To complete our series on occlusal appliances I wanted to include this video of doing an intraoral reline. Hard acrylic appliances need to be both passive, meaning they do not exert orthodontic pressure, and retentive such that the patient can not remove it with tongue pressure or when half asleep. Accomplishing this magic combination requires utilizing methyl methacryalte and performing a reline in the mouth that creates a path of insertion. I have yet to find an appliance that works as well without being relined, despite trying many different types. Although the taste of the reline material is unpleasant, the end result is well worth the five minutes of time. I make sure my patients know ahead of time that once set the material has no odor and no flavor. I also ask for their patience during the five minutes we are relining the appliance as, it is time and technique sensitive. A critical step in avoiding locking the appliance in is to make sure the buccal flange on the shell you fabricate dis not longer than 1mm over the labial tooth structure.
Step one is to try the shell over the teeth and make sure we have used accurate impressions. Also, at this point make sure you can lift the shell our ont he side of the patient’s dominant hand without it dragging over the teeth or binding.