Effects of canine versus molar occlusal splint guidance on nocturnal bruxism and craniomandibular symptomatology.

The use of interocclusal orthopedic appliances is the most common method for managing nocturnal bruxism and associated craniomandibular symptoms. Yet there is no consensus on the mechanism of action or best design for optimal clinical results. Posterior disocclusion through canine or anterior guidance is believed to be a key feature. The purpose of this study was to compare a canine versus molar guidance appliance in eight chronic bruxist patients. The appliances were used for 10 to 14 nights. The two appliances provided nearly equivalent effects on nocturnal bruxism in seven of eight subjects. Clinical examination and subjective pain ratings did not differ with the two guidance patterns. These results question the common assumption that canine guidance is a critical design feature for the management of nocturnal bruxism and associated craniomandibular symptoms.