Oral splints: diagnosis, design and treatment protocols
Oral splints: diagnosis, design and treatment protocols
Course overview
This is a course on splint therapy in the concept of Slavicek!
What you will learn
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.
Course lessons
Lesson 1. Splints - the crutches of dentistry. Intro and basic thoughts
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?
Lesson 2. Historical review - the literature up to 1995
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.
Lesson 3. Convergence of diagnostics, divergence of therapy, indications for intraoral splints
What does treatment strategy include
Stages of TMJ treatment using splint
Detailed indications for splint therapy.
Lesson 4. Concepts and terminology
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.
Lesson 5. Systematic assessment - main concern and occlusal index
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.
Lesson 6. Comparative muscle palpation
Objective information
Muscle palpation
Groups of muscles. Types of movement
Masticatory, tongue and neck muscles
Comparative muscle palpation.
Lesson 7. TMJ palpation
Ligamental structures of TMJ
Macroscopic anatomy of TMJ
Incongruent structures
Combined translation and rotation
Stability of TMJ
Border movements
TMJ palpation points.
Lesson 8. Neurological screening
Cranial nerves
Anatomy of cranial nerves
Questionnaire for cranial nerves examination
Headache and migraine symptoms.
Lesson 9. Analysis of functions - chewing function
Determining and measuring chewing function
Assessment of performance
Appliances and devices for chewing function assessment
Steps of chewing function assessment.
Lesson 10. Analysis of the functions – bruxing
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.
Lesson 11. Occlusion and posture - clinical screening
Screening of posture and balance
Relation to splint therapy
Adapted Meersseman test
Hypermobility syndrome
Chronic pain syndrome.
Lesson 12. Problem list and treatment strategy
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.
Lesson 13. Construction elements and decision making
Individual elements of oral splints
Designing the occlusal surface of splints
Deciding making about splint guide elements.
Lesson 14. Production of splints in the articulator
Basic manipulations and principles of manufacturing splints in the articulator
Digital and manual protocols for splints manufacturing.
Lesson 15. Clinical application: looping in and adaptation
Success factors for treatment using splints
Individual splints
Splint adaptation and grinding
Surveillance and monitoring of treatment.
Lesson 16. Verticalization rail
Changing the VDO as an element of splint therapy
Application of multilayer splints
Verticalization strategy. Vertical splints.
Lesson 17. Splints with a focus on myofascial problems, myorelaxation splints
Systematic assessment of the occlusion and muscles condition
Myorelaxing splints. Elimination of myofascial problems.
Lesson 18. Basics of reciprocal clicking - including condylography
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.
Lesson 19. Splints with a focus on the temporomandibular joint - anterior disc displacement with reduction
Pathophysiology of TMJ with displaced articular disc
Dynamics of dislocation and correction of the articular disc
Treatment of anterior disc displacement with reduction.
Lesson 20. Basics of chronic joint blockade - including condylography
Risks of degenerative diseases of the temporomandibular joint developing with disc displacement
Differential diagnosis of anterior disc displacement without reduction.
Lesson 21. Splints with a focus on the temporomandibular joint - anterior disc displacement without reduction
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.
Lesson 22. Distraction and compression - definition and therapeutic use
TMJ compression. Compression degree
TMJ distraction
What is synovial fluid for?
What effect does mechanical pressure have on the structures of the TMJ.
Lesson 23. Special rails
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.
Lesson 24. Walking back, final treatment strategy and therapeutic position
Retrospective method of the therapeutic position determination
How to proceed to the next necessary treatment procedures.
