Digital Splints Today: Part 1

February 28, 2018 Stephen Malone DMD

The new challenge facing us in dentistry is how to incorporate technology into our daily practice. Digital splints specifically are a subject I have been working on for about a year. 

We have had the technology available to mill a splint out of acrylic for a few years now. However, we have not had a good protocol that meets all our needs. 

Digital Splints: Challenges

Some of the problems we face are as follows:

1) Lack of digital articulators that make all of the movements we are able to with semi adjustable articulators, such as crossover transitions. 

2) Absence of centric relation record mountings in software on a computer.

3) No rotational path insertion we can achieve from relines in the mouth. 

4) Few materials that are as good or better than we have now.

I believe we are well on our way to solving these issues. The biggest problem I see is something Dr. Pankey was dealing with many years ago. He talked about how the majority of dentists are indifferent to good comprehensive care dentistry. Therefore, most of the manufacturers of our dental equipment and software are catering to a majority that does not share our own clinical demands. 

These companies give me answers like, “That sounds great doc but who will I be able to sell that to?” I think we have to find workarounds for now that will encourage development in these technologies. Keep in mind, all of the workarounds I will explain are in line with what we teach at the Pankey Institute. 

Digital Splints: Opportunities

We also need systems we can duplicate and teach without compromising the quality of care or experience for patients. I believe there is great potential for higher quality materials and great fitting splints without relines. These two potentials alone can create more value and better experiences for patients.

Today I have a protocol that is some digital and some analog. I intraoral scan our impressions with the TRIOS scanner. I believe most of the scanners on the market today work very well and produce very accurate files that can be printed into models. I also use the TRIOS because it communicates very well with the 3SHAPE units most labs use. 

Now that I have files and models I have to mount them. This is our first problem to solve. I still use an analog facebow or facial analyzer. I mount these models on an articulator like the Denar Mark 330 because this is an articulator model programmed into the 3SHAPE software. 

To be continued…

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Stephen Malone DMD

Dr. Stephen Malone received his Doctorate of Dental Medicine Degree from the University of Louisville in 1994 and has practiced dentistry in Knoxville for nearly 20 years. He participates in multiple dental study clubs and professional organizations, where he has taken a leadership role. Among the continuing education programs he has attended, The Pankey Institute for Advanced Dental Education is noteworthy. He was the youngest dentist to earn the status of Pankey Scholar at this world-renowned post-doctoral educational institution, and he is now a member of its Visiting Faculty.

One thought on “Digital Splints Today: Part 1

  1. Hi Steve,
    I have been making digital splints for about 3 years. I use a 3Shape scanner and I take the bite in centric using a Pankey deprogramer that is trimmed so the bite is open about the thickness that I want the bite splint to be. I use Jurim Dental Lab in Woodbury ,NY to make these. You have to tell them to only go about 1/2 mm beyond the height of contour other wise the splint will be to hard to remove. These splints are very accurate. I get a movie of the excursions and contacts for approval before they make it. there is some adjustment at insertion, but much less then when we used to make the bite splints.

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