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The next evolution in NTI dental splint therapy:

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CHAIRSIDE SPLINTS:
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P
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.

Listing of NTI-type and BruxSplintTM  devices
Winged Deprogrammers (NTI2.0)   introduction
(See: NTI 2.0 Chairside delivery protocol)
Rapidly becoming the treatment of choice in most cases, when compared to using a single NTI device (below), the opposing devices minimize the resistance that an opposing incisor can often provide to a single device, while keeping vertical dimension to a minimum,  Also saves the usual time required to adjust the DE to the opposing incisors. 



LOWER "INCISAL GUIDANCE" DEVICE
The Lower device has the most commonly used device. The Discluding Element (DE) of the Lower device is tapered to the lateral borders of the device. Primarily intended for the mandible (although not exclusively), the design most efficiently prevents canine occluding contact.  (See:  Chairside delivery protocol

UPPER "REDUCED VERTICAL" DEVICE
The Upper device is most commonly used when incisal overlap is more than ideal, making the Lower device contraindicated (the Lower device would cause for an excessive condylar rotation, ie, excessive VDO, during occluding on the device). The DE can be ramped "up" towards the palate to ensure minimal VDO during occluding (thereby minimizing condylar rotation).  The Upper "RV" device is the "pre-sculpted" version of the Original Standard device where the Discluding Element has been reduced.

Auxiliary "slider"

Commonly used with a "deep bite" incisal overlap, where the DE is considerably ramped or "stepped" to maintain minimal opening. It can also be used over the incisors that oppose an NTI device (typically the Lower device) to prevent the Lower device from fracture and/or to facilitate gliding movements when the incisors opposing the NTI device are irregular.  
(SEE:
Chairside protocol for delivery of Opposing Auxiliary Sliders)

Lower-Wide
Has a thicker (and therefore, stronger) DE. The Lower-Wide was originally designed for the patients whose extremely intense clenching could fracture the original Lower device (the thickness of the Lower device's DE has since been increased, now making the Lower-Wide device less frequently necessary). The width of the Lower-Wide allows for increased retention for those cases where added retention is desired.



STANDARD DEVICES

The Standard devices (original and wide) were the original design of the NTI-tss, but many practitioners feel it is no longer the treatment method of choice, due the increased likelihood of undesired outcome from lack of proper modification.  In most every case, the Discluding Element requires careful modification, typically reduction (however, the considerable size of the Discluding Element provides more versatility).   The Upper Device was developed as the replacement for the Standard device, as its DE is "pre-modified".  The Lower Device was developed as the more commonly indicated treatment of choice over the Upper Device (to avoid canine contact on the device in excursive positions). 


BruxSplintTM      (click here for fabrication and delivery protocol)

     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.




 






The maxillary BruxSplint tray (above right) has an anterior midline channel within which the practitioner allows ThermoPlastic to flow into to form a Discluding Element.  The DE creates a "B-splint" (Bruxing Splint), thereby providing for both clenching suppression, grinding protection, and tooth position retention.
 





BruxSplint flat plane dental protection

Not every case of nocturnal parafunction requires the incorporation of a Discluding Element for clenching suppression.  In the absence of symptoms, where only the objective protection of the dentition is required, a simple
BruxSplint flat plane splint can be provided by using the lower tray only.


Quick and easy technique to provision of opposing BruxSplints



Disclaimer regarding BruxSplints Full Coverage Flat Plane Splints: 
The Full Coverage Flat Plane BruxSplints shown on ChairsideSplint.com have not be submitted to the FDA for the evaluation of their safety and efficacy of the treatment of any disease or condition.   As shown, they are "inert"  without considerable modification and customization by a healthcare provider or technician.  They are intended to be used only by a licensed healthcare professional or licensed dental laboratory technician as aids in the pursuit of a diagnosis made by the professional, or as an aid to the healthcare professional in the custom fabrication of a specific prescribed treatment. 



The original NTI-tss® is the same as the  AMPSA CS ® device: