The TMJ Repositioning Appliance: A Technique for Construction, Insertion, and Adjustment

This article reviews the theory behind temporomandibular repositioning appliance therapy and discusses the complications of treatment (i.e., induced remodeling and instability of results). The technique for the design, wax-up, flasking, processing and insertion of the appliance is also presented in a step-by-step sequence for both the maxillary and mandibular appliance. This article presents guidelines on the adjustment of the appliance and the postinsertion instructions given to the patient. A brief discussion is included regarding decisions required when the repositioning appliance therapy fails, as well as guidelines on how to determine when a new therapeutic maxillomandibular relationship has been achieved.