21085 Impression and custom preparation; oral surgical splint

Name of the Procedure:

Oral Surgical Splint (also known as Dental Splint, Occlusal Splint, or Bite Guard)

Summary

An oral surgical splint is a custom-fitted appliance made to stabilize and protect teeth and jaw structures. It is commonly used after oral surgery or a traumatic injury to the mouth. This procedure involves taking an impression of the teeth to create a precise mold for the splint.

Purpose

The primary purpose is to support and immobilize teeth or jaw structures to facilitate healing and prevent further injury. It is often used after surgical procedures, fractures, or for conditions like temporomandibular joint disorder (TMJ).

Indications

• Post-surgical stabilization
• Jaw fractures
• Temporomandibular joint disorder (TMJ)
• Bruxism (teeth grinding)
• Traumatic dental injuries

Preparation

• Patients may be advised to fast before the procedure, though this is often not necessary.
• Medication adjustments might be necessary, particularly for blood thinners.
• Pre-procedure dental cleanings or oral exams might be conducted.

Procedure Description

1. Initial Assessment: The dentist will perform an oral examination and review the patient’s medical history.
2. Impression Taking: A dental impression is made using a putty-like material or digital scanning technology to capture the precise shape of the teeth and jaw.
3. Custom Fabrication: The impression is sent to a dental lab where the custom splint is fabricated, often using durable acrylic.
4. Fitting: Once the splint is ready, the patient returns for a fitting. Adjustments are made to ensure comfort and proper function.
5. Finalization: The splint is polished and the patient is given wearing and care instructions.

Tools and equipment commonly used include dental impression trays, impression materials, and digital scanners. No fine anesthesia or sedation is typically required for the impression process or splint fitting.

Duration

The impression process takes about 15-30 minutes. Fabrication of the splint can take a few days to a week. The fitting appointment lasts roughly 30 minutes to 1 hour.

Setting

The procedure is performed in a dentist's office or an outpatient dental clinic.

Personnel

• Dentist or Oral Surgeon
• Dental Assistant
• Dental Lab Technicians (for fabrication)

Risks and Complications

• Possible discomfort or gagging during the impression process.
• Minor adjustments may be needed for optimal fit.
• Rarely, allergic reactions to materials used.

Benefits

• Stabilizes and protects oral structures to promote healing.
• Alleviates discomfort from TMJ or bruxism.
• Prevents further injury post-surgery or trauma.

Recovery

• Patients typically experience immediate benefit with minimal recovery time.
• Instructions will include how to wear, clean, and store the splint.
• Follow-up visits might be necessary to ensure proper fit and function.

Alternatives

• No intervention: Risk of improper healing or continued discomfort.
• Medication: For pain or inflammation management, though it does not provide structural support.
• Alternative Appliances: Stock mouthguards available over-the-counter, though less effective and less comfortable.

Patient Experience

Patients might feel slight pressure during the impression process, but it is generally quick and tolerable. Post-fitting, there may be a short adjustment period to get used to wearing the splint. Pain management usually involves over-the-counter pain relievers if needed, though significant discomfort is uncommon.