| Custom
fabrication
of an NTI-type device for a Full Denture
|
| 1. Take an impression and pour a
model of the
maxillary full upper denture.
2. Using .06" thick plastic sheeting for vacuum
forming,
make a "suck-down" of the entire
model (referred to here as a "stent").
3. Using orthodontic acrylic in a damp, doughy
stage, form
a DE on the warm stent that will oppose
the midline of the mandibular incisors.
4. When cutting away the stent from the model, follow
the borders
of the denture and do not remove
the palate portion. The result
will look like a clear, thin, full upper denture with a DE on it.
5. Snap the stent over the patient's denture and
instruct them
to wear it during sleep (along with
their opposing denture if applicable).
Typically, the patient's appearance
may improve
with
the device in place, suggesting that the vertical dimension of
occlusion
of the denture was inadequate. The intensity of their clenching
was
most likely not the cause of their symptoms (full denture
wearers
can't generate the kind of intensity that someone with a full dentition
can), but was caused/triggered/enhanced by the the over-closed rotation
of their condyles during their clenching activity (it would not
be unusual for a full-denture patient who clenches to complain of joint
pain, whereas a primary clencher
(who doesn't clench excursively) with a full dentition rarely
complains of joint pain).
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An example of providing an NTI-type device over a partial denture:

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