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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

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.


Basics of Migraine Pathophysiology

as it relates to the NTI's Method of Action

Cleared Indication #1:
 
A device to be used in the prophylactic treatment of medically diagnosed migraine pain
as well as migraine associated tension-type headaches,
by reducing their signs and symptoms through reduction of trigeminally innervated muscular activity.
 
(NTI-tss devices are manufactured of Lexan 144R polycarbonate, deemed safe for use by the FDA)
 
 

 
Migraine:  A Disorder of the Trigeminal Nerve
 
V-divisionsV-motor-sensory
The third divsion of the Trigeminal Nerve also transmits motor  instructions to the jaw muscles. Necessary jaw muscle contraction intensity is regulated by the resistance encountered (hardness of food)
 
 
V-surface-areas
  The Trigeminal Nerve gets its name from its three sensory divisions:
1: Opthalmic (transmits sensations from around eyes, forehead, scalp, surface arteries of the brain;
2: Maxillary (upper jaw and sinuses);
3. Mandibular (lower jaw)
providing sensations from everything below the cheekbone, including teeth,lips, gums, and the jaw joint. 
 
 
In migraine, the main center for sensation reception (called the "sensory nucleus") has somehow become hyper-sensitized, responding unfavorably to normal outside stimuli (termed, "dysmodulation ") 
 
 
 
An example of "sensory dysmodulation" is the response to certain stimuli (commonly known as "triggers") with illicit neuropeptide secretions that irritate and inflame arteries surrounding the brain (via the first division of the trigeminal, resulting in migraine pain) and within the sinuses (via the second division, resulting in pain, stuffiness and discharge, or "sinus headache"). 

Sensitized-V-nerve
Hyper-V3-temp
 
Until recently, the third division had been ignored as a possible contributing factor in migraine.

In a large percentage of migraine sufferers, the motor root which travels within the same conduit as the third division is hyperactive during certain stages of sleep, commanding tremendous amounts of potentially damaging activity from the jaw muscles, termed "parafunction".  Thisresultsin a bombardment of noxious (negative) informationgoing back to the sensory nucleus, thereby sensitizing it,
 
making the patient far more susceptible to migraine attacks.
 
During uncontrolled nocturnal parafunction (jaw-clenching, either in a centered or a sideways-shifted position), massive amounts of noxious input (nociception) bombards the trigeminal sensory nucleus.
 
CONTROLLING PARAFUNCTION
 
By keeping the molar and canine teeth from touching (thereby minimizing the intensity of muscle contraction intensity) while minimizing the degree of condylar rotation (jaw opening) during the parafunctional events, Nociception to the Trigeminal is Inhibited. (therefore, it is not the presence of incisor (front tooth) contact that is therapeutic, but the absence of posterior and/or canine contact)

The NTI device reduces trigeminal motor hyper-activity and the resulting noxious afferent bombardment to the trigeminal sensory nucleus, thereby reducing dysmodulation.
 

 
 
NTI
The NTI device reduces trigeminal motor hyper-activity and the resulting noxious sensations back to the trigeminal nerve.
Model

Morning-migraine-timing

 

  

While touching the muscles of your temples, bite down on a wooden pencil with your back teeth as hard as you can.  You'll feel the muscles bulge as it intensely contracts.  Now compare to when biting on the pencil with your front teeth only.  That's how the NTI device works. 

 
 




NTI FDA trials