100% incisal overlap |
Centric occlusion |
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Using a Standard NTI without considerable reduction of the Discluding Element would be contra-indicated, due to the excessive vertical opening it would create. Reducing the DE to create appropriate vertical dimension may significantly weaken the matrix... |
A custom device can be easily fabricated: A) Significant incisal overlap; B) Vaccum formed plastic sheet material; C) A dollop of cold cure acrylic; D) Patient bites on posterior 2-3 mm thick paper towel while incisors "sink" into dollop of acrylic. Upon curing, sculpt acrylic to create a vertical stop. |
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Vaccuum a .06" thick rigid sheet, add a domb shaped Discluding Element at the cingulums |
Cut away to include lateral through lateral |
The opposing lower centrals should contact the DE in centric. Reline with an acrylic wash on the lingual side. The device should not have any flexibility upon contact. Flexibility / resiliancy encourages activity (which is not good). The device should feel like a part of their head, not a thing on their teeth. |
Although there may be the ability to occlude in excursive movements, the parafunctional pattern of the 100% incisal overlap patient (with no overjet) is usually clenching only, with no excursive movements (the canine teeth are still pointed) |
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The finished device (left) is also an example of the typical "Daytime device" for migraineurs. |
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Dr. Boyd,
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| After first night:
I can’t say I’m without discomfort, but its like you said, it feels different, an strange sensation that something is going on around my joint/temporalis area, I know I woke up quite a bit last night, probably from trying to clench against the device, but I was much better rested than normal, and I would say pain was at a 3-4 level…BUT this is the cool part, when I took out the device, for the first time in quite awhile, from the canines back, my teeth came together! What a feeling to not be hitting only on 9 and 24! I’m very enthusiastic for more improvement….I know I’ll need an equilibration because the contacts don’t mesh, but still what a sensation to have my teeth occluding in any fashion! I just want to thank you again for the time, effort, and enthusiasm in helping my plight…Please let me know if I can be of service in any way. Gratefully, pat |
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| Slept much better, aches almost non-existant, posterior teeth still coming together after removing the device, so unusual to hear all my teeth clattering when closing, thanks again! pat | |
| On day 4 (or night 4) I should say, I finally slept through the night! From 10:30 to 5:00 am I slept without getting up! This is a first in so long that I can't remember the last time...still feeling great muscle tenseness is way down and I'm excited for my trip to St Pete's beach and Dawson's course, with a fresh outlook! | |