Types of dental splints

Dental splints are widely used in dentistry for various therapeutic and preventive purposes. These devices are designed to support, stabilize, or reposition the teeth and jaw to manage specific oral health issues. Their use spans across several dental specialties including prosthodontics, orthodontics, periodontics, and maxillofacial surgery. Understanding the types of dental splints available can help both dental professionals and patients make informed decisions regarding oral care and treatment options.

1. Occlusal Splints

Occlusal splints, also known as bite splints or night guards, are among the most commonly used dental splints. They are primarily designed to manage occlusal disorders such as bruxism (teeth grinding) and temporomandibular joint (TMJ) disorders.

• Hard Occlusal Splints: Made from acrylic resin, these are durable and provide significant resistance to wear. They are often prescribed for severe bruxism or TMJ dysfunction, offering support to reduce muscle tension and prevent further dental damage.

• Soft Occlusal Splints: Constructed from softer materials like silicone, these splints are generally more comfortable and suitable for mild to moderate cases of bruxism. They are easier to adapt to but less durable over time.

• Dual Laminate Splints: These combine a soft inner layer for comfort and a hard outer shell for durability. They offer a balance between comfort and functionality and are often used for moderate bruxism cases.

2. Periodontal Splints

Periodontal splints are used to stabilize teeth that have become loose due to periodontal disease or trauma. These splints help in redistributing occlusal forces, thereby reducing tooth mobility and preventing further periodontal damage.

• Fixed Splints: These are permanently attached to the teeth using dental materials such as composite resins or wires. They are best suited for long-term stabilization of anterior teeth and can be used in both upper and lower arches.

• Removable Splints: These are custom-made appliances that can be taken in and out of the mouth. Removable splints are used when temporary stabilization is needed, or when fixed splints are not suitable due to hygiene concerns or patient comfort.

3. Orthodontic Retention Splints

These splints are used post-orthodontic treatment to maintain the alignment of teeth and prevent relapse. They play a critical role in ensuring that the results achieved through orthodontic therapy are preserved over time.

• Hawley Retainers: These consist of a metal wire that surrounds the teeth and an acrylic base that sits on the roof of the mouth or the floor of the mouth. They are adjustable and commonly used after braces.

• Essix Retainers: Made from clear plastic, these retainers cover all the teeth and are more aesthetic and comfortable compared to Hawley retainers. However, they may not be as durable and can wear out faster.

• Fixed Retainers: Often made of a thin wire bonded to the back of the teeth, fixed retainers are ideal for long-term retention, especially in the lower anterior region. They require meticulous oral hygiene to prevent plaque buildup.

4. Surgical Splints

Surgical splints are utilized in maxillofacial surgeries to reposition the jaw and guide healing. These are custom-fabricated appliances based on detailed imaging and diagnostic data.

• Intermaxillary Fixation (IMF) Splints: Used during jaw surgeries to stabilize the maxilla and mandible, these splints help in maintaining proper occlusion and alignment during the healing period.

• Guiding Splints: These aid in positioning bone segments in orthognathic surgeries. They are essential for achieving the desired facial profile and functional occlusion.

5. Trauma Splints

In cases of dental trauma, particularly avulsed or luxated teeth, splints are crucial in stabilizing the affected teeth during the healing process.

• Flexible Splints: Recommended by the International Association of Dental Traumatology, these splints allow physiological movement of the teeth while maintaining stability. Materials like nylon fishing line, composite resin, or orthodontic wire can be used.

• Rigid Splints: Rarely used in modern dentistry due to the potential for ankylosis or root resorption, rigid splints may still be indicated in cases of alveolar fractures requiring absolute immobilization.

6. Myofunctional Splints

These are used to correct muscle function and posture in patients with oral habits or developmental disorders. Myofunctional appliances are commonly used in pediatric dentistry and orthodontics.

• Trainer Appliances: These prefabricated silicone appliances help in correcting tongue posture, swallowing patterns, and nasal breathing. They can guide the development of the jaw and dentition during early growth phases.

• Functional Appliances: Devices like the Twin Block or Frankel appliance work by modifying the functional patterns of muscles to encourage proper jaw growth and alignment.

7. Snoring and Sleep Apnea Splints

Dental splints can also be used to manage obstructive sleep apnea (OSA) and chronic snoring by adjusting the position of the jaw and tongue to keep the airway open during sleep.

• Mandibular Advancement Devices (MADs): These reposition the lower jaw slightly forward, helping to keep the airway open. They are custom-made for each patient and are a popular non-invasive treatment for mild to moderate sleep apnea.

• Tongue Retaining Devices (TRDs): These hold the tongue in a forward position using a suction mechanism. They are especially useful in patients who cannot tolerate mandibular advancement.

8. Sports Mouthguards (Protective Splints)

Although technically not splints in the therapeutic sense, custom sports mouthguards function as protective devices that prevent dental injuries during contact sports.

• Stock Mouthguards: Ready-to-wear but poorly fitting, offering minimal protection.

• Boil-and-Bite Guards: Slightly better fitting after being softened in hot water and molded to the mouth, but still inferior to custom options.

• Custom-Fit Mouthguards: Made by dental professionals using impressions of the patient’s teeth, offering the highest level of protection and comfort.

Conclusion

Dental splints are versatile tools in modern dentistry, addressing a wide spectrum of oral health conditions ranging from occlusal disorders and trauma to orthodontic retention and sleep apnea. The type of splint used depends on the specific clinical needs, duration of treatment, and patient preferences. Proper diagnosis, customization, and patient compliance are critical to the effectiveness of any dental splint therapy. As dental technology evolves, newer materials and fabrication techniques continue to enhance the precision, comfort, and outcomes associated with these devices.