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Old 09-11-2007, 08:09 AM   #1
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Stabilization Vs Repositioning Splint?

Are these two different things or the same thing? There are so many names for splints out there I'm confused.
And if they are different how does the dentist decide which one is suitable for the patient?

 
Old 09-11-2007, 11:29 AM   #2
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Re: Stabilization Vs Repositioning Splint?

I was still confused, even after my specialist told me what type of splint I had because the medical name for it wasn't simply "a stabilization splint." After getting through the medical lingo, I deciphered that I have a stabilization splint for the sheer purpose of stabilizing the joints and muscles while sleeping at night. According to my specialist, stabilizing the TMJ and muscles related, should result in healing. Ultimately, the specialist is "trained to believe" that the body can generate pseudo-discs where the displaced discs once operated. Both of my discs are displaced; the left displaced about 3-4 months before the right one. My splint is a hard, clear acryllic, that covers all of my upper teeth. The splint also has a shelf built into it (this is an extra thick ramp behind the front teeth) that supposedly helps guide the jaw back into its most physiologically accurate position therefore reducing strain on the muscles and joints. Anteriorly Guided Stabilization Splint

I don't know as much first-hand about the repositioning splints, but from what I have heard and read, they basically reposition the muscles and jaws into the most anatomically correct position, therefore reducing strain on the muscles and joints. Apparently, this splint is often expected to "recapture" the displaced discs by reducing inflamation in the muscles and retraining them to allow the disc to return to its original position. The distinguishing factor that I have seen so far, is that with this type of splint, there is normally another phase of treatment once the patient has been pain-free for several months. This phase usually entails crowns, grinding, braces, or surgery, to keep the jaws and disc set in the place that the repositioning splint has accomplished. The theory is that the changes will make the repositioning splint's "corrected position" permanent.

My specialist doesn't recommend the repositioning approach because the phase 2 changes are permanent, and should you be involved in an accident that alters the..for example new crowns...you have to start at ground zero again. Or if the muscles go back to their "TMJ" status, it will pull the discs out again anyway. His point is that your joints and muscles were once in the correct position, but the muscles pulled the discs out, which could happen again even with the changes to make the position correct again...I hope you can decipher what I am trying to explain; I am not always clear in written words.

 
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Old 09-12-2007, 02:35 AM   #3
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Re: Stabilization Vs Repositioning Splint?

Thanks for the feedback. I asked my dentist and I have a Tanner or Michigan splint which falls into the stabilization catagory. One issue I am concerned with is that when I go for the adjustments they are all to balance the bite by filing down the splint over the molars to get even dots on both sides. He's very focused on the horizontal plane but the splint has a kind of bulge in the front which has pushed my jaw further back than it was before. Logically this will place the condyle further back in the fossa or am I missing something? Is this desirable. I hate having these doubts - I mean we are supposed to trust our dentists right?

I see him next Monday so will ask
By the way are you just wearing yours at night and how are you getting on with it?

Last edited by pipdog; 12-23-2007 at 12:26 AM. Reason: More clarity

 
Old 09-12-2007, 11:21 AM   #4
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Re: Stabilization Vs Repositioning Splint?

Quote:
Originally Posted by MalAlPal6 View Post
My specialist doesn't recommend the repositioning approach because the phase 2 changes are permanent, and should you be involved in an accident that alters the..for example new crowns...you have to start at ground zero again. Or if the muscles go back to their "TMJ" status, it will pull the discs out again anyway. His point is that your joints and muscles were once in the correct position, but the muscles pulled the discs out, which could happen again even with the changes to make the position correct again...I hope you can decipher what I am trying to explain; I am not always clear in written words.
What kind of accident does he mean?
If you dont change things permanently, what prevents you from going back?

Yes, my muscles were once in the right position but something has caused my entire bite to be way off, both on one side and in the front. So for me, that must be corrected and a splint can't possibly do that. My teeth will never go back without permanent intervention.

Just wondering what he would think about that. For some people this approach is necessary. That is repositioning your joints/muscles to a point where you are comfortable and THEN moving your teeth if they are that off base as mine are. Otherwise I will be wearing a splint my whole life and eating on only one side of my mouth. Some theorize that my bite shifted and my TMJD is muscular in nature because my bite is so off - my teeth/jaw can't find a comfy position.

Well anyway - it will be interesting to see what this ortho's treatment plan is. What kind of splint he recommends for me and then what kind of permanent correction is required for my teeth.

 
Old 09-13-2007, 12:24 PM   #5
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Re: Stabilization Vs Repositioning Splint?

>I think that what the specialist means, is that the muscles themselves caused the problem, not the position of your teeth. With this in mind, even if the teeth are permanently altered to correct their position, it doesn't guarantee that the same thing will not repeat itself...and then you could be in a rought spot since the changes made to the teeth are permanent(and normally extensive). My TMJ is also muscular in nature. The bite on my left side is off, and my front teeth have moved, but my symptoms are starting to resolve with the stabilization splint.

Well for me - not only do I want my symptoms to be resolved, but it is also believed that healthwise I can't continue with an open bite on the left side. It is very bad for your teeth in general to only meet on one side. So yes - I need to resolve the muscle issue but I also must straighten my teeth. Once my bite is corrected I don't think it will change again if I wear a retainer, permanent or otherwise. So if I wear a splint and reduce the muscle pain - great. But I have tried that and it did not work. So this leads them to believe that my poor bite is affecting the muscles and causing added discomfort.

Not sure how 'off' your bite is - but my left side teeth along the side do not meet AT ALL! Nor do my front teeth - it is doubtful that TMJ alone caused this entire shift.
My joints do not need to be repositioned - it is thought that this is not a joint issue for me but rather all muscular.

Best of luck to you - sounds like you are on the road to recovery!

 
Old 09-14-2007, 07:40 PM   #6
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Re: Stabilization Vs Repositioning Splint?

My front teeth do not touch, and the left side of my teeth starting at the rear molar only touch when I apply more pressure on that side. (Can you make yours touch at all? The reason I ask, is because I'm not entirely sure what constitutes an open bite, and I have wondered if my TMJ hasn't caused this as well.) I've talked to my specialist about this, but he says that my bite isn't that bad. However, he has never run any tests that would indicate how well my teeth are meeting when I put them together. What type of test did they run on you to check this? Like I mentioned, I have to put more pressure on the left side to make them touch. I really think that because my crown on the rear left molar was filed down while my muscles were inflamed due to the TMJ, it has caused a lot of my symptoms. As far as your problem not returning if you wear a retainer after having braces, I think you're probably right. I had braces when I was younger but stopped wearing my retainer, I really wish I would have kept with it now. I hope that your treatment plan cures the problem once and for all so that you can put this problem behind you and get on with your life.

 
Old 09-15-2007, 04:28 PM   #7
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Re: Stabilization Vs Repositioning Splint?

[QUOTE=MalAlPal6;3209381]My front teeth do not touch, and the left side of my teeth starting at the rear molar only touch when I apply more pressure on that side. (Can you make yours touch at all?

Whic teeth? I can't make my top and bottom FRONT teeth meet at all.
If I shift my jaw I can make some of my teeth on the left side meet but when I naturally bite down - there is space between just about all of the top and bottom side teeth on my left side.

I think an open bite is when you bite down naturally -and your teeth do not meet. Atleast on the sides. As for the front - if you have a proper bite I am not sure if your front teeth are suppose to hit evenly or not? I think they are.

> What type of test did they run on you to check this?

Mine are so bad no test is required - any dentist or oral surgeon could see that I clearly have an unhealthy bite. I will be having a tomography on Monday night that will show a 3D version of how my teeth meet. He will also take impressions and make models of my teeth so we can see just how poorly they meet - but from a better view.

> Like I mentioned, I have to put more pressure on the left side to make them touch.

Doesn't really sound normal to me.

> I hope that your treatment plan cures the problem once and for all so that you can put this problem behind you and get on with your life

Thanks and the same to you! While TMJD does interfere with many people's lives I refuse to let it stop mine. Life is too short and I know of people who deal with far worse physical ailments. I try to count my blessings and I am thankful that my pain comes and goes and is not constant.

Good luck to you.

 
Old 09-18-2007, 03:23 AM   #8
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Re: Stabilization Vs Repositioning Splint?

No- I can make some of my side teeth meet if i shift around or push certain ways, but not all - but that is not the natural way I bite down so it is naturally open.

I will decide if I go with the day splint and night splint one I meet with the ortho for the consult after he reviews my tomography and the models he took of my bite etc. There is no way I can wear a splint all day if it affects my speech and i told him that.

As for braces - if I don't have to get them I will not. If he can take away my jaw muscle spasms then I might opt to just live with my poor bite, we shall see. Still have to address the tooth which bugs me - - not sure if that is related or not, he said he did not think it was.

He told me MANY people have displaced discs, they just don't know it because they have no pain and never see anyone about it. We just realize it because it causes us issues. This can have to do with how far off the discs are displaced and I think he said which direction but I could be wrong about that. he also had me do this thing with my fingers, taking my thumb and putting it underneath all my fingers, he said there is a theory that if you can poke your thumb thru all fingers it makes you have loser ligaments then others - and that is also a sign that your jaw can become loose and out of wack.

i still don't see how my jaw would not go back to its bad position even if I DID have braces- but he said no braces and i wear a splint at night for rest of my life.

My discs do recapture but I believe i still need a repositioning splint.

 
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