Managing bruxism and temporomandibular disorders using a centric relation occlusal device

This article discusses the rationale, indications, and fabrication of the centric relation occlusal (CRO) device in the management of bruxism and temporomandibular disorders. Five methods of fabricating occlusal devices are briefly discussed. Two methods, preferred by the authors, are discussed in detail, including the laboratory phase. One method uses heat-cured acrylic resin, and the other method uses a heat-vacuum machine, thermoplastic splint resin material, and autopolymerizing clear acrylic resin. The use of the CRO device in the successful management of bruxism and temporomandibular disorders has been previously documented in the literature. Some patients may not successfully adjust to the wearing of occlusal devices (splints), which are not well-defined in terms of occlusal morphology, anterior guidance, and their relativity to centric relation. This problem usually is overcome when the dentist uses precise skill in the fabrication and delivery of a CRO device with mutually protected articulation.