Occlusal Splints and Manufacturing Techniques from Traditional to Digital

Abstract

Occlusal splints are commonly used dental appliances for the diagnosis and management of temporomandibular joint disorders, bruxism, and occlusal trauma. While traditional fabrication techniques have long relied on manual processes such as plaster models, wax-ups, and acrylic manipulation, the integration of digital technologies into dental practice has brought forth innovative methods including CAD/CAM systems, 3D printers, and intraoral scanners. This study explores the fundamental functions and indications of occlusal splints and provides a comparative analysis of traditional and digital fabrication techniques. Additionally, the effects of digital workflows on time efficiency, cost, and patient comfort are discussed. The findings suggest that digital techniques offer significant advantages over conventional methods, particularly in terms of precision and overall efficiency.

Keywords

• occlusal splint
• temporomandibular joint
• stabilization splint

Oklüzal Splintler ve Gelenekselden Dijitale Üretim Teknikleri

Abstract

Oklüzal splintler, temporomandibular eklem bozuklukları, bruksizm ve oklüzal travmaların yönetiminde sıklıkla kullanılan, hem tanı hem de tedavi amacı taşıyan dental apareylerdir. Geleneksel üretim teknikleri uzun yıllar boyunca alçı modeller, mum modelaj ve akrilik işlemleri gibi manuel yöntemlere dayanmakta iken; dijital teknolojilerin diş hekimliği pratiğine entegrasyonu ile birlikte CAD/CAM sistemleri, 3D yazıcılar ve dijital tarayıcılar gibi yenilikçi üretim teknikleri ön plana çıkmıştır. Bu çalışmada oklüzal splintlerin temel işlevleri, kullanım endikasyonları ve üretim sürecine dair detaylar ele alınarak, geleneksel ve dijital üretim teknikleri karşılaştırmalı olarak incelenmiştir. Ayrıca dijital üretim süreçlerinin zaman, maliyet ve hasta konforu üzerindeki etkileri de değerlendirilmiştir. Elde edilen veriler, dijital tekniklerin özellikle hassasiyet ve verimlilik açısından geleneksel yöntemlere kıyasla önemli avantajlar sunduğunu ortaya koymaktadır.

Keywords

• oklüzal splint
• temporomandibular eklem
• stabilizasyon splinti

References

1. Aksoy, S. ve Orhan, K. (2010). Temporomandibular eklemin disk deplasmanları. Gazi Üniversitesi Diş Hekimliği Fakültesi Dergisi, 27(1), 65–73.
2. Albagieh, H. ve Alomran, I. (2022). Occlusal splints-types and effectiveness in temporomandibular disorder management. The Saudi Dental Journal, 35(1), 70.
3. Alomar, X. ve Medrano, J. (2007). Anatomy of the temporomandibular joint. Seminars in Ultrasound, CT, and MR, 28(3), 170–183.
4. Andre, A. ve Kang, J. (2022). Pharmacologic Treatment for Temporomandibular and Temporomandibular Joint Disorders. Oral and Maxillofacial Surgery Clinics of North America, 34(1), 49–59.
5. Arslan, S. S. 2022. Çiğneme fonksiyonu: anatomi, fizyoloji ve nörolojik kontrol. Anatolian Clinic the Journal of Medical Sciences, 27(1), 95–102.
6. Barone, S. ve Paoli, A. (2017). Mechanical and geometrical properties assessment of thermoplastic materials for biomedical application. Lecture Notes in Mechanical Engineering, 0, 437–446.
7. Benli, M. ve Al-Haj Husain, N. (2023). Mechanical and chemical characterization of contemporary occlusal splint materials fabricated with different methods: a systematic review. Clinical Oral Investigations, 27(12), 7115–7141.
8. Çapan, N. 2010. Temporomandibular Eklem Rahatsizliklarinda Fizik Tedavi Yöntemleri, Egzersizler ve Postoperatif Rehabilitasyon. Turkiye Fiziksel Tip ve Rehabilitasyon Dergisi, 56(SUPPL. 1), 15–18.

9. Caruso, S. ve Storti, E. (2017). Temporomandibular Joint Anatomy Assessed by CBCT Images. BioMed Research International, 2017.
10. Chehade, M. ve Elder, M. J. (1997). Intraocular lens materials and styles: a review. Australian and New Zealand Journal of Ophthalmology, 25(4), 255–263.
11. Çifçi Özkan, E. ve Dumanlı Gök, G. (2023). Evaluation of bisphenol release of different clear aligner materials using the liquid chromatography-mass spectrometry/mass spectrometry method. The Angle Orthodontist, 93(6), 721–726.
12. Clark, M.ve Desai, H., (2025). Examining the Need for Dentist Impressions and Clinical Review of Stabilisation Splints. Oral Surgery, 0, 1–4.
13. Dawood, A. ve Marti, B. M. (2015). 3D printing in dentistry. British Dental Journal, 219(11), 521–529.
14. Dawson, P. E. 2007. Functional occlusion : from TMJ to smile design, St. Louis: Mosby Elsevier.
15. Garcia-Gonzalez, D., Rusinek, A., Jankowiak, T. Arias, A. (2015). Mechanical impact behavior of polyether-ether-ketone (PEEK) Biomaterials Impact Failure mode Perforation Polyether-ether-ketone. Composite Structures, 124, 88-99.
16. Gibreel, M. ve Perea-Lowery, L. (2021). Characterization of occlusal splint materials: CAD-CAM versus conventional resins. Journal of the Mechanical Behavior of Biomedical Materials, 124:104813.
17. Gozum, N. ve Safgonul Unal, E. (2003). Visual performance of acrylic and PMMA intraocular lenses. Eye (London, England), 17(2), 238–242.
18. Grymak, A. ve Aarts, J. M. (2022). Wear Behavior of Occlusal Splint Materials Manufactured By Various Methods: A Systematic Review. Journal of Prosthodontics : Official Journal of the American College of Prosthodontists, 31(6), 472–487.
19. Güneş, F. ve Kocacıklı, M. (2023). Dental İmplantolojide Polietereterketon (PEEK): Geleneksel Derleme. Selcuk Dental Journal, 10(3), 611–617.
20. Hardy, R. S. ve Bonsor, S. J. (2021). The efficacy of occlusal splints in the treatment of bruxism: A systematic review. Journal of Dentistry, 108:103621.
21. Harper, C. (2002). Handbook of Plastics, Elastomers, and Composites, New York: McGraw-Hill Companies.
22. Jogna, F. ve Graenicher, A. (2025). Pharmacological and non-pharmacological approaches to temporomandibular disorder chronic pain: a narrative review. Pain Management, 15(5), 285-296.
23. Kessler, A. ve Hickel, R. (2020). 3D Printing in Dentistry-State of the Art. Operative Dentistry, 45(1), 30–40.
24. Laskin, D. M. ve Greene, C. S. (2006). Temporomandibular disorders : an evidence-based approach to diagnosis and treatment, Physical Therapy, 86(10), 1451–1452.
25. Liu, C. L. ve Sun, W. T. (2016). Colour stabilities of three types of orthodontic clear aligners exposed to staining agents. International Journal of Oral Science, 8(4), 246.
26. Lombardo, L. ve Arreghini, A. (2015). Optical properties of orthodontic aligners--spectrophotometry analysis of three types before and after aging. Progress in Orthodontics, 16(1), 41.
27. Maheshwari, K. ve Srinivasan, R. (2024). Effectiveness of anterior repositioning splint versus other occlusal splints in the management of temporomandibular joint disc displacement with reduction: A meta-analysis. Journal of Indian Prosthodontic Society, 24(1), 15–24.
28. Manfredini, D. ve Guarda-Nardini, L. (2011). Research diagnostic criteria for temporomandibular disorders: a systematic review of axis I epidemiologic findings. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics, 112(4), 453–462.
29. Methani, M. M. ve Cesar, P. F. (2020). Additive Manufacturing in Dentistry: Current Technologies, Clinical Applications, and Limitations. Current Oral Health Reports, 7(4), 327–334.
30. Michler, G. ve Lebek, W. (2016). Electron microscopy of polymers, New Mexico: Springer.
31. Miura, T. ve Hayakawa, T. (2010). Antifungal Activity Against Candida albicans on PMMA Coated with Protamine Derivatives. Journal of Oral Tissue Engineering, 8(1), 30–38.
32. Nassif, M. ve Haddad, C. (2023). Materials and manufacturing techniques for occlusal splints: A literature review. Journal of Oral Rehabilitation, 50(11), 1348–1354.
33. Okeson, J. 2019. Management of Temporomandibular Disorders and Occlusion, Missouri:Mosby.
34. Ozan, O. ve Aydın, M. (2011). Temporomandibuler eklem bozukluklarında konservatif tedavi yaklaşımları: Okluzal splintler. ADO Klinik Bilimler Dergisi, 5(3), 913–923.
35. Özden, S. ve Demir, H. (2020). Polieter eter keton (peek) diş hekimliğinde yükselen materyal. Necmettin Erbakan Üniversitesi Diş Hekimliği Dergisi, 2(2), 76–85.
36. İşidağ, Ö. ve Karakaya, K. (2023). Evaluation of the effect of the strength of bonding of different cleaner solutions and sandblasting on between acrylic and copolyester plate. Current Research in Dental Sciences, 33(1), 3–8.
37. Ozkan, E. C. ve Gok, G. D. (2022). Cytotoxicity evaluation of different clear aligner materials using MTT analysis. Australasian Orthodontic Journal, 38(2), 2022.
38. Papathanasiou, I. ve Kamposiora, P. (2020). The use of PEEK in digital prosthodontics: A narrative review. BMC Oral Health, 20(1), 1–11.
39. Schweiger, J. ve Edelhoff, D. (2021). 3D Printing in Digital Prosthetic Dentistry: An Overview of Recent Developments in Additive Manufacturing. Journal of Clinical Medicine, 10(9).
40. Simsiriwong, J. ve Shrestha, R. (2015). Effects of microstructural inclusions on fatigue life of polyether ether ketone (PEEK). Journal of the Mechanical Behavior of Biomedical Materials, 51, 388–397.
41. Sohail Zafar, M. 2020. Polymers Prosthodontic Applications of Polymethyl Methacrylate (PMMA): An Update. Polymers, 12, 1494.
42. Stawarczyk, B. ve Beuer, F. (2013). Polyetheretherketone-a suitable material for fixed dental prostheses? Journal of Biomedical Materials Research. Part B, Applied Biomaterials, 101(7), 1209–1216.
43. Strub, J. R. ve Rekow, E. D. (2006). Computer-aided design and fabrication of dental restorations: current systems and future possibilities. Journal of the American Dental Association (1939), 137(9), 1289–1296.
44. Tekin, S. ve Cangül, S. (2018). Areas for use of PEEK material in dentistry. International Dental Research, 8(2), 84–92.
45. Türk, A. G. ve Dündar Çömlekoğlu, M. (2022). Additive Computer Aided Manufacturing Methods. International Archives Of Dental Sciences, 43(Supp:Ozel Sayi), 85–94.
46. Van Noort, R. 2012. The future of dental devices is digital. Dental Materials : Official Publication of the Academy of Dental Materials, 28(1), 3–12.
47. Venezia, P. ve Muzio, L. L. O. (2019). Digital manufacturing of occlusal splint: from intraoral scanning to 3D printing. Journal of Osseointegration, 11(4), 535–539.
48. Wang, S. ve Li, Z. (2020). Preliminary clinical evaluation of traditional and a new digital PEEK occlusal splints for the management of sleep bruxism. Journal of Oral Rehabilitation, 47(12), 1530–1537.
49. Wasinwasukul, P. ve Nalamliang, N. (2022). Effects of anterior bite planes fabricated from acrylic resin and thermoplastic material on masticatory muscle responses and maximum bite force in children with a deep bite: A 6-month randomised controlled trial. Journal of Oral Rehabilitation, 49(10), 980–992.
50. Wu, M. ve Cai, J. (2021). Therapeutic Agents for the Treatment of Temporomandibular Joint Disorders: Progress and Perspective. Frontiers in Pharmacology, 11, 596099
51. Yaltırık, M. ve Palancıoglu, A. (2018). Treatments of temporomandibular disorders. Yeditepe Dental Journal, 14(1), 71–80.
52. Zayan, K. ve Felix, E. R. (2020). Transcutaneous Electrical Nerve Stimulation for Facial Pain. Progress in Neurological Surgery, 35, 35–44.
53. Zhang, J. ve Yang, Y. (2021). The application of a new clear removable appliance with an occlusal splint in early anterior crossbite. BMC Oral Health, 21(1), 36.
54. Zheng, B. ve Zhang, S. (2023). Experimental investigation and modeling of the mechanical properties of construction PMMA at different temperatures. Structures, 57, 105091.
55. Zoidis, P. ve Papathanasiou, I. (2016). Modified PEEK resin-bonded fixed dental prosthesis as an interim restoration after implant placement. The Journal of Prosthetic Dentistry, 116(5), 637–641.