Today at the Southwest Dental Conference I am presenting a half day program on appliance therapy. One of the common questions we manage when making appliances is “what type of appliance should I make?”. I don’t have a belief that any one appliance is superior to others. I do believe that each design of appliance works for a specific set of clinical indications and has a certain set of contra-indications or risks. Which design I use is individualized to the patient based on their exam findings and my clinical suspicion. The anterior bite plane appliance is a design I use commonly in my practice. The principle behind this appliance is that when back teeth are separated the elevator muscles don’t fire with the same force, thereby reducing the load across the system and allowing the muscles to release. The lack of posterior tooth contact also releases the Lateral Pterygoid allowing a seated condylar position to be recorded as part of the treatment planning process. This appliance design goes by many names, but the basic design is the same and the physical principles are consistent.
Indications for using an anterior only appliance:
- All muscle diagnoses
- Post-Op protection of restorations
- Clenchers with healthy joints
Contra-indications for using an anterior only appliance:
- Increased joint pain due to load
- Worsening symptoms
Risks of anterior only appliance use:
- Anterior tooth intrusion or posterior super-eruption with excessive use
- Inability to find ICP
This appliance design can easily be fabricated in the office while the patient is there. Additionally, without posterior contacts as the muscles release and the condyles seat no posterior interferences are picked up that require monitoring and adjustment, so the process is efficient.