Why Your Splint Hits on the Second Molar at Delivery

You deliver an occlusal splint, the patient closes, and it contacts first on the second molars. You mark it, grind it, reseat, mark again, and eventually get the anterior teeth into contact. Most of us have accepted this as a normal part of splint delivery.

It isn't a fabrication error, and it usually isn't bad luck. It's geometry.

When a case arrives at the laboratory without a construction bite, the models are articulated in centric occlusion and then opened until there's enough room for the prescribed splint thickness. That opening happens on the articulator's hinge — and the hinge sits behind the teeth. Rotating around a posterior hinge doesn't separate the arches evenly. The anterior segment opens more than the posterior segment.

The splint is then built to that geometry.

But the patient doesn't close on the articulator's hinge. They close on their own arc, around their own condylar position. The two arcs don't match. Relative to the patient's real closing path, the appliance is too thick posteriorly — so it contacts first exactly where you keep finding it: the second molar region.

The laboratory built precisely what the articulated relationship described. The problem is that the articulated relationship was never the patient's relationship.

The fix is upstream, not chairside. Send a construction bite that captures the exact vertical and anteroposterior position you want, and the arbitrary opening step disappears. So does most of that posterior grinding.

Read the full technique in our Talon Splint Practice Building Bulletin. 

Written by Dr. Rob Veis, DDS. President of SML