A disclusion appliance to eliminate occlusally generated TMD symptoms prior to, and during, fixed orthodontic therapy

Temporomandibular disorders are of multifactorial origin. If it is determined that the patient's occlusal scheme is a contributing factor to his/her TMD symptoms, it is accepted that reversible, noninvasive procedures be instituted at the outset of treatment. Splint therapy conforms to this guideline and serves to provide temporary, reversible alteration of the occlusal scheme in order to provide this relief. In a mutually protected occlusion, the posterior teeth accept the occlusal force of closure, while the anterior teeth serve to separate the dentition during excursive movements. The purpose of the disclusion splint described in this article is to eliminate muscle hypertonicity, along with its ensuing problems, by establishing a mutually protected occlusion via the guide planes created by the acrylic portions of the splint. Simultaneously, it does not compromise the patient's freeway space but acts as a preorthodontic, adjunctive-orthodontic, or post-TMD "stabilization-retentive" appliance because of its inherent ability to promote disarticulation of occluding dental surfaces during function.