FDI Worldental Daily, 15 September

www.fdiworldental.org ANNUAL WORLD DENTAL CONGRESS NEWSPAPERYOUR FDI WDD #2, September 15, 2011 AquaSplint The AquaSplint is a self-adjusting, customi- sable, pre-fabricated TMD splint which can be inserted immediately without prepara- tions, impressions, or registrations. The devi- ce consists of two water pads connected by a tube (hydrostatic aquabalance). The water pads are provided with an acrylic saddle, whichcanberelinedwithalong-termsilicone material. Such individualization enables im- mediate optimum stability and comfort and, unlike conventional hard bite splints , offers the following advantages: • immediate pain relief without laboratory procedures or preparations; • universaluseandinsertableinthepatient’s mouth, within a few minutes; • self-adjusting, no grinding or frequent re- call appointments required (thanks to the hydrostaticbalancebetweenthetwowater pads) • replaces the relaxation and distraction splint (no increased compression within the joint in contrast to splints with frontal bite plane) • high accuracy and comfort of fit through individual relining • no more than 10 hours of daily wearing (8 hours by night, 2 hours by day) • excellent clinical results and patient sa- tisfaction owing to rapid pain reduction, comfort, and advantageous repositioning of the mandible • higherstabilityandlessvisibilitycompared to a maxillary splint In comparison to similar aqua pads the AquaSplint offers the following advanta- ges: • increased muscle relaxation: i.e. conven- tional products must be held in position by permanent mouth closure or muscular activity, which may interfere with sufficient muscle relaxation. The immanent stabi- lity of the AquaSplints (relining) and the favourable positioning of the mandible enable improved muscle relaxation. • the only self-adjusting customisable TMD bite splint applicable even during or- thodontic treatment (“prior blocking out of brackets with protection wax”) (Fig.3, 3a) • longer life time (4-6 weeks) with hardly any loss of fluid • devoid of sharp edges Indications • Rapid pain relief, particularly in acute ca- ses (e.g., accidents, trauma, and disc dis- placement, without reduction, associated with markedly limited mouth opening and difficult impression-taking) • Muscle relaxation, particularly in cases of acute or intermittent teeth grinding (Bruxism/clenching), e.g. during stress periods such as exams and acute psycho- logical trauma (not suitable for chronic bruxism) • Identification and elimination of hidden functional disorders, premature contacts, forced bites • Simple pre-prosthetic / pre-orthodontic bite determination • High differential diagnostic validity and supportive therapy in associated diseases with multifactorial aetiology (neck disorder syndrome, tinnitus, migraine headache, stress syndrome and sleep apnoea) • Adjunct treatment supportive of osteopa- thic/physical therapy after trauma and surgery Due to the hydrostatic effect of the two water pads, the jaw position and occlusal contacts become levelled and harmonious, without grinding-in and adjustment (conventional bite splint), i.e. the mandible achieves a self- balanced position. Thisnewpain-free/pain-reducedtherapeutic position provides the basis for subsequent occlusal rehabilitation (prosthetic in vertical discrepancies, orthodontic in transversal, and sagittal discrepancies). In addition, the three primary tasks of clas- sic splint therapy are addressed: decoupling of pathological occlusion, tone reduction of hyperactive masticatory muscles, and reduc- tion of enamel abrasion. Convenient and simple handling The saddle width can be adjusted, when ne- cessary, through expansion, compression or cutting. This makes the AquaSplint applica- ble to any tooth shape, crown/bridge, and brackets or bands.The Aqua Splint can not be used as a permanent splint without an additional 0.5 mm thin stabilizing material (Fig.9), as undesired occlusal alterations/ changes cannot be ruled out. The additional 0.5 mm splint has proved a good compro- mise solution especially for patients who are unable or unwilling to wear a rigid bite splint, after AquaSplint therapy. Furthermore, those additional thin splints clearly prolong the life- timeoftheAquasplint,particularlyinbruxism cases. Usually, prosthetic/ orthodontic re- habilitation or an adjusted permanent splint (as a compromise) should follow AquaSplint therapy. If the malocclusion has been the mainreasonofthepain,andifthereisahuge discrepancybetweentheoldandthenewthe- rapeutic/painlessocclusion,thenpermanent phase2changesarerequired.Insomecases, occlusal rehabilitation is unnecessary, espe- cially if the existing TMD mainly results from trauma or systemic disease rather than from the malocclusion. Should AquaSplint therapy fail to yield consi- derableimprovementafter4-6weeks,stoma- tognathic factors can be ruled out as a main cause of TMD. Unfortunately, such patients cannot be helped in the dental practice, ex- cept for abrasion prevention. In these cases, interdisciplinary consultation involving other disciplines such as ENT, orthopaedics or psy- chology is recommended. Conclusion Our experience with the AquaSplint concept has shown excellent clinical results and pa- tient satisfaction, particularly due to rapid pain reduction, wear comfort, and favourable repositioningofthemandible.Greatadvanta- ges for the provider are the simple and quick diagnostic procedure, the effective therapy, andthechancetodispensewithimpressions, registrations, laboratory procedures and grinding-in of hard splints. The new concept does enable us to provide exact diagnosis, and targeted therapy, at a reasonable time and expense. 28