1. Refractory CMD Case 5 years of treatment, 3 years of “Hell”, 5 months of Torment; 4 days to basic comfort!!

2. Presentation 5/21

3. Glued On Splint, Hygiene??

4. Splint Fractured, Failed Restoration

5. Splint Ends First Molar What’s This?

6. R

7. Lower Anterior with Splint Off

8. What is the Intent of Treatment? Extra Length, Molars in Occlusion, Would the resultant Vector distalize the Mandible?

9. Not Very Comfortable,

10. Old Splint Where is She Rubbing?

11. Incisal Ramp Is it A Little Big?

12. 1 st Mark, Splint Rocks! What Is the Effect of A Rocking Splint?

13. What do you call this splint? What is the Basic Design? Is this a Tanner Splint? NO!!! Can we use it? If so, what is next step?

14. Reline And Re- surface PGA

15. 1 st Adjustment

16. 2 nd Adjustment

17. 3 rd Adjustment - “Freedom”

18. 3 day PO, Splint Great, Chewing with Teeth Bad

19. 1 st Adjustment, Feels Good

20. 4 th Day PO, “Cadillac” of Splints

21. First Smile in Months

22. 4 th day PO, 1 st Adjustment Still Cannot Eat or Leave Splint Out

23. What is Next Check?

24. 2+ Fremulous #8

25. Now What?? Allow her to feel motion Allow her to choose the affected tooth Ask permission to reshape a tooth Which one? #25, lower right incisor!!!

26. Is it the Bevel on #25, or the length?

27. Unposed photo’s, 4 days apart What is the real Effect??