A repositioning splint is an oral appliance used in dentistry to manage various jaw issues. This custom-made device addresses temporomandibular joint (TMJ) dysfunction by improving jaw alignment and alleviating symptoms.
Understanding Repositioning Splints
A repositioning splint is a custom-made dental appliance, typically fabricated from hard acrylic resin, designed to fit over either the upper or lower teeth. Unlike general nightguards, which primarily protect teeth from grinding or clenching, this splint has a distinct purpose: to guide the lower jaw (mandible) into a specific, predetermined forward position.
The unique design of a repositioning splint features ramps or indentations that direct the jaw’s movement, preventing the teeth from sliding over the bite plane. This intentional guidance helps to achieve a precise jaw position. While both are types of occlusal splints, the repositioning splint’s goal is to actively change the jaw’s relationship, not just protect the teeth.
Conditions Addressed by Repositioning Splints
Repositioning splints are primarily prescribed for temporomandibular joint (TMJ) disorders, particularly internal derangements like disc displacement with reduction. This condition occurs when the articular disc, a small cartilage disc within the TMJ, is displaced from its normal position when the mouth is closed, but returns to its correct alignment upon opening. This displacement often causes audible clicking, popping, or snapping noises in the jaw.
The need for repositioning arises because jaw misalignment or disc displacement can lead to pain when chewing or talking, headaches, earaches, and general orofacial pain. By guiding the jaw into a specific position, the splint aims to “recapture” the displaced disc, allowing it to return to its proper relationship with the condyle and fossa. This re-establishment of disc-condyle harmony is effective in alleviating symptoms like joint pain and often eliminates reciprocal clicking.
How Repositioning Splints Function
The mechanism of a repositioning splint involves physically guiding the mandible to a therapeutic position, often forward or forward and downward, to allow the displaced articular disc to return to its proper place. This forward positioning helps to “capture” the disc, ensuring it remains correctly positioned relative to the condyle and fossa during jaw movements. This action reduces intra-articular pressure and minimizes stress on the affected joint tissues.
By maintaining the disc in its correct anatomical relationship, the splint can alleviate symptoms such as pain, clicking, and popping. The continuous repositioning allows the jaw muscles to relax and facilitates a more harmonious relationship within the stomatognathic system. This can lead to a reduction in abnormal muscle activity and a decrease in joint loading, which promotes tissue adaptation and repair within the temporomandibular joint. The splint essentially provides a stable and balanced bite, allowing the joint to heal and function more smoothly.
The Repositioning Splint Treatment Journey
The treatment journey with a repositioning splint typically begins with a thorough diagnosis and examination by a dental professional to assess the specific TMJ condition. If a repositioning splint is deemed appropriate, impressions of the patient’s teeth are taken to allow for the custom fabrication of the acrylic appliance in a dental laboratory. This ensures a precise fit tailored to the individual’s oral anatomy.
Once the splint is fabricated, the dentist will fit it and make any necessary adjustments to ensure comfort and proper jaw positioning. Patients are generally advised to wear the splint for an extended period, often around 20-24 hours per day, only removing it for meals initially, for approximately three months. Regular follow-up appointments are scheduled to monitor symptom progression, assess the splint’s fit, and make further adjustments as needed. The goal of this initial phase is to achieve stability and symptom remission, with the possibility of gradually reducing wearing time or transitioning to a different phase of care, such as a stabilization splint, once the joint has stabilized.