Materials and manufacturing techniques for occlusal splints: A literature review

Abstract

SUMMARYObjectiveTo review the materials and fabrications methods of occlusal splints with their advantages and shortcomings and to clarify the indications for each.BackgroundTemporomandibular joint disorders (TMDs) encompass a range of conditions affecting the masticatory system. Occlusal splints are currently recognised as a viable option for the management of TMDs when they are adopted in conjunction with additional approaches varying from conservative procedures (counselling, biofeedback, physical therapy, pharmacotherapy) to irreversible and less conservative ones (occlusal adjustments, orthodontics, arthroscopy and surgery). These splints can vary in design, function and material. The components used to fabricate the splints must withstand occlusal forces, be aesthetically pleasing, comfortable and minimally interfering with function and phonetics. Traditional methods for fabricating splints include sprinkle‐on, thermoforming and lost wax techniques. However, with the advancement of CAD/CAM technology, additive (3D printing) and subtractive (milling) manufacturing methods expand the range of possibilities by introducing novel solutions for elaborating splints.MethodsAn electronic search was conducted on PubMed using the following keywords: “occlusal splint”, “guard and “materials”, and “manufacturing.” Thirteen in vitro publications were screened and they consisted of four clinical studies, nine reviews (three of them were systematic reviews), and five case reports.ConclusionThe choice of material is crucial for the success of splint therapy. Factors such as biocompatibility, ease of fabrication, adjustability, cost and patient preference should be considered. Newer materials and techniques are emerging because of advancements in material science and manufacturing techniques. However, it should be noted that most of the evidence is based on in vitro studies with different methodologies, limiting their validity in daily practice.

Literature Review of an Anterior Deprogrammer to Determine the Centric Relation and Presentation of Cases

“…The success of splint therapy is heavily reliant on the choice of material. Factors, such as biocompatibility, ease of fabrication [78], adjustability, cost [24], and patient preference must be considered during material selection [81,82]. Using bio-compatible and medically certified materials, 3D printing technology produces occlusal splints with high geometric accuracy [47,80,83,84].…”

The Effect of Build Angle and Artificial Aging on the Accuracy of SLA- and DLP-Printed Occlusal Devices

“…Occlusal splints are a valid treatment option for temporomandibular joint dysfunction (TMD), protecting the teeth from excessive antagonist wear or positioning teeth for aesthetic treatments [ 1 , 2 , 3 ]. The conventional way to manufacture occlusal splints is vacuum thermoforming or injecting heat curing acrylic resin into a silicone form after premodeling the occlusal device in wax [ 4 , 5 ].…”

Complete Digital Workflow for Fabricating an Occlusal Device Using Artificial Intelligence– Powered Design Software and Additive Manufacturing: A Dental Method

“…Regardless of whether the design is analog or automated, computer-aided manufacturing (CAM) technologies, including additive manufacturing (AM) and subtractive manufacturing (SM) methods, can be used to fabricate occlusal devices. CAM of occlusal devices may have advantages such as reduced cost, reproducibility, time-efficiency, and fewer laboratory stages [17][18][19][20][21][22] than traditional occlusal device-fabrication methods of thermoforming, sprinkle-on, and lost wax techniques. Although SM has been preferred over AM for fabricating occlusal devices for many years due to the better mechanical properties of SM resins, 21 newly introduced 3D-printed resins have promising mechanical properties.…”

“…CAM of occlusal devices may have advantages such as reduced cost, reproducibility, time-efficiency, and fewer laboratory stages [17][18][19][20][21][22] than traditional occlusal device-fabrication methods of thermoforming, sprinkle-on, and lost wax techniques. Although SM has been preferred over AM for fabricating occlusal devices for many years due to the better mechanical properties of SM resins, 21 newly introduced 3D-printed resins have promising mechanical properties. Due to AM's several advantages (eg, less material waste, reduced cost, and high productivity by fabricating multiple objects with complex geometries at the same time), AM-generated occlusal devices are increasingly used.…”

“…Due to AM's several advantages (eg, less material waste, reduced cost, and high productivity by fabricating multiple objects with complex geometries at the same time), AM-generated occlusal devices are increasingly used. 21,22 To the present authors' knowledge, there is limited information on the digital workflow for occlusal device fabrication, including automated design with AIpowered software followed by AM. In an in vitro study.…”