The best splints I have ever delivered have been from intraoral scans so I think you are swimming in the right direction. My patients tolerate hard appliances very very well when they fit perfectly. And from Trios scans...they fit perfectly. I have had to dial back retention and undercut for a sensitive patient but I have not had a single patient reject a hard appliance since making them digitally. Cured materials placed on settable materials poured into viscoelastic impressions....give that vice like feeling referenced earlier and thus the love of dual laminates to compensate in the industry (imho). But no doubt, pound for pound a dual layer is more comfy, just doesn't satisfy all the objectives sometimes.
Printed materials are getting there. KesplintSoft people are loving, but it's a little bit of a sensitive resin to printing (more print failures). Too early to tell on longetivity in the mouth. Last gen hard materials (Dental LT Clear, Nextdent etc) were brittle, and like emax, sometimes used too thin and then blamed for being brittle. But with adequate thickness in less severe bruxers they have been an extremely well fitting, cheap, fast to turn around, ugly as sin (yes they are discolored),not great to polish, and less wear resistant alternative to traditional materials. I tell my patients exactly that and that I'll replace it when it cracks or upgrade them to milled. No one has ever commented on the color, which surprised me. But my nextdent days will soon be behind me as materials improve, but I did not have any catasrophes as others have described. I think I've had 3 or 4 crack out of maybe 50 to 100? in 3 years. However I'm an expert in design, I know the limitations and I'm not a splint machine so my sample size is low.
The absolute best splints I've delivered have been milled...They fit just as well, beautiful, durable, clear, pretty, polishable....just expensive to manufacture.
But, if your doctors are ONLY sending intraoral scans, now you have to decide which compromise to make. Add cost and print models? Add cost and mill? Make quality compromise and print? If I'm a doctor looking at it from a lab point of view, my recommendation is to provide the relationship with the doctor and design but outsource the milling or outsource to a KeySplint Clear (Carbon only printers) lab until you have the capacity to invest in the equipment. My fear is that whatever printing tech for splints you invest in today, is obsolete in 2 years? People also seem to like EGuard2 from Envisiontec
Best,
Patrick
