Every restorative, cosmetic, or therapeutic dental procedure has a risk of failure resulting from the potentially destructive forces of occlusion. Dentistry anticipates these forces and incorporates into most every dental procedure techniques to withstand them:

• The reduction of the occlusal surface immediately following a root canal prevents further
                complications resulting from occlusal trauma;
• Posterior composites have high compressive strength and amalgam is condensed thoroughly, not to
                withstand the pressures from chewing food but from the impact of possible parafunction.
• Periodontally involved teeth are splinted together to reduce the acceleration of their mobility due to
                parafunctional forces.
• The chronically sore tooth resulting from occlusal trauma is "adjusted out of occlusion".
• Following comprehensive cosmetic or restorative procedures an occlusal guard is prescribed to
               protect and ensure against damage resulting from parafunction.
• Re-prepping a tooth to the optimum six-degree taper makes the crown least susceptible to dislodgment
               resulting from parafunctional forces.
• Occlusal splints are designed to reduce the amount of TM joint strain during parafunction.

The critical variable of parafunction is the intensity of the act. As the amount of force supplied by the musculature increases, so does the possibility of failure of the above procedures.

A new and simple 10-minute chairside technique, the N.T.I. Tension Suppression System, offers a method to eliminate most every problem presented by parafunction.

The intensity of the destructive muscular contractions is dependent on the availability of canine and/or posterior tooth contact. As soon as canine and/or posterior teeth are in contact, contraction of the temporalis and/or masseter can reach destructive levels. Conversely, if only anterior incisor teeth are in contact, contraction intensity is suppressed by 67%. This is the concept exploited by an anterior deprogrammer. When providing comprehensive restorations, an anterior muscle deprogrammer can be used to reduce muscle contraction intensity and allow for optimal condylar position in centric. However, when the mandible moves laterally, canine contact onto the deprogrammer allows intense temporalis contraction and resultant joint strain, which is why a deprogrammer fails when used therapeutically.

Used primarily during sleep, the N.T.I. Tension Suppression System is a simple (and profound) enhancement of a muscle deprogrammer. A pre-formed matrix provides a centrally located occluding surface which is narrowed to a center contact, thereby preventing canine contact in excursive movements, and extended anteriorly and posteriorly to maintain tension suppression in full protrusive and retrusive movement. An auxiliary can execute the majority of the fabrication of the NTI-tss, with a final check by the practitioner. The matrix is relined with cold cure acrylic (Parkell’s clear and colorless SNAP is recommended) which allows for a secure, stable and retentive fit in which the device can only be removed by the intentional effort of the patient. Following adaptation of the matrix, the discluding element is customized for the individual patient, allowing for minimal vertical opening with canine and posterior disclusion in all excursive movements. Since it is impossible to chew with the NTI-tss in place, daily masticatory stimulation prevents any adverse tooth movement, while the suppressed muscle contraction prevents trauma to the incisors.

An NTI-tss is ideal in everyday practice:
 

• For the prevention of occlusal trauma (i.e., following root canal therapy or for the chronically sore tooth);
• To prevent damage to cosmetic and/or restorative procedures;
• For occlusal protection from nocturnal bruxism;
• For reduction of joint strain and symptoms of TMD.

The N.T.I. Tension Suppression System can be ordered direct from the manufacturer, NTI-TSS, Inc., by calling toll-free: 1-(877) 4-NTI-TSS.