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Flatplane & Permissive Splints.......

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Cymy Sue	Flatplane & Permissive Splints.......	Lead	[-]
Posts: 7179 (12/05/05 19:48:50) Senior Member * Moderator * Reply Quote More My Recent Posts	Tags : None I was ask what type of splint has helped me. We've had a couple of articles posted before on flat planes and permissive designs, hopefully they'll be useful again. My splint is a bottom fit, hard acrylic. It doesn't have a specific name other than possibly, altered flat plane...... My dentist makes them for each individual's problems. However, it's similar to many I've seen on the net called flat planes, permissive/passive, muscle relaxant types, etc. Many dentist use a basic flat plane and will adjust it a little for different problems. I have an article from one doctor's site that explains it better than I can and will post it. Mine is very thin due to the surgical changes I have. I was told it was to support my joints and let the muscles relax passively back to a normal state of function. It did exactly that. This is mine. They all look somewhat similar. Cymy Sue Last Edited By: Cymy 03/11/09 04:24:25. Edited 1 time.
Cymy Sue	Flatplane & Permissive Splints.......	#1	[-]
Posts: 7179 (12/05/05 19:50:50) Senior Member * Moderator * Reply Quote More My Recent Posts	TMJ & FACIAL PAIN INSTITUTE - Coral Springs, Florida TMJ/TMD Facts To Help You Ease Your Facial Pain Dr. Harold Menchel (excerpts from web-site) Part of our mission at the TMJ & Facial Pain Institute is to help educate our patients as well as the general public, much of the health care field, and third party payers about TMJ, TMD and facial pain in general. Our goal is to eliminate some of the confusion that exists about these health issues and how their treatments should make logical, scientific sense Accordingly, you can make informed decisions about your treatment options and receive the proper care you require to relieve your pain. Additional sources of information about TMJ, TMD and facial pain can be found on the Links page. Why use conservative treatments? The basis of Dr. Menchels philosophy of treating TMD is: Not to make permanent changes to a patients teeth, through dental procedures, or permanent changes to the jaws or joints, through surgery, until he is certain these permanent changes are going to benefit the patient. In short: Conservative and reversible treatments should always precede permanent changes to a patients teeth or surgery. What is conservative Phase 1 therapy? Conservative TMD therapy does not change the patient permanently in any way. It should always be the first approach to TMJ pain unless there is an obvious surgical situation such as a fractured jaw. Conservative therapy is also called Phase 1 therapy and in the majority of TMD cases, no additional treatment is needed. Conservative therapy utilizes the following approaches: Bite splint or orthotics Medication for pain control and muscle relaxation Physical therapy Injections for relief of pain (anesthetic or steroid) Behavioral modification (stress relief, habit avoidance, improved sleep and nutritional habits) What are bite splints? Bite splints are plastic appliances that fit over the upper or lower teeth and provide a surface for the dentist to control how the teeth opposite the splint will hit. By doing this, the dentist can control the positioning of the jaw and use the splint to reduce forces to the affected temporomandibular joints, relax muscles, and prevent further wear on natural teeth from grinding forces. ......... Other than certain technical considerations for each individual patient, it makes no difference whether the splint is worn on the upper or lower teeth. It is Dr. Menchels personal preference to use lower splints because many of his patients wear the splint all day and night. Lower splints tend to be more comfortable, and allow better speech. Partial coverage splints cover only the back teeth or the front teeth. Because the teeth not covered do not touch with continuous wear of the splint, these teeth can now change position and erupt. The teeth that are covered by the splint can be compressed and unwanted major bite changes can occur. Dr. Menchel avoids using these splints whenever possible . Full coverage splints cover all the upper or lower teeth. Because all of the teeth are covered, the teeth under the splint are retained and cannot shift. In this case, bite changes are minimized because all of the upper teeth are touching the splint. The patient can wear these splints safely for a long time. Dr. Menchel and most other practitioners prefer to use these types of splints. Directive vs. permissive splints Directive splints have depressions or guides in them that fix the opposite teeth and hold the jaw in a fixed position. These splints were very popular in the 1980s, especially splints that held the lower jaw forward in patients that had clicking joints. Permissive splints are totally flat and smooth. They allow the muscles to relax and the jaw to find its own natural unstrained position. They provide equal contact for opposite teeth so that the jaw is supported. They also allow smooth gliding movement of the teeth as the patient grinds, so that muscles are not activated. (Think of riding in a truck on a rough road versus a limousine on a smooth highway and how much more comfortable you are when you arrive at your destination while in the limo). Permissive splints are also constructed so that patients put less force on their jaw joints when they move their jaw to the side or front. This type of splint is the workhorse of Dr. Menchels practice. Most TMD patients who respond well to bite splints will continue to wear them when they sleep even after TMJ pain has been relieved. New website listed below. Harold F. Menchel, DMD is one of a few practitioners in Florida who possesses the extensive training and experience required to manage difficult and complex facial pain problems such as TMD. Since 1981, he opened his dental practice in Coral Springs, Florida and has successfully treated facial pain patients since 1989. He earnedhis dental degree from the University of Pennsylvania School of Dental Medicine. In addition, Dr. Menchel intensively trained at the University of Florida Facial Pain Center, the L.D. Pankey Institute, and has taken hundreds of hours of continuing education instruction in TMJ treatment, pain management, anatomy, neuroscience, pharmacology and physical therapy. Dr. Menchel is board certified as a Diplomate of the American Board of Orofacial Pain. Dr. Menchel is a member of the: American Academy of Oral Medicine American Dental Association Florida Dental Association Broward County Dental Association American Headache Society American Academy of Orofacial Pain American Equilibration Society University of Florida Facial Pain Center Alumni He has held a number of offices for the Broward County Dental Association, including president, vice president, secretary, area director and program director. In 2000, Dr. Menchel received the Broward County Dental Association Service Appreciation Award. In addition, he has served as the Florida Dental Associations Atlantic Coast Delegate. Currently, he is an Adjunct Faculty member for Continuing Education in TMD and facial pain education in the Nova Southeastern University Dental School, Ft. Lauderdale, Florida. Dr. Menchel enjoys speaking to a variety of organizations about TMD and facial pain. He engages his audiences by drawing upon his extensive scientific knowledge along with his personal patient experiences to deliver emotionally charged and compelling presentations. Contact Dr. Menchel at drmenchel@tmjtherapy.com American Dental Association Florida Dental Association American Academy of Orofacial Pain American Board of Orofacial Pain American Academy of Oral Medicine American Equilibration Society Dr. Menchel has a new website. I recommend reading the TMJ/TMD & Headaches & Facial Pain portions, if not all. http://www.tmjtherapy.com/
Cymy Sue	Flatplane & Permissive Splints.......	#2	[-]
Posts: 7179 (12/05/05 19:51:58) Senior Member * Moderator * Reply Quote More My Recent Posts	I also had this explanation of flat plane splints and the different names from a long article written by Dr Shankland. The entire article contains a lot of great information and very well worth reading. Standard treatment options Dr. Wesley E Shankland II, DDS, MS, Phd, FAGD (excerpt) SUPERIOR REPOSITIONING APPLIANCE Known by numerous names, including gnathologic appliance, centric relation splint, stabilization splint, flat-plane splint, anti-bruxism appliance, and occlusal appliance, the superior repositioning appliance is used to treat bruxism, muscle hyperactivity, and muscle pain. Regardless of the name, the appliances major purpose is to provide neuromuscular relaxation via the trigeminal afferent neurons, first through the mesencephalic nucleus and then through the motor nucleus. Through this complex reflex, the motor innervation to the elevator muscles (that is, the temporalis, masseter, superior head of the lateral pterygoid andthe zygomandibularis) is adjusted, producing a neuromuscular relaxated position of the mandible that is independent from the occluding surfaces of the opposing teeth. The superior repositioning appliance covers all of the teeth in either the maxilla or mandible. Mechanically, there is no difference which arch is used as long as all of the teeth in the arch are covered, the determinants of occlusion (anterior guidance, posterior disclusion of the teeth in lateral mandibular movements,and canine disclusion) are in the splintsconstruction, and the vertical thickness is kept to a minimum (1.02.0 mm). Some dentists prefer to cover the mandibular teeth so as not to impinge orreduce the rhythmic motion of the cranial bones. Regardless of which arch is used, the goals are the same; namely, neuromuscular relaxation and the reduction of muscle hyperactivity, pain, and the effects of chronic bruxism. 64.233.179.104/search?q=c...land&hl=en

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