The clinician must frequently make treatment decisions with limited knowledge of the appropriateness and consequences of the different options. Patients have specific expectations: that the treatment they receive is the usual one, that they have been informed of the alternatives and the consequences, and most importantly that the treatment has a reasonable chance of success. In TMJ therapy, as with most treatments, the patient's improvement is closely connected to a proper diagnosis based on sound physiologic principles. This investigation will review four basic splint types and discuss their success in the resolution of various temporomandibular disorders. Since the position of the condyle-disc-fossa, the occlusal contact pattern and the masticatory muscle dynamics are interrelated, this study will focus on the physiologic changes splints may cause with modification of this tooth, joint and muscle relationship. Hopefully, selection of a specific splint design appropriate to the patient's disorder will be facilitated by better understanding of its physiologic and therapeutic effects.
Dr. Boero is on the faculty of the Orthodontic Department at the University of the Pacific. He maintains a private practice in San Rafael, California