Occlusal Splints

Cushion Bite Splints
The next generation of occlusal therapy
Designed by Dr David Penn BDS MBA

Gelb style cushion splints in Bioflex material

The key to delivering bite splints in an effective manner is to use a material that requires little or no adjustments whilst providing maximum comfort to the patient foe best compliance. A material that fits both of these requirements is the SMH BioFlex.

Figure 1. Typical clinical appearance of bruxism

Indications

• Bruxing & clenching patients
• Symptomatic TMD patients
• Pre & Post restorative patients
• Periodontal stabilization

The incredibly soft yet durable and flexible material is the secret to the success of this device. Dr. Gordon Christensen remarked that there are between 500 to 1000 bite splints waiting to be made in every dental surgery. He estimates that one-third of the population either brux or clench their teeth, resulting in tooth damage (Figures 1). He also states that “If a dentists merely ‘watches’ patients as they wear their teeth down, he or she is practicing supervised neglect and contributing to continued tooth destruction.”

Gelb Cushion splint in vivo

Bruxism is most commonly defined as the non-purposeful grinding of teeth in eccentric positions that eventually removes canine rise, incisal guidance, and posterior tooth cusp tips. Most bruxism takes place at night, although patients tend to deny this habit. As a result of their advanced tooth wear, most bruxers have a group function occlusion. The end result of bruxism is usually highly worn teeth,with a relatively flat plane of occlusion, and a group function occlusion in the dentition. If left untreated, many of these patients have unsightly and mutilated dentition by the age of 40.

Clenching is typically defined as the non-purposeful closing of teeth in centric occlusion. Clenchers are also more active at night, but you may notice them clench at any time by observing their bulging, strongly developed masseter and temporalis muscles in action. Typically, clenchers accentuate and deepen centric occlusion tooth contacts. They tend to have steep canine rise, incisal guidance, and posterior tooth cusp tips. Dr. Christensen feels the solution to both of these conditions is a bite splint worn at night, as well as, during periods of psychological stress, in the daytime. In his 40 years of practice, he estimates that 80% of TMD cases have been muscular in nature and have responded well to bite splint therapy, and subsequent occlusal equilibration.

Figure 2. PVS impressions with a light body wash creates accurate master model

While a bite registration is not necessary to construct a bite splint, the best fitting splints are constructed using an accurate CO bite.

The models or the impressions, along with the bite registrations and the prescription requesting a Cushion Bite Splint, with either flat plane occlusion or anterior guidance, are forwarded to SCDL.

As a result of the Cushion Splints material, you should expect there to be no adjustments necessary to seat the splint, and perhaps just a minor adjustment to the bite . Unlike delivery of hard bite splints where the patient often winced when the splint was being placed for the first time, the patient is often able to place the Cushion Splint for the first time by themselves, with no discomfort or feeling that their teeth are being forced out of position.

Michigan Style splint in Bioflex material