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Occlusal splints are classified in this article into three groups according to the way that opposing teeth contact the splint: 1) partial occlusal contact; 2) full occlusal contact in retruded arc of closure; and 3) full occlusal contact in protrusion. Each type of splint has relative advantages and disadvantages. Splints do not reliably or predictably reduce bruxism and there are differences between individuals in their response to the wearing of splints. When treating temporomandibular disorders, splints should be provided as part of a package of conservative physiotherapy type measures. There is no evidence that any one type of splint is most effective. Long-term wearing of designs that may lead to permanent occlusal changes should be avoided or the patient should be carefully monitored for occlusal changes.
CPD/Clinical Relevance: The article describes the effect of splints on bruxism. Advice is provided on best practice in respect of the use of splints in the management of temporomandibular disorders.
Article
Occlusal splints are interocclusal appliances commonly used in dental practice to manage bruxism and temporomandibular disorders (TMD). There are many articles and studies on the effectiveness of occlusal splints. Many of the articles provide only opinions and many of the studies are not well designed and include different types of patients followed over different periods of time with different assessment and outcome criteria. There is also a large amount of web-based information regarding treatment of TMD with splints, much of which is inaccurate and misleading. This, unsurprisingly, has led to confusion about the value of dental occlusal splints.
The purpose of this article is to describe the different types of occlusal splints and to examine the evidence relating to their effectiveness in managing bruxism and TMD.
Many types of occlusal splints have been described. They may be classified according to the material from which they are made or by whether they cover some or all the teeth in the dental arch. More usefully, they can be classified into three general groups according to the way that opposing teeth contact the splint:
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