IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 17, Issue 4 Ver.2 April. (2018), PP 51-56 www.iosrjournals.org DOI: 10.9790/0853-1704025156 www.iosrjournals.org 51 | Page Occlusal splints Dr. Saloni Dalal 1 , Dr. Omkar Shetty 2 , Dr. Gaurang Mistry 3 1 (Department of Prosthodontixs, D.Y.Patil University- School of Dentisrty, India) 2 (Department of Prosthodontixs, D.Y.Patil University- School of Dentisrty,India) 3 (Department of Prosthodontixs, D.Y.Patil University- School of Dentisrty, India) Abstract:Occlusal splints alone or in combination with other treatmentmodalities are efficacious in the management of pain in patients with temporomandibulardisorders.Splint therapy is a proven modality for alleviating the pain of many types of temporomandibulardisorders and bruxism. The goal of this article is to review the basic principles of occlusal splinttherapy for treating temporomandibular disorder (TMD), bruxism, and toreview the basic splint designs and explain how to use these effectively. --------------------------------------------------------------------------------------------------------------------------------------- Date of Submission: 22-03-2018 Date of acceptance: 09-04-2018 --------------------------------------------------------------------------------------------------------------------------------------- I. Introduction Occlusal splint therapy has been used for many years for the diagnosis and treatment of various disorders of the masticatory system. It is recommended in oral para function, unstable occlusion, stress related pain symptoms, occlusal interferences, and in extensive restorative treatment. Splint therapy may be defined as the art and science of establishing neuromuscular harmony in the masticatory system and creating a mechanical disadvantage for parafunctional forces with removable appliances. 1 A properly constructed splint supports a harmonious relation among the muscles of mastication, disk assemblies, joints, ligaments, bones, teeth, and tendons. It is a proven modality for alleviating the pain of many types of temporomandibular disorders and bruxism. It is relatively simple, reversible and non-invasive; it has a low cost as compared with other treatments. Occlusal splint 2 (GPT-9) is defined as any removable artificial occlusal surface affecting the relationship of the mandible to the maxillae used for diagnosis or therapy; uses of this device may include, but are not limited to, occlusal stabilization for treatment of temporomandibular disorders, diagnostic overlay prior to extensive intervention, radiation therapy, occlusal positioning, and prevention of wear of the dentition or damage to brittle restorative materials such as dental porcelain. Occlusal splints have the following functions 1 : (1) to relax the muscles, (2) to allow the condyle to seat in CR, (3) to provide diagnostic information, (4) to protect teeth and associated structures from bruxism, and (5) to reduce cellular hypoxia levels. Relaxing the muscles: Hyperactivity of the lateral pterygoid muscle is caused by tooth interferences to the centric relation arc of closure 3 ; posterior tooth interferences during excursive mandibular movements cause hyperactivity of the elevator muscles 4 ; and the elimination of posterior excursive contacts by anterior guidance significantly reduces elevator muscle hyperactivity. It follows that a splint with equal-intensity contacts on all of the teeth, with immediate disocclusion of all posterior teeth by the anterior teeth and condylar guidance in all movements, will relax the elevator muscles providing neuromuscular harmony. The literature reveals that very small (50 μm) occlusal interferences can cause changes in coordinated muscle activity. 5 A muscle that is fatigued through ongoing muscle hyperactivity can present with pain. The pain caused by this activity usually will disappear if the hyperactivity of the muscle is stopped. 6 Occlusal splints are a means of reversibly altering the occlusion to reduce masticatory muscle activity. Okeson et al. found that acute or chronic symptoms of muscle hyperactivity were lessened significantly with 24- hour splint wear. Fuchs reported the advantages of splint therapy in the reduction of nocturnal EMG masseter activity in patients with temporomandibular disorder (TMD). 7 Beard and Clayton also reported reductions in muscle symptoms with splint therapy. 8 Allowing the condyle to seat in centric relation: For the condyle to completely seat under the disk in this centric relation position, the lateral pterygoid must completely relax because of its attachment to the disk through the superior belly. If this muscle stays hyperactive, the disk will be pulled anteromedially and will not seat completely over the condyle. When the disk is loaded in a power bite or through parafunctional activities, the disk, attached muscle, condylar head, condylar