NTI-SS Daytime Device

SKU:

NTI-DD
NTI-IGR
NTI-IGW
NTI-RV1
NTI-SD
NTI-UD
NTI-WD

 

Daytime Device:

When lined with a clear orthodontic cold-cure acrylic, the Daytime Device can be used at habit-breaking device for daytime use.  In patients with a deep overbite (thereby with less probability of protrusive parafunction beyond incisal edge-to-edge), this device can also be used during sleep.

Also considered an “Auxiliary Slider”, it can be modified to be delivered as an opposing device to any of the of the other NTI devices, or most ideally,  two Auxiliary Sliders opposing each other .   Due to its extremely low profile, the Auxiliary Slider should not be automatically considered as an individual nocturnal therapeutic device, except for daytime use.

 

Incisal Guidance Device:

The Lower device is the most commonly used device. The Discluding Element (DE) of the Lower Device is tapered to the lateral borders of the device. Primarily intended for the mandible (although not exclusively), the design most efficiently prevents canine occluding contact.

 

Incisal Guidance Wide Device:

Has a thicker (and therefore, stronger) DE. The Lower-Wide was originally designed for the patients whose extremely intense clenching could fracture the original Lower device (the thickness of the Lower device’s DE has since been increased, now making the Lower-Wide device less frequently necessary). The width of the Lower-Wide allows for increased retention for those cases where added retention is desired (however, with the use of the ThermoPlastic material instead of cold-cure acrylic, extending to acquire more retention makes having a wide and “bulky” device no longer necessary).

 

Reduced Vert Max Dev:

The Discluding Element has been “pre-reduced” (making the DE not as large as that of the Standard device).

The Upper “Reduced Vertical” NTI device is most commonly used when incisal overlap is more than ideal (excessive), making the Lower device contraindicated (the Lower device would cause for an excessive condylar rotation, ie, excessive VDO, during occluding on the device). The DE can be ramped “up” towards the palate to ensure minimal VDO during occluding (thereby minimizing condylar rotation).

 

Standard Device:

For general nighttime use, the Discluding Element of the original Standard device must typically be altered by the practitioner for proper vertical dimension and horizontal orientation. Upon final modification, the Standard device will closely resemble the  current Upper or Lower device.  The Standard device was the original design of an NTI.

 

Universal Device:

 

Standard Wide Device:

For general nighttime use, the Standard WIDE must typically be considerably altered by the practitioner for proper vertical dimension and horizontal orientation. Upon final modification, the Standard device will closely resemble the Upper or Lower device.  The Standard WIDE device is the wider version of the original design of an NTI (for additional retention).

 

To Learn More:

Minimize joint strain/load  (that is, ensure minimal condylar rotation during occluding by keeping the vertical dimension of occluding (the posterior freeway space) at a minimum in ALL excursive/protrusive positions). (ideal posterior freeway space would be no more that 2mm)

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Determination of the placement of an NTI device on either the maxillary incisors or mandibular incisors is a factor of the resulting degree of condylar rotation (Vertical Dimension of Occluding) and lack of providing the accessibility of canine contact on the device in excursive movements.

The default placement is on the mandibular incisors, as opposing maxillary canine contact on the device is less likely when using the lower device.

When excessive incisal overlap results in considerable VDO, the upper device is used, and the Discluding Element is contoured (typically ramped “up” towards the palate) to minimize the VDO.

Using “opposing auxiliary sliders” can provide a superior outcome in most cases.

 

Click on the diagram below to enlarge, or download the pdf of the Fabrication Protocol Flow Sheet:

 

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NTI devices are always provided with accompanying ThermoPlasticBeads.  TPBs have become the standard method of adapting and retaining oral devices (particularly apnea devices).  Modifications and re-adaptations are readily accomplished.

CLICK HERE for Essential insights when using the ThermoPlasticBeads.

Upon lining a device with the TPB material, external trimming is easily accomplished with a “safety razor” (the kind you buy at the hardware store for scrapping windows, etc.)  The resulting surface can be “brushed” with an alcohol torch, and then placed it back in the mouth, allowing the buccal mucosa to create a smooth, slick surface.

An acrylic (egg-shaped) bur can be used, but only at the highest speed, and with a gentle shaving motion (otherwise, it just gums up), followed by the “flame-brushing” of the shaved surface.

 

Delivery insight from Dr. Boyd’s presentation:  The Where and Why of the NTI

 

Below is a chairside delivery example of an NTI device for a migraine and jaw pain patient.

 

Some “insider info” on NTI delivery

A critical insight in avoiding the most common source of failure:

 

Many practitioners prefer to have an outside laboratory fabricate the NTI device.  Keller Laboratory (and their licensed labs) is the exclusive licensed lab to provide the “NTI-plus“.

Keller Lab has produced a fantastic series of helpful videos regarding NTI protocol.

 

Practitioners can send their request for a Trial Kit of NTI devices to Help.ChairsideSplint@gmail.com.  We’ll then provide the link to the NTI Trial Kit page and a checkout code for a 100% discount on the kit fee (you’ll pay for postage/handling only).  We’re always interested in how you became aware of the NTI Therapeutic Protocol, so please let us know where you’ve heard or read about the NTI.

 

Curiously, there are some “educators” who provide “disinformation” regarding the NTI Therapeutic Protocol.  Before is a photograph of a slide presented by Terry Tanaka, DDS, regarding the NTI and “anterior jigs”.  The audio from the lecture can be heard.  The audio is paused occasionally to insert corrections and insights so as to properly inform the viewer.