Efficient.  Economical.  Effective.




The next evolution in NTI dental splint therapy:

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ORDER
INTRODUCTION PAGE
CHAIRSIDE SPLINTS:
      NTI-tss devices
      BruxSplint (full coverage)
ASSISTANCE with NTI protocol
     NTI 2.0 Chairside delivery protocol 
     ThermoPlasticBeads / Indications
      COMMON OVERSIGHTS
      Invisalign integration
      Orthodontic bracket adaption
      Upper or Lower?  Flowchart
      TROUBLE SHOOTING
     Contraindications
      Interpreting Patient Responses
ADMINISTRATION
     Documents
           Informed Consent, Brochures,
         
MSDS, Headache Questionaire,
          Recent articles

EDUCATION 
      TMD, Parafunction, Migraine
LABORATORY PROVIDED
      Keller Lab's NTI-plus    
SUPPORT 
      Contact for assistance
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Opposing
Winged Deprogrammers








Opposing Winged Deprogrammers are intended to be used as diagnostic tools on a "provisionally permanent" basis (shown above prior to being lined with ThermoPlastic).  Once the practitioner has confirmed (or ruled out) the diagnosis through the observation of the change (or persistence) of symptoms, the practitioner may elect to use Opposing Winged Deprogrammers on a long term supervised basis, or transition to Full Coverage Clenching Suppression Splints.


     Often times, a patient presents without symptoms, but has an obvious need for dental protection from nocturnal bruxism.  While an NTI device can fulfill that need, the dentist (and patient) would be obligated to following NTI Therapeutic Protocol, which for the asymptomatic grinding patient, may be unnecessary.
     The BruxSplint is ideal for the immediate delivery of a hard, flat dental guard, which can be used on a provisional basis, or finessed for long term use.
     Additionally, the BruxSplint can be configured to provide the therapeutic protocol of a "B-Splint", which is a full-coverage maxillary splint that has an NTI-style Discluding Element that opposes a mandibular full coverage splint.
BruxSplintTM

VIDEO tutorials:

Lower tray:
Adapting ThermoPlastic
Upper tray:
Adapting Thermoplastic
Severe bruxism:
Opposing flat planes




Pre-adjust the BruxSplint for width prior to applying the ThermoPlastic material.
Remove the distal sections of the BruxSplint if they extend beyond the most distal molar.


Example of adjusted BruxSplint. Thermoplastic is intended to extrude distally to include the occlusal surface of the most distal molars. BruxSplint ready to be adapted with warmed ThermoPlasticBead material.  Anterior border of the BruxSplint should positioned directly over the Incisal edges of the anterior incisors.


ThermoPlasticBeads (TPBs) prior to being immersed in hot water.
TPBs after immersion in hot water.


Coalesced TPBs are then applied onto internal surface of BruxSplint tray.
Apply TPB putty no higher than vertical lingual retaining wall.P


Press theBruxSplint firmly onto occlusal surfaces.  Adapt extruding TPB putty to buccal surfaces and onto occlusal surfaces of the distal molars.  (although the amount of TPB material on the buccal surfaces in this example may be more than necessary, it is easily trimmed with scissors during the cooling/setting phase).
Patient can gently bite onto BruxSplint, although not required, if lower BruxSplint is intended to be used independently as bruxism device. Remove/replace several times as TPB putty begins to opacify to prevent excessive retention. 


Internal of near-finished lower BruxSplint (not quite white/opaque yet).
Final delivery of the completed lower BruxSplint. Total time to deliver:  10 mintues




Opposing Full Coverage BruxSplints with a Discluding Element  ("B"- splint)



Prior to adapting TPB putty to the upper BruxSplint tray drill an "extrusion port" hole at the anterior midline.
Adjust the upper BruxSplint to the maxillary arch for width.  The distal segments have been removed in the above example so that they do not extend beyond the distal molar.


Load the upper BruxSplint with TPB putty. Place an additional small dab of TPB putty on the "extrusion port".
Press the upper BruxSplint onto the maxillary teeth. Adapt the buccal TPB putty against the teeth.  As the TPB putty begins to turn grey, pump the device on and off several times to prevent excessive retention.


Have the patient close and allow to compress the TPB dab, allowing for ~2mm posterior separation of the opposing Flat Planes.  (The TPB of the lower BruxSplint has not be trimmed in this example, thereby providing maximal retention).
The final "B-Splint" (opposing BruxSplints with an NTI Discluding Element). Without pumping the upper device on and off during initial placement, the above upper example would be too retentive.


Right excursive movement.  Posterior "adjustments" can be made by grinding directly on the BruxSplints, which can be perforated without consequence.
Left excursive movement.  If vertical dimension is determined to be excessive, the TPB Discluding Element can be easily shaved down with a razor blade.  To increase VDO, use an alcohol torch to quickly heat the surface of the DE (a clear, sticky layer will quickly form), and add a small dab of TPB putty.


Protrusive movement.
Opposing BruxSplints with an NTI style Discluding Element.  Total time to completion:  20 minutes.

Video demonstration of adapting heated ThermoPlasticBead material onto an upper BruxSplint tray. (the midline Discluding Element channel should be ground off if device is intended as a flat plane bruxism splint)


Video demonstration of adapting heated ThermoPlasticBead material onto an lower BruxSplint tray.


For severe asymptomatic bruxers (the patient who grinds through everything that is provided to them, yet have no symptoms), no Discluding Element is required.  Opposing flat BruxSplint planes need no "adjustment" and provide no means of being worn through.  (the example below shows removing the Discluding Element Channel of the upper tray and then opposing it with the lower flat tray).