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Article: Volume 44 Number 7 Page 648 - July/August 2017

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  Dent Update 2017; 44: 648-654

Restorative dentistry:  The Bilaminar (Dual-Laminate) Protective Night Guard

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Abstract: Tooth wear is an increasing problem for general dental practitioners. Attrition is associated with bruxism, primarily a stress-related condition that is difficult to manage dentally. Direct composite restorations are frequently used to restore the worn anterior dentition. Soft occlusal appliances (night guards) are often prescribed in bruxism, despite debatable clinical benefit. Bilaminar (dual-laminate) splints or night guards are composed of two distinct layers of ethylene-vinyl acetate; a soft inner and a harder outer layer. These occlusal appliances are cost-effective to construct, easy to fit and offer greater resistance to occlusal forces than entirely soft occlusal appliances. Patient compliance is excellent. Bilaminar night guards are proposed as an alternative occlusal appliance to prevent further attritional tooth wear from bruxism when TMD is absent and for protection of composite placed to restore the worn dentition.

Clinical relevance: The soft occlusal guard is widely used in dentistry but lacks durability and cannot be adjusted. To prevent further attrition and protect restorations, the use of a bilaminar or dual laminate material is advocated in cases of bruxism.

Author notes: Nicholas N Longridge, BSc(Hons), BDS(Hons), MFDS RCS(Ed), Dental Core Trainee, Department of Restorative Dentistry, Liverpool University Dental Hospital, Pembroke Place, Liverpool L3 5PS and Alexander Milosevic, BDS, PhD, FDS RCS(Ed) DRD RCS, Professor and Head of Prosthodontics, Hamdan bin Mohammed College for Dental Medicine, Dubai, United Arab Emirates.

Objective: To introduce and promote the use of bilaminar night guards in bruxism.