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Confirm a passive fit over the
incisors before the device is re-lined (left) Reduce the internals
of the device where necessary to allow full seating (the palatal internal
line-angle may need altering) (middle). Align device over the
opposing midline upon closure. Position the device laterally
if necessary (left). It is preferable to have the patient bite on
the Discluding Element (DE) during initial 2-minute cure(right) (the
instructional video says otherwise). This will help to ensure a comfortable
orientation to the opposing incisors. |
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Never “condition” the internal
of the device with monomer or create a too wet or “runny” mixture of acrylic.
Doing so will allow the device to fracture.Allow the acrylic mixture to
be in a “damp and sluggish” state before re-lining device and seating.
Do not pump the device on and off after the first two minutes. Remove
and set aside to fully cure and then trim internals to create a snap fit.
(pumping jams the interproximal acrylic into the papillas) |
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Always check to confirm that
the DE has not created too much opening (left) Reduce the DE as necessary
to create normal freeway space and minimal clearance between canine cusp
tips in excursive (right). Allowing for too much vertical opening
in excursive can strain the joint and symptoms my persist or increase.In
the event the there is an approximately greater than 50% incisal overlap,
the DE may be “ramped” to allow for the appropriate disclusion freeway
space. |
Confirm that in excursive movement
there are no posterior contacts. A palatal cusp may be able
to contact a lower distal buccal cusp. The patient may not be able
to do this upon initial delivery. Within several days to a few weeks,
normalization of the musculature and seating of the condyle may allow for
this contact. Do not increase vertical by adding to the DE,
but reduce the opposing cusp tips. |