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TMJ splints

Kinesiology of the temporomandibular structure

Static jaw relations
(Central relation - Maximum affiliation - Central closure, Rest position)
Dynamic relations
(Κατάσπαση - Προλίσθηση - Πλαγιολισθήσεις)
Λειτουργικές κινήσεις
(Μάσηση - Κατάποση - Φώνηση)

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Construction of TMJ Splint

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The splint is an intraoral structure placed on the upper or lower dental bow, with characteristics of: sleek-flat joint surface, cervical limits to the major perimeter of every tooth, frontal guide for the dismantle of the back teeth during protrusive movement, canine teeth protection on the working side during lateral movement and functionally constitutes a guide for a more consistent loose muscular jaw relation.

The use of splint is suitable either for treatment of TMJ disorders (stabilization or centric relation splint), or checking of (bruxism) parafunctions, or after the completion of a prosthetic restoration for the need of occlusion checking or protection of the prosthetic work. It can also be used in cases where an increase of the vertical dimension is needed or as a front tooth movement splint (clicking restoration).

The TMJ dysfunction and pathology in general seems to constitute a plague of our times, considering that a 20-25% of the population has a relevant problem. A traumatic event, stress, a parafunction (bruxism) or a reflex pain can be the causes of these problems. After clinical examination and study of the medical background of the patient an exact diagnosis can be made and in the majority of cases the TMJ splint constitutes the therapeutic means so that the suffering TMJ acquires the characteristics of a normal TMJ.

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Bruxism splint

“Heavy dental contact exists in persons that exhibit (bruxism) parafunction resulting in grinding of chewing and cutting surfaces. The creation of a perfect anterior protection is necessary in these persons so that the parafunction incidents are reduced and the back teeth are protected from grindings.

A correct anterior protection includes the following elements:

1. The front teeth of the lower jaw have a lighter contact with their antagonists compared to the back teeth when they are in the position of maximum intercuspation.
2. In lateral movement there must be contact only with the canine of the working side (canine protection)
3. In protrusive movement there must be contact of the cutting surfaces of the lower incisors. If it is not possible for the four incisors to be all in contact, two contacts in both sides of the center line are considered acceptable.

Required records

Face bow record (relation of the upper jaw to the horizontal reference point).

Record of static relations of the lower jaw to the upper jaw (record of maximum intercuspation - record of centric relation with the use of anterior deprogrammer).

Records of dynamic relations of the lower jaw to the upper (intraoral & bite registrations) - (protrusive movement - left right lateral movement { placement of registration material only on the working side}).

Record transfer and adjustment of articulators

Articulators (mechanical devices that represent the TMJs and jaws and on whom the molds of the upper and lower jaw can be attached).
Classification of articulators (according to the alterable Adjustments that each system accepts and according to the placement of the condylar elements)

Classification of articulators according to the variables: Hinge - Fixed value - Semi-adjustable - Fully adjustable.
According to the placement of the condylar elements there are ARCON, NON ARCON (ARCONs have the elements of the condylar path “glenoid fossa” in the upper part and the condylar elements in the lower part).

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    Samples of TMJ Splints