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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.


Try-in/adapt in the protrusive, edge-to-edge position


Reline with ThermoPlasticBead putty, remove, reseat as TPB opacifies.


Final delivery, incisor
edge-to-edge position.



Protrusive.  RAMP THE LOWER DE "DOWN' TO MINIMIZE
VERTICAL DIMENSION.



Retrusive


Left excursive.   Distal ends of devices can be "rounded" to provide tangent contact to
opposing device.



Right excursive.


NTI2.0 "Winged Deprogrammer" Chairside Protocol

Winged Deprogrammer Delivery:      ( How to increase Vertical Dimension , click here)                              




The adjustable lateral wings of the Winged Deprogrammer devices are employed when adapting to an arch when lateral incisor(s) are malaligned, or arch width is narrow.




The un-bent wing of the
device would feel excessively bulky under the patients lip...




The practitioner can bend and adapt the wings to conform to the patient's arch.



  Immerse the ThermoPlasticBeads in hot water until they coalesce into a clear putty state.




The adapted device (with bent wing) prior to lining with warmed ThermoPlasticBead material.




Upon lining each device with warmed ThermoPlastic, have the patient occlude  in an incisal edge-to-edge relationship.

As the ThermoPlastic is cooling, its appearance will transition from clear, to translucent grey, to opaque white.  Pump the devices on and off a couple of times at the "grey but still translucent" stage to ensure  proper, but not excessive, retention.




 Retruded and protruded positions






Right and Left excursions


Internal adjustment and/or re-adaptation is easily accomplished (for example, upon delivering a new restoration to one of the teeth encompassed by the device) by immersing the entire device in hot water for 4 seconds.  The surface of the ThermoPlastic material will soften before the entire device does (don't leave the device in the hot water for too long!).   The device can then be easily re-adapted

If improved retention is desired, proceed as above, but refrain from pumping the device on and off during cooling.

Additional retention can be acquired by extending more ThermoPlastic laterally.  Dip only the distal ends of the device into hot water, place back onto the teeth, and directly place more ThermoPlastic putty onto the warmed (it will be "sticky") portion of the device's ThermoPlastic. 
Extend a retentive lateral "wing" as necessary.

Increasing Vertical Dimension
In the event that the two oppsing devices do not adequately disclude the posterior teeth (as shown on the left), have the patient bite on either a cotton roll (or folded paper towel) when loading and delivering the devices with the ThermoPlastic material, allowing the ThermoPlastic material to extend apically as necessary to provide for labial retention.



The image on the right shows only the maxillary device being repositioned in order to increase vertical dimension.  The practitioner may elect instead to "split the difference" by repositioning both devices half as much as one by itself.