Protrusive positioners

Techniques were described for fabricating maxillary and mandibular protrusive positioners for treatment of disk-condyle derangements. Treatment time with the splints varies from 4 to 12 months depending on the age of the patient, the degree of existing symptoms, and patient motivation. At the end of the treatment period and after removal of the splints, the patient may have (1) no pain or internal derangement, (2) no pain but internal derangement with or without reduction, or (3) pain and internal derangement with or without reduction. If dental treatment is required, patients in the first two categories can be treated at a physiologically acceptable treatment position with existing treatment modalities. For patients in the third category, definitive, irreversible stabilization should be reevaluated. For these patients a mandibular cast splint can be changed to an interim splint by replacing the self-polymerizing resin with Isosit (Ivoclar-Vivadent, Schaan, Liechtenstein) or heat-processed acrylic resin.