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cosmetic dentistry_ beauty & science

24 I I industry report _ TMJ QuickSplint Fig. 4_Intra-oral realignment, patient wearing the TMJ QuickSplint. Fig. 5_The take-home package for same-day night-time wear. cosmeticdentistry 1_2013 disharmony and overall destabilisation of the bite. Sleep bruxism, like many other oral condi- tions, is often painless but without intervention leads to more tooth wear and can result in TMJ pain and pathology. Moreover, studies have shown that more than half the patients who grind their teeth due to para-functional habits are not aware of the behaviour, which can interfere with treatment needsandcaseacceptance.Withtime,sleepbrux- ism can result in firm and enlarged muscles of mastication. Enlarged muscles can increase the challenges of case aesthetics and often make it difficult to obtain a passive centric relation oc- clusal bite record. In my practice, anterior deprogrammers have been used successfully for many years. These devices can help relax overused or hyperactive muscles. They allow the joints to seat passively in their anatomically ideal location through a protective pathway once the patient’s occlusion is disengaged. Used as a diagnostic tool, as a first line of treatment or as a step in treatment, anterior deprogramming devices are a valuable treatment tool. The TMJ QuickSplint is a semi-custom anterior bite plane (deprogrammer) that was developed for immediate placement with minimal demand on the provider regarding time, cost or treatment expertise. Although other methods currently exist, I have found the TMJ QuickSplint to be especially useful in the following two areas in aesthetic dental care. _Achieving accurate open-bite centric relation records A simple technique that can be used to achieve accurate bite records involves using the TMJ QuickSplint as a night-time appliance for one weekpriortorecordmaking.ThedesignoftheTMJ Quick Splint shell and recommended fabrication technique provide a simple, consistent, reliable and fast method to deliver this device chairside. The TMJ QuickSplint used as a deprogrammer will relax the patient’s muscles of mastication and help provide a repeatable, accurate centric relation record. The TMJ QuickSplint is designed for maxillary or mandibular arch use, based on maximum contact, occlusal stability, operator preference or patient comfort. The procedure is simple. After using the device for seven to ten days, the patient returns for records to be made. With the TMJ QuickSplint in place, the patient is asked to bite on the anterior plate (of the TMJ QuickSplint), slide forward and backward a few times and then while the jaw is in the most retruded position to firmly bite down on the TMJ QuickSplint and to hold and squeeze the jaw to stabilise the position. Bite record material is then injected between the posterior teeth and allowed to set. The TMJ QuickSplint is then removed and the patient is asked to bite into the freshly made posterior sec- tions that provide stability while new material is injected onto the anterior region, providing an ac- curate full-arch open-bite centric relation record. _Protecting provisionals and final restorations Another common and significant problem is keeping provisionals in place while waiting for laboratory-fabricated restorations to be com- pleted. It is not practical to fabricate any perma- nent bite protection for patients in provisionals and most systems on the market involve rigid acrylic liners that could potentially damage and Fig. 4 Fig. 5