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  • What's the difference between upper and lower bite splints? A cause of open bites?

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    Old 06-07-2004, 04:04 PM   #1
    MSUGuy02
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    Question What's the difference between upper and lower bite splints? A cause of open bites?

    After going through an upper repositioning bite splint 2 years ago, I ended up with an open bite. Not as much pain, but definitely an open bite. I went through orthognathic surgery to fix that. But since symptoms have worsened (ten fold worse than ever before braces or surgery), I went to the new specialist that says upper splints "do nothing" to help the compression, and I'll be having a lower bite splint.

    All I know is that I do NOT want to end up with an open bite again. Not after going through all that surgery and over a years worth of braces. I want the pain to be gone and normal function, but does that mean I have to sacrifice the only good thing that came from my surgery?

    Also - have you guys heard of a true difference or benefit of lower/upper splints?

    Thanks
    Andy

    Last edited by MSUGuy02; 06-07-2004 at 04:06 PM.

     
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    Old 06-08-2004, 06:53 PM   #2
    Michelle99
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    Re: What's the difference between upper and lower bite splints? A cause of open bites?

    FWIW, I can tell you what I know about bites opening during splint therapy. I'm basing this on the experience I've had with my bite opening while using NTI. In my case, the NTI allowed my muscles to be less tense which in turn allowed my condyles to seat in a more stable position. In this more stable position, my bite is open in the anterior. It's just an opinion, but it makes sense to me that any type of treatment that diminishes muscle tension long term could potentially allow the condyles to seat differently.

    I don't think it's that the splint causes the open bite, but it uncovers it. What I mean by that is, I believe by clenching for so many years I caused my muscles to always be tense and force my bite to be more closed. If I weren't a clencher, I believe my bite would have been naturally open anyhow

    I think some people are more prone to open bites with splint therapy than others though. My teeth were edge to edge with no overlap, so it didn't take much for my bite to open. If you have a good degree of overlap now, I would think the risk is smaller.

    I don't know if it matters whether the splint is worn on the upper or the lower. Definitely discuss your concerns with your doctor, and good luck with the rest of your treatment.

     
    Old 06-09-2004, 10:56 AM   #3
    Katie G
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    Smile Re: What's the difference between upper and lower bite splints? A cause of open bites?

    Quote:
    Originally Posted by MSUGuy02
    After going through an upper repositioning bite splint 2 years ago, I ended up with an open bite. Not as much pain, but definitely an open bite. I went through orthognathic surgery to fix that. But since symptoms have worsened (ten fold worse than ever before braces or surgery), I went to the new specialist that says upper splints "do nothing" to help the compression, and I'll be having a lower bite splint.

    All I know is that I do NOT want to end up with an open bite again. Not after going through all that surgery and over a years worth of braces. I want the pain to be gone and normal function, but does that mean I have to sacrifice the only good thing that came from my surgery?

    Also - have you guys heard of a true difference or benefit of lower/upper splints?

    Thanks
    Andy
    Hey there again Andy, how's it going? Interesting that your TMJ guy said upper splints do nothing, because my "expert" here in central MI says upper splints generate the quickest recovery. So who knows? I think the whole TMD/TMJ process is sometimes just a "shot in the dark" and I can only pray that mine turns out for the best.

    I truly do trust my ortho here since he has treated TMD for years (as well as gone through the treatment himself) and I know his treatment practices continue to evolve since what he recommended to me 15 years ago is completely different today since my TMD has worsened considerably in that time. Just to let you know what's going on with me related to splint therapy. According to my X-rays and measurement results, I ended up with an upper splint 24/7 (started Oct. '03), and since that time, my already open bite has actually become more open. My ortho says that's actually progress related to the splint, because my jaw joints were actually displaced forward (anterior) to the fossa, and my bite appears to be more open because the condoyles are actually becoming more "seated" in the correct posterior position. Therefore, once the condoyles are stable and my TMD symptoms are virtually (if not completely) gone, then I will move onto Phase II which will require surgery to adjust the position of the maxilla and "close" my bite. I will probably also need braces to align my teeth.

    So in other words, my ortho believes in an upper splint for me to reposition the mandible/condoyles, and allow them to move into their correct position.

    Does this all make sense?

    Katie G

     
    Old 06-12-2004, 09:03 PM   #4
    MSUGuy02
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    Re: What's the difference between upper and lower bite splints? A cause of open bites?

    Katie,

    Sounds like what happened to me about 2 years ago with my other splint therapy - I was doing fairly well then had an open bite that was INCREDIBLY over-diagnosed and it was all downhill after that.

    I had an MRI on friday and I'm seeing my specialist again on Tuesday to get my splint. My ortho gave me a splint 2 months ago, but it actually made things 10x worse and I'm going to have a nicely heated discussion with him. I've never liked the man, and he's blatently disregarded that I had TMJ while I was going through the whole surgical process. It was horrible. My parents are actually considering pressing charges for major malpractice. I guess we'll see what the new guy has to say.

    Also - my new specialist submitted stuff to my insurance company and he put that my orthotic device (the splint) would be $1,500. I'm pretty sure I heard him say he'll price it higher so the insurance company will more than likely pay the costs and then we don't have to pay anything - but if he only put $500 then they'd pay like 50 bucks! Smart, but I hope it works.

    Anyways... what do you think about the malpractice and some other stuff??

    Thanks,
    Andy

     
    Old 06-14-2004, 07:56 AM   #5
    Katie G
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    Smile Re: What's the difference between upper and lower bite splints? A cause of open bites?

    Quote:
    Originally Posted by MSUGuy02
    Katie,

    Sounds like what happened to me about 2 years ago with my other splint therapy - I was doing fairly well then had an open bite that was INCREDIBLY over-diagnosed and it was all downhill after that.

    I had an MRI on friday and I'm seeing my specialist again on Tuesday to get my splint. My ortho gave me a splint 2 months ago, but it actually made things 10x worse and I'm going to have a nicely heated discussion with him. I've never liked the man, and he's blatently disregarded that I had TMJ while I was going through the whole surgical process. It was horrible. My parents are actually considering pressing charges for major malpractice. I guess we'll see what the new guy has to say.

    Also - my new specialist submitted stuff to my insurance company and he put that my orthotic device (the splint) would be $1,500. I'm pretty sure I heard him say he'll price it higher so the insurance company will more than likely pay the costs and then we don't have to pay anything - but if he only put $500 then they'd pay like 50 bucks! Smart, but I hope it works.

    Anyways... what do you think about the malpractice and some other stuff??

    Thanks,
    Andy

    Hi there Andy - gosh, I'm not sure what to think. I'm beginning to think my treatment sounds an awful like your first treatment, and I sure as heck don't want to end up worse than I am now.

    I always think "malpractice" in the back of my mind with any specialist, but then I also have to remember that these guys are hopefully (!) providing the best treatment possible for each patient to the best of their skill and knowledge. I've been trying to take this whole TMD treatment one day at a time, but still I question my ortho every time I go in just to make sure I'm really on the right course of treatment. Of course, he could be lying and saying I'm doing great when I'm not, and I know my case is a challenging one for him since my TMD is so severe. However, I know he's also not so egotistical that he won't refer me to someone else if he's unable to complete my treatment successfully.

    I think when it comes to malpractice, talk to an attorney with malpractice knowledge and see what steps you should follow. It makes me sad to read so many "un-success" stories on this board, that I'm always worried I may be another one in the future. I think TMD treatment must be individualized for the patient, and I know that I don't have all the answers when it comes to my treatment.

    Keep me posted on what you decide.

    Katie G

     
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