Custom NTI-type device fabrication
for excessive incisal overlap

100% incisal overlap

Centric occlusion
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.

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)
The finished device (left) is also an example of the typical "Daytime device" for migraineurs.
Background of the above specific case

Dr. Boyd,
I just saw you listed in the occlusion circle panel discussion and have been frustrated for some time with my occlusion...its a long story, but I'll summarize and hopefully you can help. I was hit by drunk drivers on 2 different occasions, before I was 19. At  19 I had my ortho removed to serve a mission and wore retainers, my apartment burnt down 6 mos later and the retainers melted..I tried to have new ones made in Argentina, but they were never comfortable. At 21 I had all 4 3rds ext'd under general and that's when I noticed a decrease in my ability to open and some grinding habits becoming apparent, whether it was from an aggresive oms showing off to my dad ( usc class of 56) who was watching the procedure and wanting him to refer, my dad wasn't impressed and didn't refer to him in the future, or maybe the stress of keeping my academic scholarship and trying to get my bs in 2 years which I did. Anyways, shortly thereafter my dad placed 4 veneers on 7-10 to close diastemas that reappeared with the disappearance of my retainers and made a max n.g. and I was comfortable for several years, towards the end of dental school (ohsu class of 95) things started to deteriorate and the headaches and sinus and tooth pain increased...this is when I ran into a myotronics seminar. there a NM dentist said he worked in la and after I told him my situation, he said he'd love to have me as a study case, so after four saturdays helping in his office and between pts doing my own workup on the machine, he made me a great lower nightguard and I was the most comfortable that I could remember....then he said that'll be 25,000 dollars to finish the case and I was very upset as he told me nothing about fees and I was just out of school with little kids and a new practice I was starting from the ground up....so I left and he sent me a bill for 3500 for the ng....So after about six monthes the ng split in half, so I mounted my mouth with half the ng and made targis-vectris splints from the canine back  set at that bite and it was awesome, until they started to  isentegrate, so I went to my orthodontist and said I want my teeth moved to this bite, he tried for 21/2 years and couldn't really extrude my molars to open my bite to what the splints had done....so now after that I'm back to ngs that don't work, I've had 2 prosthodontists make me ones that were intolerable, I've tried all the versions of nti and with my overbite so severe they haven't worked and I even went to a neuromuscular guy for a complete workup and thats not comfortable for more than one day, so lately, I'm trying to sleep without a ng, for the first time in 13 years and lets just say that's not so hot either, lots of molar pain and headaches, so sorry to be so long-winded, but I surf in carlsbad, leucadia every wed and fri and so your office is close, if you think you can help I'd love to give it a try, I've read jerry simon's book stop headaches now and am going to pete dawson's lecture next weekend. thanks pat t. or e-mail thanks in advance for reading this long-winded e-mail, I look  forward to your response.

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

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!