagnosis, Design and Treatment Protocols

Category: Orthodontics

Instructor(s): Gregor Slavicek

Course structure: Lessons: 24 lessons | Duration: 8 h 15 min

Course overview

Master diagnosis-to-delivery protocols. Learn functional status exams, axiography/condylography, individualized articulator settings, and precise appliance design so your splints fit, function, and hold—predictably.
During the course you will learn how to:
– Conduct muscle and occlusion examinations
– Make a functional diagnosis
– Determine indications to a specific type of a splint
– Plan TMD treatment using a splint
– Reposition the mandible and change the VDO.
The course is for prosthodontists, orthodontists and functional dentists.

Curriculum

Lesson 1. Splints - the crutches of dentistry. Intro and basic thoughts

• Lesson program:
• – Structures and functions of the Chewing organ
• – What is our diagnostic and therapeutic focus?
• – Individual clinical application of the splint
• – The importance of the use of splints
• – Synonyms for intraoral splints. Splint types and their characteristics
• – Statistics about splints
• – Dental splint prescription patterns
• – What specialists use splints?
• Recommended for: Functional dentists, Prosthodontists, Orthodontists.

Lesson 2. Historical review - the literature up to 1995

• Lesson program:
• – Supposed modes of splint action
• – Verticalization and Costen's syndrome
• – The discus-positioning effect
• – The muscle "pacifying effect"
• – The bruxism effects. Splint materials
• – The effect of removing interferences
• – The congitive-awareness effect
• – Disc dislocation
• – "Re-capturing"
• – Relieve of the TMJ.
• Recommended for: Functional dentists, Prosthodontists, Orthodontists.

Lesson 3. Convergence of diagnostics, divergence of therapy, indications for intraoral splints

• Lesson program:
• – What does treatment strategy include
• – Stages of TMJ treatment using splint
• – Detailed indications for splint therapy.
• Recommended for: Functional dentists, Prosthodontists, Orthodontists.

Lesson 4. Concepts and terminology

• Lesson program:
• Splints indication referred to muscle disorders: neuromuscular dysfunction, muscle spasm, muscle, spasticity, muscle splinting.
• Splint as a device: nightguard, stabilization splint, positioning splint, re-positioning splint, reversible splint, over the counter splints, reflexed splints, jig, sandwich splint, drum splint.
• Short term splints and long term splints.
• Recommended for: Functional dentists, Prosthodontists, Orthodontists.

Lesson 5. Systematic assessment - main concern and occlusal index

• Lesson program:
• – Systematic functional analysis
• – Patient and expert: a possible and frequently observed discrepancy
• – Subjective and objective of the treatment
• – Medical anamnesis
• – Questionnaires
• – Occlusal Index
• – Dialog and conversation.
• Recommended for: Functional dentists, Prosthodontists, Orthodontists.

Lesson 6. Comparative muscle palpation

• Lesson program:
• – Objective information
• – Muscle palpation
• – Groups of muscles. Types of movement
• – Masticatory, tongue and neck muscles
• – Comparative muscle palpation.
• Recommended for: Functional dentists, Prosthodontists, Orthodontists.

Lesson 7. TMJ palpation

• Lesson program:
• – Ligamental structures of TMJ
• – Macroscopic anatomy of TMJ
• – Incongruent structures
• – Combined translation and rotation
• – Stability of TMJ
• – Border movements
• – TMJ palpation points.
• Recommended for: Functional dentists, Prosthodontists, Orthodontists.

Lesson 8. Neurological screening

• Lesson program:
• – Cranial nerves
• – Anatomy of cranial nerves
• – Questionnaire for cranial nerves examination
• – Headache and migraine symptoms.
• Recommended for: Functional dentists, Prosthodontists, Orthodontists.

Lesson 9. Analysis of functions - chewing function

• Lesson program:
• – Determining and measuring chewing function
• – Assessment of performance
• – Appliances and devices for chewing function assessment
• – Steps of chewing function assessment.
• Recommended for: Functional dentists, Prosthodontists, Orthodontists.

Lesson 10. Analysis of the functions – bruxing

• Lesson program:
• – Analysis of bruxing facets in oral cavity and on the cast model
• – Instrumental clinical analysis of bruxism
• – BruxChecker application. Analysis of the results
• – Correlation between occlusal discrepancies and aggressive periodontitis
• – Graduation and clinical classification of bruxism
• – Fundamental paradigm of bruxism
• – Digital services for bruxism evaluation
• – Analysis and evaluation of data received.
• Recommended for: Functional dentists, Prosthodontists, Orthodontists.

Lesson 11. Occlusion and posture - clinical screening

• Lesson program:
• – Screening of posture and balance
• – Relation to splint therapy
• – Adapted Meersseman test
• – Hypermobility syndrome
• – Chronic pain syndrome.
• Recommended for: Functional dentists, Prosthodontists, Orthodontists.

Lesson 12. Problem list and treatment strategy

• Lesson program:
• – Problems that may arise when treating with splints
• – Involvement of occlusion on splint therapy
• – Occlusal quality and occlusal functions
• – Initial therapy and interim analysis
• – Therapeutic sequence
• – CMS system.
• Recommended for: Functional dentists, Prosthodontists, Orthodontists.

Lesson 13. Construction elements and decision making

• Lesson program:
• – Individual elements of oral splints
• – Designing the occlusal surface of splints
• – Deciding making about splint guide elements.
• Recommended for: Functional dentists, Prosthodontists, Orthodontists.

Lesson 14. Production of splints in the articulator

• Lesson program:
• – Basic manipulations and principles of manufacturing splints in the articulator
• – Digital and manual protocols for splints manufacturing.
• Recommended for: Functional dentists, Prosthodontists, Orthodontists.

Lesson 15. Clinical application: looping in and adaptation

• Lesson program:
• – Success factors for treatment using splints
• – Individual splints
• – Splint adaptation and grinding
• – Surveillance and monitoring of treatment.
• Recommended for: Functional dentists, Prosthodontists, Orthodontists.

Lesson 16. Verticalization rail

• Lesson program:
• – Changing the VDO as an element of splint therapy
• – Application of multilayer splints
• – Verticalization strategy. Vertical splints.
• Recommended for: Functional dentists, Prosthodontists, Orthodontists.

Lesson 17. Splints with a focus on myofascial problems, myorelaxation splints

• Lesson program:
• – Systematic assessment of the occlusion and muscles condition
• – Myorelaxing splints. Elimination of myofascial problems.
• Recommended for: Functional dentists, Prosthodontists, Orthodontists.

Lesson 18. Basics of reciprocal clicking - including condylography

• Lesson program:
• – Reciprocal clicking. Symptoms and etiology
• – Consequences of the reciprocal clicking for the TMJ
• – Choice of therapeutic position for splint therapy based on the condylography data.
• Recommended for: Functional dentists, Prosthodontists, Orthodontists.

Lesson 19. Splints with a focus on the temporomandibular joint - anterior disc displacement with reduction

• Lesson program:
• – Pathophysiology of TMJ with displaced articular disc
• – Dynamics of dislocation and correction of the articular disc
• – Treatment of anterior disc displacement with reduction.
• Recommended for: Functional dentists, Prosthodontists, Orthodontists.

Lesson 20. Basics of chronic joint blockade - including condylography

• Lesson program:
• – Risks of degenerative diseases of the temporomandibular joint developing with disc displacement
• – Differential diagnosis of anterior disc displacement without reduction.
• Recommended for: Functional dentists, Prosthodontists, Orthodontists.

Lesson 21. Splints with a focus on the temporomandibular joint - anterior disc displacement without reduction

• Lesson program:
• – What to do in case of anterior disc displacement without reduction
• – Signals on condylography with a permanently displaced disc
• – Treatment planning for anterior disc displacement without reduction.
• Recommended for: Functional dentists, Prosthodontists, Orthodontists.

Lesson 22. Distraction and compression - definition and therapeutic use

• Lesson program:
• – TMJ compression. Compression degree
• – TMJ distraction
• – What is synovial fluid for?
• – What effect does mechanical pressure have on the structures of the TMJ.
• Recommended for: Functional dentists, Prosthodontists, Orthodontists.

Lesson 23. Special rails

• Lesson program:
• – Special types of splints. Placebo splints
• – Flat splints. Their effect on the position of the mandible in the absence of guidance
• – Difference in efficiency of arbitrarily or kinematically manufactured splints.
• Recommended for: Functional dentists, Prosthodontists, Orthodontists.

Lesson 24. Walking back, final treatment strategy and therapeutic position

• Lesson program:
• – Retrospective method of the therapeutic position determination
• – How to proceed to the next necessary treatment procedures.
• Recommended for: Functional dentists, Prosthodontists, Orthodontists.