The Dental Lab Expert – digital tooth grinding

tooth grindingWith a growing number of splints to avoid tooth grinding, Ashley Byrne explores how dental labs can make designing the splints a scalable business solution.

Whether it’s the pandemic, modern life, or simply greater patient awareness, we are seeing dramatic growth in patients requiring splints to help avoid tooth grinding.

In the past, this has been a slow and costly procedure for both labs and clinicians. Should the patient grind through that splint, it’s back to the start and another expensive splint.

The conventional method is impressions, face bow reading, articulated models and then the splint is carefully hand waxed to ensure the patient glides nicely on the ramps and to get the natural posterior disclusion.

The model is duplicated, the splint is processed using a lost wax technique and cured with a clean PMMA that shrinks on processing.

This is ground in, polished, and returned. Then, often the clinician would do further adjustments as splints shrink on curing. Slight adjustments to the occlusion ensure it is all balanced.

It’s exhausting just thinking about it. That’s of course not even considering the plaster mess, the grinding dust as well as the lack of production volume due to intensive labour.

There is already a huge technician shortage. So as this product demand grows; it is going to become an enormous problem to scale up volume production for such a manual and resource intensive process that technicians do not enjoy.

Tooth grinding splints

Let’s look at solutions. Embrace the digital revolution of CAD and 3D printing. Even better, enjoy the seamless workflows if the clinician has a modern intraoral scanner (IOS).

High end IOS can now scan a patient’s teeth accurately, whilst also recording dynamic movements. Easily record retrusive, protrusive, left and right, ICP and RCP. Thus this removes the need for a face bow.

Within minutes of these scans, it’s in the virtual hands of the technician and imported into their CAD system.

A quick selection of the margin of the splint and then the software builds a template. The technician’s occlusal and design skills now come in to play. We can ensure the technician designs the splint correctly with just a mouse. No wax knife or carving tools.

Normally the clinician would have to trust the technician’s design. But now, through digital, we can even ping over the design for the clinician to check on their phone or laptop before we process to finish.

Then the magic can happen. We nest the splint on the 3D printer. In a matter of an hour or so, a splint appears, nearly perfectly and accurately printed with zero shrinkage.

If the patient wants a spare for the car or office, then it’s simply a case of adding a second or even a third. If the dog decides to try the splint out for size and then returns it in 100 parts, it is very cost effective to re-print rather than a complete re-design and re-make.

Scalable solutions

Digital makes the process leaner and scalable for labs. To print one splint on our printers is the same time it takes to print 16.

Of course there is more design time, but when we are really busy, there are support solutions to consider such as the chance to outsource the design to a CAD centre.

It’s a truly scalable aspect of the modern digital dental lab. And an area that truly benefits the lab, clinic and patient.

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