In this particular case, we designed an occlusal splint for a patient that is a heavy bruxer. We captured the bite by having the patient gently bite down on cotton rolls on both sides. The first purpose of this is to block out the tongue and the orophayrynx when imaging the buccal bite. But it can also help you find the proper vertical dimension and dramatically reduces the time it takes to deliver an appliance.
Ideally, you place the cotton rolls in such a manner so that you don’t obstruct your view of the second molars. This allows you to see and verify the proper clearance in the most critical area! If you take it one step further and design the guard to the opposing, your seat appointments are just a few minutes long.
Once the upper jaw and the lower jaw are related to each other in the medit scan, and the clearance is verified, the models are brought into exocad’s Bite Splint Module. The case is designed in the CAD software and then milled with a 5 axis milling machine. This step should ideally be delegated to a lab as it is not practical to fabricate these in the office.
The delivery of the appliance is very predictable when you capture the bite with digital impression and you don’t have to grind away to get the jaws to close in the anterior, as the distance was taken into consideration during the design process.