IPT II

Occlusal Stabilization Splint: Laboratory Practice

The Occlusal Stabilization Splint is designed/shaped to

1. Provide an Optimized occlusion biting surface and

2. Allow the condyles to seat in the CR position.

The Dual Layered version of this splint which is taught

here is designed to maximize
1. Comfort
2. Compliance

Richard White DDS

Chi Tran DDS
Criteria for Maxillary Occlusal Stabilization Splint
• Thickness- 2mm minimal at posterior (3mm is preferable)
• Centric Stops - All mandibular teeth have a centric stop

- One centric stop per tooth is sufficient

- Slight Freedom in Centric

- #22-#27 have centric stops on a 2-3 mm wide horizontal surface distal to the ramp
- Premolar and molar centric stops on splint are slightly concave. They provide a flat area of occlusal contact for the opposing cusp
– More pronounced concave shape is required in some situations, frequently in the second molar area to avoid perforation
– Articulating paper(AccufilmII) reveals small diameter contacts without inclines
• Anterior Ramps- Provides slightly delayed disclusion in protrusive and lateral excursions

- Protrusive markings show #22 through #27 provide shared protrusive guidance OR only the Canines provide protrusive guidance

- Steepness of the ramp is similar to the natural dentition's angle of disclusion but not steeper, unless necessary due to horizontal
wear of natural teeth. 


•  Vertical Pressure

- Posterior Centric Stops hold one thickness of Accufilm II articulating paper - Anterior Centric Stops #22 through #27 hold 2 layers but
1 layer slides through 


•  Excess Bulk Removed. Contours are smoothed. 


Goals
1.  Use your splint patient’s casts so that your lab splint will simulate the occlusal
scheme of the clinical splint. 


2.  Understand that the idealized occlusal scheme of the splint follows the same
core principles as an occlusal equilibration or the adjustment of new restorations in
the mouth. 


3.  Compare the function of the equilibrated splint posterior contacts to the

equilibrated posterior contacts for a complete denture and to the concept of
mutually protected occlusion 


4.  Understand delayed disclusion, freedom in centric and stepped flat planes of

occlusion to accommodate cusp tips of different height in a Curve of Spee. 

 Build Up and Cure the Lab Splint Material…..
mount the cast, adjust incisal pin in front. Molars should have 2-3mm of cleareance

Steps 1 & 2
condyle to incisors: typically close to 10cm, we don't care what red line on pin is -> adjust it so when you look from the back have clearance

•  Mount second best

Phase One:

Build Up and Cure the Lab Splint Material
models of your “splint
Step 1 &pa0ent” using Kois
2
•  Mount second best models of your
Analyzer and CR record
“splint patient” using Kois Analyzer and CR
record 

•  Raise/lengthen incisal pin
to create 3mm of
•  Raise/lengthen incisal pin to create 3mm
clearance between the
of clearance between the closest cusp to
cusp relationship posteriorly (Splint Criteria for
closest cusp to cusp
Thickness) 


rela0onship posteriorly
(Splint Criteria for
Thickness)
Step 3 Draw Step 3: Develop the extensions for your splint…
essentially on facial aspect, line for practice splint at least half way down buccal surface
draw at junction of gingival and middle third, same with incisors
the outline
on palatal side, draw right at gingiva

for practice splint ONLY: use triad to make quick splint

Step 4

Cut and
apply Triad
material to
the outline

adapt material to line

 Adapt material to embrasures for SECURE reten0on.
Adapt material into
embrasures for
secure retention

make sure material goes into embrasures

 Step 5: Close ar0culator so that pin touches table and mandibular cusps
form shallow indents into uncured triad resin. Add extra material cuspid
Step 5: Close articulator so that pin touches table and mandibular cusps form shallow indents
into uncured triad resin.to cuspid to form ramp and stops for 22-27.
Add extra material canine to canine to form ramp and stops for 22-27.

gap between incisors, very light

indentation of lower incisors, premolars,
molars

some cusp tips are touching: we wnat mandibular buccal cusp tips to touch the triad-> crossbite, we
might want lingual cusp tip
rac0ce splint will meet the Splint Criteria for Centric
Note dimples for posterior stops, flat area for canine to canine stops and anterior ramp. Do not
move articulator in excursions prior to initial light cure. Shape the TRIAD so this practice splint
Stops and Anterior Ramp
will meet the Splint Criteria for Centric Stops and Anterior Ramp

be in centric position ONLY

pay attention to where lower incisors touch, want
flat
 Step 6: Once criteria is met, cure resin in triad oven for 2 minutes.
Step 6: OnceOnce cured, the anterior ramps should provide general posterior
criteria are met, cure resin in Triad oven for 2 minutes. Once cured, the anterior
ramps should providedisclusion in protrusive and lateral excursions.
general posterior disclusion in protrusive and lateral excursions.

Note: Do Not Remove Splint from cast. The splint should

remain firmly attached to the cast for this entire exercise!
Phase Two:
Shape and Equilibrate the Lab Splint to meet the Splint Criteria for
Centric Stops, Anterior Ramp, and Vertical Pressure
•  Slow speed or lab motor 

close articulator, place shimstock, couple spots that touch ONLY-> locate, mark, grind it away -> more and more
contacts available

•  Acrylic burs 
 eliminate interferences until simultaneous stops

•  Articulating paper – horseshoe & Accufilm II 


•  We will fine tune the occlusion / disclusion through subtraction via lab burs and marking
media. 


•  This week’s practice splint adjustment is the dry run for your clinical splint deliveries on
each other...master these concepts!!! 

appear for all
Eliminate heavy contacts to maximize
ble posterior teeth
Eliminate distribu0on
all heavy contacts until you obtain simultaneous bilateral posterior stops.
or contacts 22-27
hold two
esses of marking
(Accufilm II) while
or contacts hold
ckness
eans that one layer
Remark to reveal new contact paiern
king media can be •  Con0nue this repe00on
pulled through the un0l equal-density,
ver0cal occlusal shallow bilateral posterior
ts marks appear for all
applicable posterior teeth
•  Anterior contacts 22-27
should hold two
thicknesses of marking
Shape the TRIAD to meet the Splint Criteria for Centric Stops and Ramp
•  Use Watermelon Bur side-ways to shape slightly concave posterior contacts. This avoids
perforating splint at the cusp tips of the splint arch
•  Use the Watermelon bur
Eliminate heavy contacts to maximize in an end-on position to develop the anterior contacts while
simultaneously shaping the anterior ramp 
 Watermelon bur hollow grinds contact
distribu0on
 concave shape with a flat center for the occlusal
contact for the opposing den00on
The watermelon bur shape creates a slightly concave area with a flat center for the occlusal
contact for the opposing dentition
Repeat marking and grinding to reveal new
contact pattern
•  Continue until equal-density, shallow
bilateral posterior marks appear for all applicable
•  The completed guidance
posterior teeth 


will have smooth

•  Anterior contacts 22-27 should hold two
transi0ons from centric
thicknesses of marking media (Accufilm
posterior contacts hold one thickness 

II) while

up onto the protrusive

ramp.
•  This means that one layer of marking
media can be gently pulled through the 22-27
•  Ramps for lateral Canine
vertical occlusal contacts 

disclusion are developed
in the same manner
Eliminate heavy contacts to maximize
distribu0on
•  The completed guidance
will have smooth
transi0ons from centric
up onto the protrusive
ramp.
•  Ramps for lateral Canine
disclusion are developed
in the same manner
initial

•  Note the small diameter

final bilateral contacts

of the centric stops. The

stops do not include
inclines.
contacts are
•  Once anterior centric contacts
equilibrated, begin to
•  Once anterior centric
are equilibrated, begin to check
contacts are
check markings through
markings through excursions (un-
lock condyles) 

equilibrated, begin to
excursions (un-lock
check markings through
•  Adjust ramp to distribute
condyles) excursions (un-lock
guidance across anteriors (as many
condyles)
teeth as possible on both sides of
Adjust ramp to
midline) 
 •  Adjust ramp to

distribute guidance
distribute guidance
fine tune anterior teeth

across anteriors (as

across anteriors (as
lighter contact than posterior teeth-> one layer to hold

many teeth as possible

many teeth as possible
on both sides of
on both sides of midline)
midline)
 •  The completed guidance
will have smooth
•  The completed guidance
will have smooth transition
transi0ons from centric
from centric up onto the
protrusive up onto the protrusive
ramp. 

ramp.
•  Ramps for lateral Canine
•  Ramps for lateral Canine
disclusion are developed in
disclusion are developed
the same manner 

in the same manner
•  Note the small diameter of
•  Note the small diameter
the centric stops. The stops
of the centric stops. The
do not include inclines. 

stops do not include
•  Color of protrusive? 

inclines.
•  Color• ofColor of protrusive?
lateral? 

•  Color of lateral?
blue lines: canine guidance -> protrusive
 Smooth guidance = continual contact throughout excursive stroke from start to finish!

ramps replicate anterior guidance

want it to be smooth
excursive stroke from start to finish!
Smooth guidance = con0nual contact throughout
want it hitting flat surface
we don't want incisors hitting on incline
anterior to labial incisor line angle: gap right there, gives freedom in centric-> slight delay in guidance

o finish!
l contact throughout
Note the freedom in centric, slightly delayed disclusion and flat centric stop in this example.
Adjust your splint like this
orange line: centric stop
green line: space before incisor touches ramp (freedom)
yellow line: anterior or lateral guidance
purple line: edge to edge
Close-up of splint shape for flat centric stop, freedom in centric, slightly delayed
disclusion most patients need freedom in centric
 •  Visually check ramp
quality in• allVisually check ramp
excursions 

quality in all excursions
purple: lateral excursions, canine guidance

•  Note Canine Guidance

•  Note Cuspid Guidance
in right lateral excursion 

in right lateral
excursion
•  Note shared protrusive
guidance 

•  Note shared
protrussive guidance
•  As illustrated here, It is
preferable to have canines
•  As illustrated here, It is
participate in protrusive
guidance 
 preferable to have
cuspids par0cipate in
protrussive guidance
green: protrusive anterior guidance
 How do these posterior contacts compare to cont
Example of a completed Practice Splint
 in lower posterior denture teeth?
How do these posterior contacts compare to contacts in a mandibular complete denture?
yes, same pattern
simultaneous bilateral stops

would we see anterior guidance? not in dentures

too much force in anteriors, dislodge denture (some anterior guidance ok, but also
have some with molars)
 2) What if this becomes a fulcru
What is the blue mark?
Advanced Concepts:
(Centric stop or excursion?)
HowName the blue mark.
do do you adjust this?

red circles are good centric stops

blue lines: protrusive interfereance, or mediotrusive interference
not laterotrusive interference, would see line pointing sideways
Advanced Concepts: freedom in centric.
Name the blue mark. Preserve the most distal por0on of the contact.

Step-like flat centric stop that has

eliminated the blue mark. Now there
is freedom in centric on that stop.
Now the adjacent tooth shows a new blue
eliminate 1 protrusive interference, but another showed up so ADJUST IT
mark. What happened? What should be
done?
Did you accomplish the Goals?
1.  Use your splint patient’s casts so that your lab splint will emulate the occlusal scheme of
the clinical splint. 


2.  Understand that the idealized occlusal scheme of the splint follows the same core
principles as an occlusal equilibration or the adjustment of new restorations in the mouth. 


3.  Compare the function of the equilibrated splint posterior contacts to the equilibrated
posterior contacts for a complete denture. 


4.  Understand delayed disclusion, freedom in centric and stepped flat planes of occlusion
to accommodate cusp tips of different height in a steep Curve of Spee. 

Criteria for Maxillary Occlusal Stabilization Splint
• Thickness- 2mm minimal at posterior (3mm is preferable)
• Centric Stops - All mandibular teeth have a centric stop

- One centric stop per tooth is sufficient

- Slight Freedom in Centric

- #22-#27 have centric stops on a 2-3 mm wide horizontal surface distal to the ramp
- Bi-cuspid and molar centric stops on the splint are slightly concave yet provide an essen0ally flat area of
occlusal contact for the opposing cusp
– More pronounced concave shape required in some situations, frequently in second molar area to avoid
perforation
– Articulating paper(AccufilmII) reveals small diameter contacts without inclines
•  Anterior Ramp

- Provides slightly Delayed Disclusion in protrusive and lateral excursions

- Protrusive markings show #22 through #27 provide shared protrusive guidance OR that only the Canines
provide protrusive guidance

- Steepness of the ramp is similar to the natural dentition's angle of disclusion but not steeper, unless necessary
due to horizontal wear of natural teeth.
•  Vertical Pressure

- Posterior Centric Stops hold one thickness of Accufilm II articulating paper - Anterior Centric Stops #22 through
#27 hold 2 thicknesses of articulating paper but 1 thickness slides through
•  Excess Bulk Removed. Contours are smoothed.