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If the NTI was delivered as above, protruding "down the ramp" can cause joint strain. The ramp should be parallel to the maxillary occlusal plane as the mandible protrudes beyond edge-to-edge. |
| Once the surface of the Discluding Element is parallel to the maxillary occlusal plane (above), vertical dimension can be altered more effectively. When reducing vertical, it is best to first level the DE. Beveling or ramping the DE is permissable so long as the patient can clench on the DE and NOT experience pain or tenderness of the opposing incisor(s). |  |