References

Baad-Hansen L, Jadidi F, Castrillon E, Thomsen PB, Svensson P. Effect of a nociceptive trigeminal inhibitory splint on electromyographic activity in jaw closing muscles during sleep. J Oral Rehabil. 2007; 34:105-111
Becker I, Tarantola G, Zambrano J, Spitzer S, Oquendo D. Effect of a prefabricated anterior bite stop on electromyographic activity of masticatory muscles. J Prosthet Dent. 1999; 82:22-26
Bereznicki T, Barry E, Wilson NHF. Unintended changes to the occlusion following the provision of night guards. Br Dent J. 2018; 225
Poyser NJ, Porter RWJ, Briggs PFA, Chana HS, Kelleher MGD. The Dahl Concept: past, present and future. Br Dent J. 2005; 198
Kinoshita Y, Tonooka K, Chiba M. The effect of hypofunction on the mechanical properties of the periodontium in the rat mandibular first molar. Arch Oral Biol. 1982; 27::881-885
Lund S, Broberg C. Effects of different head positions on postural sway in man induced by a reproducible vestibular error signal. Acta Physiol Scand. 1983; 117:307-309
Stapelmann H, Türp JC. The NTI-tss device for the therapy of bruxism, temporomandibular disorders, and headache – Where do we stand? A qualitative systematic review of the literature. BMC Oral Health. 2008; 8
Todd MA, Freer TJ. Anterior open bite as a complication of splint therapy. Aust Orthod J. 1994; 13
Magdaleno F, Ginestal E. Side effects of stabilization occlusal splints: a report of three cases and literature review. Cranio. 2010; 28:128-135
Blumenfeld A, Bender SD, Glassman B, Pinto A. Patterns of use for an enhanced nociceptive trigeminal inhibitory splint. Inside Dentistry. 2011;

Letters to the Editor

From Volume 46, Issue 2, February 2019 | Pages 184-185

Authors

Matt Everatt

Technical Director S4S Dental & Smilelign UK

Articles by Matt Everatt

Article

(Dent Update2018; 45: 912−918)

I would like to respond to an article published in the November issue of Dental Update. There are a number of issues with the article in which the authors, Jagger and King, make some comments without adequate references.

The authors report that evidence on splints and efficacy is limited and most articles are opinion based. On this I agree: there are limited clinical studies for occlusal splints.

The authors mention in the section on ‘Anterior bite planes’ that ‘the splint must contact the opposing 4 incisors to prevent overloading teeth’. There is no scientific reference to suggest that the teeth would be overloaded. On the contrary, EMG studies have been shown to reduce forces when posterior contacts are removed.1, 2

The authors suggest that anterior bite planes cause teeth to supra-erupt. This is a common myth that sadly causes much debate and confusion in dentistry. The Dahl appliance is often referenced with regard to supra-eruption, however, this can also be misleading. Bereznicki et al refer to a review of the Dahl concept by Poyser et al ‘the time to achieve intrusion/extrusion of teeth to a new, desired vertical dimension is considered to range from one to 24 months, with continuous 24 hour a day wear of an appropriate, suitably designed appliance. The Dahl appliance is designed to be bonded in the patient's mouth and worn 24/7 with all teeth except those in contact to never be in any function. The idea is to supra-erupt the posterior teeth during a restorative phase of treatment. This is not the same as a patient using a night time splint for a few hours’.3, 4 The research by Kinoshita et al would also suggest that teeth are unlikely to supra-erupt.5

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