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NTI
Tension Suppression System
The most effective FDA-approved method of
migraine prevention
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Clinical insights using auto-cure
composite resin
(courtesy of, and described by, Stephen Markus, DMD)
When the "shells" come in from NTI, before we
stock them, one assistant takes a slow speed, and a large inverted
cone, or round bur, and puts about 6 retention notches on the internal
aspect of the buccal and lingual.
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The shell is then silanated for a minute, and
then Prime and bond one step (so you can bond a self-cure to it) is
light cured over the whole interior portion.
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Use
a non-filled composite, like Luxatemp, Integrity, or Perfect Temp, or
any material you
would normally use to make shrink-wrapped temps.
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This
saves me a whole lot of time at fabrication, because all my shells are
ready to roll.
Looking at the second hand of my watch, I start
to load the composite. I pinch the
shell between the thumb and forefinger of my left hand while loading.
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At the 35 second mark, from when I started loading, with the patient
sitting up, I place and hold the loaded shell in the proper position,
making sure that the DE appears to be parallel to the opposing plane of
occlusion (not sloped down or up, but allowing protrusion of the
mandibular arch in a straight line parallel to the plane). |
At the 90 second mark I take my fingers off the
shell and take a Hollenbach carver and trim off the excess beyond the
shell. Between 1:45 and 2:00 minutes I remove the shell, noting
mentally how retentive it feels.
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Give
the patient the informed consent to read and sign, and go back to the
lab. I round all corners with the acrylic bur. If I felt
the retentiveness was too much, I will take the 4 round, and trim the
interproximal struts to lighten the contact. In the future, if
the patient ever complains it's gotten loose (which seldom, if ever
happens), just add some light cured flowable to the interproximal
areas, reseat the NTI and cure right through it.
When I
have patients in temporaries, I will take the shell and fill it with
Discus' Vanilla Bite until the permanent veneers and crowns are
done. Then I will strip the shell, refresh the bonding agent, and
proceed as above. This eliminates the possibility of the NTI
locking in or snapping the incisal aspect of the tempS.
Hope
this helps everyone.
Symphonic Smiles - hands-on
training in cosmetic dentistry and library of dental office letters
www.symphonicsmiles.com
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