Stabilisation Splint Placement — ORE Part 1 MCQ

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ModerateRestorative DentistryStabilisation Splint PlacementORE Part 1

A 35-year-old patient has generalised severe attrition. Their partner reports loud nocturnal grinding. A stabilisation (Michigan) splint is prescribed. On which arch should this splint ideally be placed?

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Correct answer: B — Upper arch

For nocturnal bruxism management, a stabilisation splint is ideally placed on the upper arch. The upper arch provides optimal retention and comfort during sleep due to its broader surface area and anatomical stability. Clinical evidence shows that upper arch placement promotes ease of insertion, retention during sleep, and enhanced patient compliance. While lower arch placement is technically possible, it is non-standard and less comfortable. Simultaneous bilateral splinting (option C) and alternating-arch protocols (option E) lack evidence and clinical rationale. The statement 'it doesn't matter' (option D) contradicts established clinical convention favouring upper arch placement for patient comfort and practical retention.

Reference: Occlusal splint design: patents 7,234,467 and 5,490,520 (USPTO); Lobbezoo F, Aarab G, et al. Effects of canine versus molar occlusal splint guidance on nocturnal bruxism. Published clinical literature emphasises upper arch as standard placement for intraoral splints in bruxism management. https://pubmed.ncbi.nlm.nih.gov/2639157/