Splint Appliance Selection Guide - Great Lakes Orthodontics
Splint Appliance Selection Guide - Great Lakes Orthodontics
Splint Appliance Selection Guide - Great Lakes Orthodontics
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<strong>Great</strong> <strong>Lakes</strong><strong>Splint</strong> <strong>Appliance</strong><strong>Selection</strong> <strong>Guide</strong>This guide includes helpful tips on how tochoose the right splint for your patient andinformation on standard function andspecifications for <strong>Great</strong> <strong>Lakes</strong> appliancesincluding:• Anterior Deprogrammer• Flat Plane <strong>Splint</strong>• Full Contact <strong>Splint</strong> with Anterior Guidance&Several appliances as taught by clinicalleaders including:• Dr. Frank M. Spear• Dr. Peter E. Dawson• Dr. DeWitt C. Wilkerson• Pankey Institute• Dr. Jeffrey J. Brucia / FACE• Dr. John C. Kois• Dr. John C. CranhamSee inside...
<strong>Splint</strong> <strong>Appliance</strong> <strong>Selection</strong>4 steps to choosing the right splint for your patients1Choosing an <strong>Appliance</strong> TypeIssue/Concern• Occlusal muscle disorder• Protection against bruxing and clenching• Finding comfortable joint position• Occlusal muscle disorder• Protection against bruxing and clenching• Certain intracapsular disorders• Long-term wear• Occlusal muscle disorder• Protection against bruxing and clenching• Certain intracapsular disorders• Long-term wear• Provides immediate disclusion of posterior teeth(ramp provides guidance)<strong>Appliance</strong> TypeAnterior DeprogrammerFlat Plane <strong>Splint</strong> (nightguard)Full Contact <strong>Splint</strong> with Anterior Guidance2Material OptionsConsiderations• RetentionRecommended Materials<strong>Splint</strong> Biocryl<strong>Great</strong> <strong>Lakes</strong> standard for splint fabricationRetentionMost retentive• Tooth sensitivity• Increased comfort• Crown and bridgework or veneers• Tooth sensitivity• Increased comfort• A difficult path of insertion• Patient complianceHard/Soft <strong>Splint</strong> BiocrylA hard/soft combination dual layer material,acrylic is bonded to the hard side of the materialVariflex A heat-softening acrylic that softens under warm tapwater and self adjusts once seated, features goodretention. Does not contain methyl methacrylateor plasticizersCannot add ponticsCannot relineLess retentive than <strong>Splint</strong>BiocrylMore prone to wear than<strong>Splint</strong> Biocryl andHard/Soft <strong>Splint</strong> Biocryl
34Patient-Specific ConsiderationsIssue/ConcernRetention – Absence of undercutsBall ClaspsAdams ClaspsArrow ClaspsRetention w/missing teethC ClaspsAcrylic CoveragePrevent Eruption . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Full OcclusalSensitive Gag Reflex . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Horseshoe or no tissuecontact or mandibular splintMaximum Retention . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Full PalatalPatient Comfort . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . No tissue contactEdentulous or PartialImplant ProcedureDifficulty seeing splint materialEasier speech / Day wear<strong>Splint</strong> <strong>Selection</strong> & OrderingRecommendationPonticPontic or acrylic blockTint can be addedMandibular splintReview the following pages to select the exact splint to fit your patient's needs.Contact <strong>Great</strong> <strong>Lakes</strong> Technical Support Specialist, Renée Zureck, if you need assistanceor have any questions.Direct: 716.319.1223 Toll Free: 1.800.828.7626, Ext. 223E-mail: reneez@greatlakesortho.comWe will be happy to send you Rx forms and shipping supplies!We have many tools availablefor you and your staff…Ask us about instructions for takingaccurate impressions, bite registrationtechniques, and guidelines for makingefficient chair-side splint adjustments.Lower or Upper <strong>Splint</strong>?Although the majority of splints are fabricated on the upper arch,most can be fabricated on either the maxillary or mandibular arch.For the most effective splint therapy, use the Angle classificationsystem as a guideline when selecting an upper or lower splint:Class I: Maxillary or MandibularClass II: MaxillaryClass III: MandibularLaboratory Lead TimesA due date should be provided on each prescription. This date should be one day prior to the actual appointmentdate. We appreciate advance notice for all RUSH cases. Lead times may vary based on fluctuations in volume. Wewill contact you if we are ever unable to meet your requested due date. Contact Laboratory Customer Servicefor all special arrangements.
<strong>Great</strong> <strong>Lakes</strong> Standard <strong>Splint</strong>s & DeprogrammersFull-coverage splints or mini deprogrammers remove occlusalinterferences and promote normal muscle function.*Indicated for patients who can accept joint loading without pain.Full Contact <strong>Splint</strong> with Anterior GuidanceA full-coverage splint with an anterior acrylic ramp that provides lateral andprotrusive guidance against the opposing arch during function.• Full occlusal coverage• Lateral and protrusive incisal guidance• Anterior acrylic ramp• Std angle 5° greater than required to discludeposterior teeth• Std protrusive and lateral length extends from contact pointto just beyond the labial surface of the upper anteriors(approx. 4-6mm)• Point contact from lower posterior buccal cusp tipsLower: Same as upper, point contact from upper lingual cusp tipsA variety of articulators are used in-house at <strong>Great</strong> <strong>Lakes</strong>.SAM ® Panadent ®Denar ® Whip Mix ®HanauKaVoArtex ® Stratos ®We have the most common models on hand so there’s noneed to ship your articulator. We recommend sendingthe bite registration with mounted cases.If unmounted, all cases will be mounted on a SAM 2articulator unless otherwise specified.
Flat Occlusal Plane <strong>Splint</strong>(Also known as a hard nightguard)A full-coverage splint with an even, flat occlusal surfaceproviding contact for the opposing teeth.• Full occlusal coverage• No guidance• No ramp• Even, flat occlusal surface• Point contact for each opposing toothLower: Same as upperMini DeprogrammerAn anterior deprogrammer designed with a flat anterior bite plateto disclude posterior teeth, all interferences are removed.• 5-5 occlusal coverage• Open enough to eliminate interferences during function• No guidance• No ramp• 4-point contact of opposing anteriorsOption: Minimal vertical opening so posterior teethare just slightly out of contact. Ideal for patientswith a deep bite.Lower: Same as upperA mini deprogrammer can beused as a nightguard, to relaxmuscles, to treat bruxism, todetermine centric relation, andto take centric relation records.Fabrication Requirements: Upper and lower stone models with a centricrelation bite open a minimum of 1.5mm in the posterior. Facebow mountedmodels are always recommended to obtain the most accurate results.
Clinical Leader <strong>Splint</strong>s & DeprogrammersFull Contact <strong>Splint</strong> with Anterior Guidance – Spear StyleA full-coverage splint with an anterior acrylic ramp that provides lateral and protrusiveguidance against the opposing arch during function.• Full occlusal coverage• Lateral and protrusive incisal guidance• Anterior acrylic ramp• Std angle 5° greater than required to disclude posterior teeth• Std protrusive and lateral length extends from contact point tojust beyond the labial surface of the upper anteriors (approx. 4-6mm)• Point contact from lower posterior buccal cusp tipsLower: Same as upper, point contact from upper lingual cusp tipsAnterior Deprogrammer – Spear StyleA standard anterior deprogrammer featuring 1mm full occlusal coveragewith maximum contact points.• 3x3 anterior bite plate• No guidance • No ramp• 6-point contact of opposing anteriors• Open enough to eliminate interferences during functionLower: Same as upperFull Contact <strong>Splint</strong> with Anterior Guidance –Dawson StyleA full coverage splint with the addition of a small anterior lingualshelf designed to prevent the teeth from sliding out of position.• Full occlusal coverage• Lateral and protrusive incisal guidance• Anterior acrylic ramp• Std angle 5° greater than required to disclude posterior teeth• Std protrusive and lateral length extends from contact point tojust beyond the labial surface of the upper anteriors (approx. 4-6mm)• Point contact from lower posterior buccal cusp tips• 1mm anterior lingual shelfLower: Same as upper, point contact from upper lingual cusp tips
Flat Occlusal Plane <strong>Splint</strong> – Kois Style(Also known as a hard nightguard)A standard flat plane splint with a small anteriordiscluding element.• Full occlusal coverage• No guidance • No • rampNo ramp• Even, • flat occlusal surface• Point contact for opposing arch• Anterior discluding element• 2mm – length• 3mm – widthLower: Same as upperKois DeprogrammerA retainer-type anterior deprogrammer designed to discludeposterior teeth.• No occlusal coverage• No guidance • No • rampNo ramp• Point • contact for opposing centrals• Anterior discluding element• 2mm – length• 3mm – width• Wrap-around labial bow from most distal toothon each side of arch• Recommended for equilibrationLower: Same as upperCranham DeprogrammerAn anterior deprogrammer designed to disclude posterior teeth.• No occlusal coverage, full palatal coverage• No guidance • No • rampNo ramp• Point • contact for opposing centrals• Anterior discluding element• 2mm – length• 3mm – width• No clasping• Recommended for equilibrationLower: Same as upperFabrication Requirements: Upper and lower stone models with acentric relation bite open a minimum of 1.5mm in the posterior. Facebowmounted models are always recommended to obtain the most accurate results.
The Latest Technology –Digital <strong>Splint</strong> Fabrication TMfrom <strong>Great</strong> <strong>Lakes</strong>Digital System CapabilitiesCapture of 3-D ImageUpper and lower modelsare scannedFor unmounted cases, a third scanis taken with the centric relationbite record to capture theproper relationship. Casesmounted on a Denaror SAM articulator aregeometrically reproducedprecisely in software.• Full coverage single arch appliancesFlat Plane splint or hard nightguard• Even contact from all teeth on opposing arch• Smooth transitions from point to pointFull Contact <strong>Splint</strong> with Anterior GuidanceFlat plane splint with anterior ramp to guide disclusion• Ramp angle can vary - standard angle is 5° greaterthan required to disclude posterior teeth• Cases mounted on Denar or SAM articulatorsSoftware optimizes theposition of the contactpoints on theopposing arch• Unmounted cases with CR bite registration• Digital Mounting of Unmounted Cases• Rotation axis 100mm from lower centrals• Occlusal plane angle set 15° to horizontalFor splints with ramps, software isused to define canine guidance orgroup function3-D splint with even centric contactsand anterior guidance<strong>Great</strong> <strong>Lakes</strong> digital splints haveexceptionally smooth transitionsbetween contact points thatcannot be reproduced manually
Impressions & Work ModelsYour expertise,our technology & skill –A successful partnershipSuperior Quality <strong>Splint</strong>Less Chair-timeCR Bite RegistrationIncreased Practice ProfitabilityCase Arrives at <strong>Great</strong> <strong>Lakes</strong>ScanningWe will help youstep-by-step to…• Select an appropriate splint• Get the results you wantfrom the lab• Adjust and seat a splintContact Renée Zureck,<strong>Great</strong> <strong>Lakes</strong> <strong>Splint</strong> Specialist716-871-1161, ext. 223.ArticulatingDigital <strong>Splint</strong>Finished <strong>Splint</strong>Adjustment & Seating200 Cooper Avenue I Tonawanda, New York 14150 I 1-800- 828-7626 I www.greatlakesortho.com
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