Constructing occlusal splints.
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Ruminatory reflex chewing activities in the comatose patient and the associated prostheses used in their treatment have been well documented in the literature. The comatose patient, whose condition is further complicated by the need for oral-endotracheal intubation, requires the aid of a prosthesis which will allow for long-term patency of the tube to maintain proper ventilation.
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The use of an interim protective prosthesis during cancer chemotherapy allows immediate patient comfort and function by protecting ulcerated mucosa and providing a platform against which to masticate. Chemotherapeutically induced lesions can be exacerbated by trauma from the remaining natural dentition during mastication and parafunctional habits. The interim prosthesis protects ulcerated tissue from further injury, and healing is promoted. The greater the integrity of the oral tissues, the more resistant they become to microbial invasion, subsequent microbial colonization, and infection during periods of granulocytopenia. By the use of a conservative technique, the patients's quality of life is improved during cancer treatment, and definitive prosthodontic treatment is deferred until therapy can be better tolerated by the patient.
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More and more handicapped individuals may be seeking dental treatment. Treatment may include construction of special devices to help these patients lead more productive and fulfilling lives. A mouthstick has been designed that can be constructed from readily available parts. The versatility and decreased cost of the mouthstick make it readily available to these needy patients.
In the past, the maxillary and mandibular teeth have been firmly indexed on the mouthpiece prosthesis, which can produce significant occlusal discrepancies. The construction of a mouthpiece consisting of a maxillary interocclusal splint is described. The two advantages for this type of mouthpiece are (1) it can be adjusted clinically to accommodate errors in the mounting of the casts and the laboratory processing of the prosthesis, and (2) the use of the maxillary interocclusal splint will reduce the likelihood of the development of masticatory muscle spasms.
During tooth preparation, the air and water from a dental handpiece occasionally cause painful stimulation of hypersensitive teeth. Use of mouthguards may be an alternative for the management of patients with tooth hypersensitivity.
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A visible light-cured resin system enables the dentist to accomplish chairside relining of removable prosthesis. The material is pliable and can be initially cured in the mouth with the regular hand-held visible light. A special unit is needed to completely cure the material, which thereafter is comparable in quality to heat-polymerized acrylic resin. The value of this system for the practice of maxillofacial prosthetics is demonstrated by the ease of relining of various devices and obturator prostheses.
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