RehaSplint Dental Splint

On the inner sides of the bite pads, there are small indentations, similar to a golf ball, to achieve better retention on the occlusal surfaces of the upper jaw (maxilla). Both bite pads have a slight wedge shape to ensure even occlusal support.

1. Initial Splint Therapy for TMD

The RehaSplint is an immediately applicable occlusal splint for the protection of teeth. For patients showing typical signs such as scalloped tongue (indentations) or lesions on the cheeks, such a temporary splint is recommended. Also for patients reporting typical symptoms of TMD (Temporomandibular Disorders) such as headaches, TMJ pain, etc., the RehaSplint can be helpful as initial care as well as an entry point into further splint therapy.

2. The Neuromuscular Relaxed Position of the Mandible

The RehaSplint resolves adapted protective postures and can guide the lower jaw (mandible) into a neuromuscularly relaxed position after prolonged wear (min. 30 min).

Once a comfortable neuromuscularly relaxed position has been determined for the patient using the RehaSplint, this position can be registered using a bite registration. Since the RehaSplint is open anteriorly, silicone bite registration material can easily be introduced between the anterior tooth rows. The RehaSplint remains in the mouth during this process. It is also possible to register the found position of the mandible using a wax bite (e.g., BAUSCH Arti-Pink x-hard).

Using the neuromuscular bite registration, the models are then mounted in the articulator to fabricate a fixed individual occlusal splint in this neuromuscular position later in the therapy. Transferring the anatomical position of the maxilla using a facebow is also recommended before articulating the models.

3. RehaSplint as a Diagnostic Tool

Summary:

For patients with typical symptoms of Craniomandibular Dysfunction (CMD/TMD) or myoarthropathy, the RehaSplint can be used for differential diagnosis.

The Diagnostic Protocol:

1. Initial Test Phase (24 Hours)

To check if the pain status changes, the patient wears the RehaSplint initially for a short period of 24 hours.

2. Evaluation of the Clinical Reaction

Scenario A: Significant Relief of Symptoms

• Cause: A neuromuscular cause can be assumed. The soft bite pads compensate for disturbing premature contacts (occlusal interferences), thereby resolving adapted protective postures.
• Next Steps: The patient wears the RehaSplint as a temporary splint for 2–4 weeks until the individual occlusal splint is fabricated.

Scenario B: No Noticeable Relief

• Cause: The symptoms are likely superimposed by other factors (multifactorial diagnoses). These include, for example, disc displacement or inflammation of the joint capsule (capsulitis).
• Next Steps: Before further treatment, a comprehensive diagnosis using other techniques should be performed (e.g., manual structural analysis acc. to Prof. Axel Buman or electronic recording of jaw movements).

Medical Background: Mode of Action and Pathology

Occlusal interferences are a possible etiological factor for such myoarthropathy. Every restoration, extraction, prosthetic treatment, as well as orthodontic treatments always change the occlusion in statics and dynamics. Even the smallest occlusal interferences in the µm range are perceived as disturbing via the proprioceptive information of the stomatognathic system.

This leads to adaptation mechanisms that can result in functional overload of the craniomandibular system. In patients complaining of typical TMD symptoms after new fillings, crowns, bridges, and orthodontic treatments, the occlusion should be examined thoroughly. Premature contacts are often perceived as unpleasant. Teeth have a reflex function that is immediately registered by proprioceptors in the periodontium, tooth contacts, as well as premature contacts. Masticatory force and thus muscle function are controlled via this control loop.

If this control loop is disturbed by an occlusal interference, the patient attempts to compensate for it by adopting a new MIP = Maximum Intercuspation (habitual, non-physiological position), with corresponding consequences for the involved tissue structures. Through the soft bite pads of the RehaSplint, such disturbing premature contacts are compensated and the mandible can move freely. Adapted protective postures are quickly resolved, and the patient adopts a symptom-free neuromuscular position.

Should the patient report no noticeable relief of symptoms, the neuromuscular complaints are likely superimposed by other causes. Such multifactorial diagnoses can be, for example, a displacement of the disc or already an inflammation of the joint capsule. Therefore, before further treatment with the RehaSplint, a comprehensive diagnosis with other techniques or diagnosis-specific instruments should be undertaken.

Manual structural analysis according to Prof. Axel Buman and electronic devices for recording jaw movements (ZEBRIS JMA, Bluefox, Arcus Digma, Axioquick (SAM)) have proven effective in this context. The AFR-Mini-Reg System manufactured by us can also be used for simple determination of TMJ movements.

Thus, the RehaSplint can be used as a quick initial diagnostic tool to check whether the patient's pain state changes (better, unchanged, worse).

If improvements are noted, the patient can wear the RehaSplint as a temporary splint over a period of (2-4 weeks) until their individual occlusal splint is fabricated.