Unusual tools in the preparation of splints
ne in every five Germans grinds their teeth in their sleep. Dental splints can help reduce the damage this can cause to the teeth. Others need correction to their bite or temporary treatments. As a result, the range of applications for splint technology is huge. Ulrich Heker, a Master Dental Technician in Essen, Germany, produces a variety of different splints for different solutions. It is thought that twenty percent of people in Germany grind their teeth at night. That would mean there are 16 million 'teethgrinders' in Germany alone. As a result, these people suffer from headaches, neck pain, erosion, abrasions, fractured enamel and inflammation. Quite often problems also arise with the jaw/temporomandibular joint. In approximately 15 per cent of cases, the grinding can cause more serious medical conditions requiring treatment. This affects women between the ages of 30 and 45 in particular, possibly because they have stressful professional and family lives. In a recent article, Stern, a popular German magazine, aptly described this grinding of teeth: „At night, whilst you're sleeping, your worries wander from head to jaw“, and called those who gradually grind away their tooth enamel as “Dream biters“ ("Traumbeißer"). The extreme pressure can cause fracturing of the neck of the tooth, which again could lead to oversensitive teeth. In the worst case, the teeth might even break.
Fig. 1: Its sharpness and sturdy build make the large diamond disc an ideal tool to use on tough thermo-formed splints.
Master Dental Technician, Ulrich Heker, has run his own dental laboratory in Essen since 1996. Early on he was interested in Studio photography and computing. In 2007 he set up his English language website, Teeth'R'Us, aimed at dentists and patients in Britain. Visit: www.german-smile.info
(see Figures 2 & 3) as Ulrich explains. In his experience, "the shavings don't cling and the disc cuts freely" (Fig. 2). Also, due to its special construction, you can see through the large diamond disc during use and position it with precision. Consequently, it is ideal for subsequent shaping (Fig. 3). The easiest way to polish the edges is by using fibre discs. Such flexible discs contain abrasives and contour themselves around the object (Fig. 4). It is best to use these in sequence; first the brown, then the grey and finally the red one. In addition to using the thermo-formed splint to protect against abrasion, Ulrich also uses them as the basis for teeth-borne splints.
Fig. 2: The disc combines the saw-tooth with double sided, extremely sharp diamond technology.
Fig. 3: A good line of sight allows for precise contouring/shaping
A thermo-formed splint is still the quickest form of relief for 'teethgrinders'. Whilst there isn't a therapeutical aim behind a typical gum shield, it does reduce jaw movements and the pressure of chewing, thus preventing abrasion. Ulrich's laboratory produces these thermo-formed splints.
For instance, before a total reconstruction, he makes two identical plates. One represents the current dental situation (Fig. 5 and 6), the other is worn by the patient until preparation. When the patient comes into the surgery for their appointment, this splint can be of help to the practitioner to check the correct bite at any time.
A good tool for coarse and fine work on splints
A CeraLine milling tool is used to refine the edges. The brilliant white cutter is made from ceramics. (Fig. 7). As with modern kitchen knives, if used correctly, the cutting edge remains permanently sharp and clean.
Recently, Ulrich has started to use the large diamond cutting disc from Komet to cut out the moulded shape from two millimetre thick plates (Fig. 1). Although the disc was developed to make clean cuts for gears made from plaster or modelling plastic, its sharpness and sturdy nature makes it an ideal tool for working on tough thermo-formed discs. “The disc cuts effortlessly through the material being worked, due to the combination of saw teeth and super sharp diamond technology
Almost invisible The third type of splint made by Ulrich is a modified ‘Tanner’ splint, made from Orthocryl clear (Dentaurum, Germany). This stabilises the bite even in free-end situations (Fig. 8) or raises the bite if required (Fig. 9). The acrylic bars are joined by an individually cast CrCo connector.
Source: DZW ZahnTechnik · Edition 3/12 from 07.03.2012
connector. After adjusting the occlusion, the surface is finished with fibre discs. The occlusion is bedded into the bridge and the plastic is smoothed using fibre discs.
Fig. 4; Edges can be finely polished using flexible fibre discs.
The junctions between plastic and metal can be worked with a “Soft cutter”. This tool, with its unusual square shape, is effective at removing plastic without damaging or scratching adjacent metal surfaces (Fig. 10). After polishing, Ulrich sandblasts the plastic occlusal walls with 50 µm Aluminium oxide.
Fig. 8; Modified ‘Tanner’ splints serve to stabilise a free-end situation ...
This matt surface makes it easier to see any marks produced by the opposing bite. “From the patient’s perspective, the good thing about this type of splint is that the acrylic doesn't overlap the front teeth. Consequently you can't see the construction and it doesn't affect speech“, says Ulrich. Author Thomas Dürr, Bremen Translated by Dr Chris Thomas Milton Contact Ltd Fig. 5; A thermo-formed base used as a bite registration.
Fig. 7; The CeraLine-Mill with its ceramic parts is ideal for the edges of tough thermo-formed plates.
Fig. 9; ... or even raise the bite where there are gaps on one side
Fig. 10; The Softcutter, with its distinctive square shape, removes acrylic without scratching the metal surface.
Fig. 6; ... for a teeth-borne splint Picture credits; Fig. 1–3, 5–10; Ulrich; Fig. 4; Komet
Source: DZW ZahnTechnik · Edition 3/12 from 07.03.2012