how do you see the difference in the two splints?

like the compact design of the splint and the dots and the lines

“Lines in the front, Dots in the back.”
Dr Clayton A. Chan and others, how do you see the difference in the two splints? I like the compact design of the splint and the dots and the lines. Thanks !


Discussion


Rick Coker
Amit, you have to go back and realize that marks with typing paper are inherently unreliable, and show neither force, timing or balance of the bite. While it is a lot of work to get the dots and lines done, it isn’t meaningful according the technology we have today. There has never been a study showing accuracy of articulating paper.

JP Kaminski
yet, this is what my dentist has done at every visit for the past year.

Rick Coker
It is better than nothing, like riding a horse is better than walking, but there are better ways to get around!

Amit Alok Pandey
JP Kaminski how many dots do you get on one side? I get only 5. Missing the vital second bis dots on either side.

JP Kaminski
I’m missing 4 bis- and a molar. My molar is going to be replaced by either an implant or denture

JP Kaminski
Dr. Coker, do you think one would be better than the othet

Amit Alok Pandey
which bis and which molar?

Amit Alok Pandey
How many teeth do you have in the opposing arch, 12 or 14? If you use the lower splint then how many teeth in the upper arch?

Amit Alok Pandey
The missing teeth can be the missing link in the TMJ puzzle.

Rick Coker
JP Kaminski- I don’t think either would be accurate, unless I measured them! 🙂 My point is that no matter how it might look, you don’t know all you need to know with just articulating paper!

Amit Alok Pandey
I have a new splint which is similar to the second splint and it has given me great relief. It has been only two days using it. Though I have missing second bis and so I have no contact or dots for the second bis

Gregory Yount Dmd
There is much more to it that just dots and lines. The dots can all be in the wrong place in space, just as they can be more or less forceful than necessary. Also, “lines” that you see are no more important than “lines” that you cannot see because they are not present. I agree that articulating paper without technology is pretty basic and not nearly accurate enough for a highly proprioceptive patient with multiple issues. However, technology does exist to make this process much more predictable and accurate…….

Denise Wells-Johnson
Hi, I was wondering….I know there is a scan on the K7 to determine first tooth contact, but does the K7 give any information about tooth contact as you move your jaw around in all dimensions? Thanks in advance for your reply.

Rick Coker
I never was able to correlate the K7 reading with specific teeth very well!

Gregory Yount Dmd
Denise Wells-Johnson I have never really used the K7 to examine tooth contacts outside of the “centric” areas. When the jaw moves around in other dimensions if I understand you correctly, the posterior teeth generally do not touch except in retrusive movement. The posterior teeth are discluded by the anterior teeth which are coupled to prevent premature contacts in the posterior regions. The K7 allows you to reach a point where the posterior teeth are able to occlude at virtually the same instant and intensity…….

Gregory Yount Dmd
Rick Coker I know you better than that !! LOL You are a wise and seasoned clinician., who would have no trouble with a scan 12 K7 reading…..

Tatiana Gelfand
The second splint looks great! I had a similar one made and it was the best and actually the only good thing which was done to me by a dentist in nearly 16 years now. My jaw relaxed in a few seconds!
Good luck with your splint! Don’t let it be ruined! Make small steps forward, one by one.
Amit Alok Pandey, it is not the number of dots or lines that matters! Some might be missing, it’s not a big deal. It is not what is decisive here!

Amit Alok Pandey
This is my splint. The design is awkward but giving some relief and is a confirmation of what I have been asking for. I badly need the support of second bis. The number of dots matter to me and that is decisive for me. I am saying so because this is my 21st splint. Inferences-
1 I need minimum height of 1.5-2mm on the molars
I need maximum contacts also the second bis on the splint
I don’t need forwarding of the jaw
I need higher and expanded left arch than the right. Left to be 2mm and right 1mm
more efficient design of the splint. No photo description available.

Tatiana Gelfand
Amit Alok Pandey The “plane” of occlusion does not look great which might indicate that the uppers are not quite on the proper plane either.
BTW, can you eat in it?

Amit Alok Pandey
No I can’t eat with it.

Tatiana Gelfand
I think it’s too thick for that. Right?

Amit Alok Pandey
Just not comfortable eating with it. The muscles are in a process of deprograming and that makes chewing risky. I may bite the tongue and cheek

Bjørn Hogstad
Use 12 my foil. A splint might have a lot of contact points. But the question is. Are the dots in the right position?

Rick Coker
Wouldn’t you like to know which spot hits first and how hard it hits, and when the other spots contact? I just think it is strange how we ignore timing and force here. Why not take advantage of current technology- even though it is 30 years old?

Tatiana Gelfand
This is true. Yet, IMO, if a patient is very sensitive and self-bite-aware, as most on patients on this forum became, then it is just as good as the current technology or even better! IMO, and from my experience!

Eva Willer-andersen
badge icon
cause the bite wafer itself is quite thick ? maybe the foil is actually quite good ?

Clayton A. Chan
I know foil is fine and mylar paper works as well as any other EMG timing occlusal measuring devices are great…but also, just as importantly how about knowing and determining the finer jaw positioning (locational) to land the dots precisely in all dimensions. I would hate to miss a dimension or two when trying to establish a physiologic balance of all 6 dimensions….not just balancing 2 or 3 occlusal dimensions.

Rick Coker
What are the six positions of occlusion? Are you counting trajectory there as well?

Amit Alok Pandey
What is the difference between anatomical and flat splint?
Do number of dots also important apart from right placement of dots?

Tatiana Gelfand
Excuse my interference with your conversation. Wouldn’t the trajectory depend on the damage in TMJ’s? And isn’t the goal to undo the damage as much as possible but no one can tell in advance how much can and would be undone? Yet, we do not want to force an injured TMJ into an “ideal” trajectory. How are these issues addressed with the help of computers, i.e. K7?

Gregory Yount Dmd
Tatiana Gelfand, you are correct as usual and your questions are no interference on any discussion. As the “damage” to the joints improves the trajectory does change. It can change significantly in all 6 dimensions as the cervical spine and cranial structures also change as well as the disc. Most likely the first trajectory and bite are not the optimum ones, especially in a long term closed lock situation for example. But isn’t it nice to be able to objectively follow the change in trajectory in correlation with “dots” and “lines” to see how the case is progressing ??? Rather than subjectively guessing at what is going on ???

Tatiana Gelfand
Yah… I’d say, in many cases one can just see pretty well how the jaw is deviating and whether this changes or not. Moreover, the eyes can see much more– one can see if the facial muscles, eyes, eye brows, wrinkles, ears, etc of the patient change their look and their movements during opening-closing. I’d say, K7 can be a good addition for a dentist with good visual skills and of course, a must for one who has no visual skills (it’s not that rare as one might think– LOL).

Gregory Yount Dmd
Exactly. Also, it is extremely difficult, if not impossible to see what is actually happening when the teeth are close to being closed as the lips and all are in the way. You just can’t see inside the mouth and certainly not way in the back teeth as the jaws come together. That is where something such as the K7 becomes very valuable. You are correct, it takes great visual skills and a keen attention to detail to decipher the many things that are going on all at once. In a healthy patient it is not quite such a big deal, but in someone who is severely compromised everyone needs all the help they can get from any source.

Tatiana Gelfand
I don’t have much experience with K7. I thought it’s just a few electrodes placed on the major TMJ muscles on the neck, head and face which send the info to a computer. Then how will K7 show the exact closing and contacts during the final closing along the back molars?
I used different ways when adjusting my temps. Of course, back then my jaw was not yet dislocated by a dentist. It was just completely unstable. From the dentists’ point of view, I “had no bite” so they could not help me but for myself I knew that I had “my bite”. So I was able to help myself at least to a semi-functional level which was possible without the dental work I needed (like raising ceramic crowns, putting composites, etc). I became “an easy case”, as they said. And then the new one, took it all down to the bottom– LOL.
What I want to say here is that computers can be of help but they cannot substitute good dental skills which IMO should include good eyes, good hands, good head and good heart! 🙂 LOL.

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