r/Dentistry • u/Odd-Law7112 • 15h ago

Dental Professional Nightguard Design for Clenching

What is your preferred design for occlusal guards for pts who are clenchers vs bruxers?

I typically have been doing flat plane hard NG for pts who are asymptomatic with signs of bruxism, and flat with anterior guidance for pts who have tmj symptoms.

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11

u/Acrabat321 15h ago

Michigan/ tanner for joint issues or joint and muscle.

Dual arch B splint for muscle issues

Flat plane hard splint for pure bruxism protection w/o symptoms.

These 3 cover 90% of my tmd referrals

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u/stefan_urquelle-DMD 14h ago

What's a Michigan/tanner

2

u/Tribalwarrior_ 12h ago

Stabalisation splints. Michigan for upper; tanner for lower.

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u/stefan_urquelle-DMD 10h ago

Define stabilization

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u/Acrabat321 4h ago

Michigan is an upper hard splint with ramps to create textbook incisal and canine guidance. It is fabricated for biting in CR. Tanner is the lower arch version of the same.

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u/Tribalwarrior_ 12h ago

The research is equivocal, so if your aim is to reduce damage to teeth, any occlusal guard will do that. If it is for TMD then everybody has a different opinion with a litany of designs which come and go into vogue. No systematic review will give you only one design of guard.

There was one study that suggested soft guards increase muscular activity but that had like 10 subjects and poor methodology. So in my opinion is make the one you're comfortable making and review after fit to ensure symptoms do not worsen and it is well tolerated by the patient.

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u/Acrabat321 4h ago

There’s another study re soft mouth guards with 70 participants too, highlighting increased muscle activity