This activity has been
planned and implemented in
accordance with the standards of Academy of General
Dentistry Program Approval
for Continuing Education (PACE) through the joint program provider
approval of
Meridian Center of Keller Laboratories, Inc., Dr. Jim Boyd, and Dr.
Barry
Glassman. The Meridian
Center
is approved for
awarding FAGD/MAGD credit.
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NTI
Tension Suppression System
The most effective FDA-approved method of
migraine prevention
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A selection of submitted photos demonstrating common errors and
misconceptions
DAYTIME DEVICE
FAILURE Although the patient may
prefer a Daytime Device due to its smaller size and greater comfort,
its use during sleep can allow for considerable persistance (or
increased) symptoms
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UNCLEAR ON THE CONCEPT
Submitted by a patient, wanting to know if the design of their NTI
device was within normal limits.
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Canine clenching in excursive
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Excessive vertical opening
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Canine clenching in excursive
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THE DEVICE STOPS WORKING
Following a period of resolution of signs and/or symptoms, the patient
may report that the signs/symptoms eventually returned, as the device
"stopped working"
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The labial margin and labial bulk of the DE should be reduced for
patient's comfort.
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The patient should be informed that in the event a divot develops in
the DE, to return to have it restored.
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As a result of the deep divot, osterior clenching contacts may allow
signs/symptoms to return.
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In each example to the right and left, following
resolution of joint signs/symptoms, an excursive shift created for a
unilateral posterior contact which allowed signs and symptoms to
return. The reduction of the opposing cusp tips resolved the
signs/symptoms.
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Without addressing the
contacts that an un-adjusted NTI can allow for (left: canine contact on
the lateral aspect of the device; center: canine contact on the DE in
excursive; right: posterior clenching in protrusive), the presense of
the device and resulting parafunctional activity can cause
signs/symptoms to persist or increase. An IG device was
provided to the above patient and symptoms resolved shortly thereafter.
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EXCESSIVE PROTRUDING SLOPE
An upper device is indicated for a deep incisal bite (left), as the DE
can be ramped up towards the palate to keep VDO to a minimum.
However, the slope of the DE as it protrudes beyond #8 and #9 (center)
can create excess condylar rotation during parafunction protrusive
clenching. Alter the slope of the DE that is anterior to
the incisors by leveling to parallel with the maxillary plane.
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