bruxing appliance for ortho patient

hydent · 01-27-2010, 11:44 AM

ok here is probly a dumb question from a denture guy to all of you ortho techs.
I have been in braces for a year and a half my teeth arent moving for sh!t me and my orthodontist think it is due to my clenching and bruxing problem. Is there a devise that could keep me from clenching and bruxing at night that wont interfere with my treetment?

kcdt · 01-27-2010, 04:48 PM

What about a modified NTI?

hydent · 01-27-2010, 06:32 PM

Ive seen some nti patients with some major problems with anterior splaying. what is a modified nti?

kcdt · 01-27-2010, 08:01 PM

If you're in braces, then how is this splaying supposed to happen? by modified i mean to fit the situation...
The problem you described is ineffective ortho treatment because the bruxing keeps forcing the teeth back into original MI.
An NTI would stop the duelling forces and let the ortho move the teeth, and if you're in ortho, then i really can't see how that would lead to anterior flaring, which would be occuring because there is nothing like a labial arch wire to stop the force pushing from the lingual.
The major issue with NTIs are AOB as a result of condylar seating in CR, and since you're in ortho, you'd wind up idealized in CR...
so what's the problem?
Its just a form of anterior deprogrammer, and as it covers fewer teeth it would be easier to adapt as the ortho does its thing, as opposed to a full coverage splint, which would have to be remade everytime the teeth moved, if it didn't wind up being counterproductive to the ortho (like wearing a retainer that maintains the original position that ortho's trying to alter). Also the NTI reduces the clenching forces during the bruxing episodes, and as the posterior teeth are discluded, the forces forcing them into MI contrary to the goals of ortho are out of the picture.

hydent · 01-27-2010, 10:04 PM

thanks Ken for your input I'm willing to try anything to speed this up.

Smilewire · 01-28-2010, 02:42 AM

Are you sure your teeth are not ankleous(sp?) I find it odd that clenching would prevent movement. You can go with a acrylic palate with some type of bitepad and 4 total ball clasps....I've also made sportguards for people with Braces a soft thermoformed appliance may help yet it wont prevent you from clinching, nothing will...Well except for some Yoga and other types of stress relievers

here I found it:
Sometimes the roots don't dissolve properly, and instead they fuse directly to the jawbone. The fusion may occur because the ligament that normally surrounds the tooth in the jawbone is lost. This condition is called ankylosis (ang-kil-LO-sis).

hydent · 01-28-2010, 12:11 PM

my orthodontist asked me if I had any trauma to these certain teeth and I didn't. the spaces all closed but my midline will not move to line up. I know my teeth are capable of moving because they already have moved now they are just at a standstill.
Yoga now thats a different aproach way to think outside of the box. that might have to be a last resort if my friends found out I was doing yoga who knows what they would start to think.

kcdt · 01-28-2010, 03:36 PM

Stress reduction may help a bit, but nothing ever really stops bruxism. The occlusion gurus will tell you that all that can be done is to get the teeth into mutually protected occlusion in CR. this won't stop bruxing, but will protect the teeth from damage (MPO), and overload/ damage to the TMJ (CR).
All mammals chew to relieve stress and in humans this tends to happen during sleep, and as such we have very little control over it.
It is impossible to stop it by alteration of the occlusion, as was once believed, and the current thinking is more along the lines of force and damage reduction.

hydent · 01-28-2010, 05:05 PM

Ken have you attended any seminars by Frank Spear? (it seems like you have) If you haven't he is a great teacher on the subject of occlusion. The more I think about it I think something like the nti would be great for my case. I agree there is no cure for bruxism. The band aid is, as you said force and damage reduction.

kcdt · 01-28-2010, 08:19 PM

Quote:

Originally Posted by hydent

Ken have you attended any seminars by Frank Spear? (it seems like you have) If you haven't he is a great teacher on the subject of occlusion. The more I think about it I think something like the nti would be great for my case. I agree there is no cure for bruxism. The band aid is, as you said force and damage reduction.

My background is Pankey/Dawson. I fabricated fixed and removable in house for one of the founders of the Pankey Institute.

hydent · 01-29-2010, 12:22 PM

Quote:

Originally Posted by kcdt

My background is Pankey/Dawson. I fabricated fixed and removable in house for one of the founders of the Pankey Institute.

Wow that must have been great to be mentored by someone like that!

Smilewire · 01-29-2010, 12:30 PM

Yoga is getting more mainstream! I teach yoga.. I have defintely improved my TMJ disorder through exercises from yoga and destressing.. we tend to store stress in different parts of our bodys shoulders neck and jaw.. Next summer Im going to be teaching a yoga class focusing on these types of disorders and as advertisement to all the Dr.s and Orthodontists I'm going to give them coupons to give there patients for the free class! hows that for thinking outside the box? holistic
Class Schedule

kcdt · 01-29-2010, 03:41 PM

Quote:

Originally Posted by hydent

Wow that must have been great to be mentored by someone like that!

those were great years for me, and that despite the fact that it was a typical office full of typical office politics, which I can't stand.
I had more pieces of the puzzle click into place in my head there than any other place I'd ever worked, and it led to my first lab.

kcdt · 01-29-2010, 03:44 PM

Quote:

Originally Posted by Smilewire

Yoga is getting more mainstream! I teach yoga.. I have defintely improved my TMJ disorder through exercises from yoga and destressing.. we tend to store stress in different parts of our bodys shoulders neck and jaw.. Next summer Im going to be teaching a yoga class focusing on these types of disorders and as advertisement to all the Dr.s and Orthodontists I'm going to give them coupons to give there patients for the free class! hows that for thinking outside the box? holistic
Class Schedule

Sounds brilliant to me. if you're in the Bay area you just about have a ready made market for it.
Let me know how it goes, as cross marketing its one of the most imaginative I've heard.

hydent · 01-29-2010, 07:41 PM

ready made market for the bay area, now thats funny!!! I dont care who you are.

karabear · 01-29-2010, 07:44 PM

Quote:

Originally Posted by hydent

Ive seen some nti patients with some major problems with anterior splaying. what is a modified nti?

I am a clencher and keep my tongue in a forward interdental posture. I tried an NTI modified to fit around my upper labial bow. I still had splaying.

kcdt · 01-29-2010, 10:25 PM

Quote:

Originally Posted by karabear

I am a clencher and keep my tongue in a forward interdental posture. I tried an NTI modified to fit around my upper labial bow. I still had splaying.

Well I've always contended there are no magic bullets, and as treatment modalities go, the NTI does have downsides.
Did they ever come up with a workable appliance for the situation?

Brian · 02-01-2010, 05:01 PM

Quote:

Originally Posted by Smilewire

Yoga is getting more mainstream! I teach yoga.. I have defintely improved my TMJ disorder through exercises from yoga and destressing.. we tend to store stress in different parts of our bodys shoulders neck and jaw.. Next summer Im going to be teaching a yoga class focusing on these types of disorders and as advertisement to all the Dr.s and Orthodontists I'm going to give them coupons to give there patients for the free class! hows that for thinking outside the box? holistic
Class Schedule

Ken has pretty much nailed this one up...

As for Yoga?? Hey I don't knock anything, but from my experience the best stress reduction exercise is scotch and sex.. And may I add when both are used simultaneously you can get the what I call the noodle leg effect..

karabear · 02-01-2010, 06:36 PM

Quote:

Originally Posted by kcdt

Well I've always contended there are no magic bullets, and as treatment modalities go, the NTI does have downsides.
Did they ever come up with a workable appliance for the situation?

Nope. I just crunch and chew thru several nightguards a year.

karabear · 02-01-2010, 06:39 PM

Quote:

Originally Posted by Brian

Ken has pretty much nailed this one up...

As for Yoga?? Hey I don't knock anything, but from my experience the best stress reduction exercise is scotch and sex.. And may I add when both are used simultaneously you can get the what I call the noodle leg effect..

I guess a teetotalling, sexually abstinent woman can expect this kind of angst to express itself somewhere.
Pass the Alfredo sauce!

01-27-2010, 11:44 AM	#1 (permalink)
hydent Member Join Date: Dec 2009 Location: Nevada Posts: 94 Rep Power: 1	bruxing appliance for ortho patient ok here is probly a dumb question from a denture guy to all of you ortho techs. I have been in braces for a year and a half my teeth arent moving for sh!t me and my orthodontist think it is due to my clenching and bruxing problem. Is there a devise that could keep me from clenching and bruxing at night that wont interfere with my treetment?

01-27-2010, 08:01 PM	#4 (permalink)
kcdt Senior Member Join Date: Jun 2008 Posts: 507 Rep Power: 2	If you're in braces, then how is this splaying supposed to happen? by modified i mean to fit the situation... The problem you described is ineffective ortho treatment because the bruxing keeps forcing the teeth back into original MI. An NTI would stop the duelling forces and let the ortho move the teeth, and if you're in ortho, then i really can't see how that would lead to anterior flaring, which would be occuring because there is nothing like a labial arch wire to stop the force pushing from the lingual. The major issue with NTIs are AOB as a result of condylar seating in CR, and since you're in ortho, you'd wind up idealized in CR... so what's the problem? Its just a form of anterior deprogrammer, and as it covers fewer teeth it would be easier to adapt as the ortho does its thing, as opposed to a full coverage splint, which would have to be remade everytime the teeth moved, if it didn't wind up being counterproductive to the ortho (like wearing a retainer that maintains the original position that ortho's trying to alter). Also the NTI reduces the clenching forces during the bruxing episodes, and as the posterior teeth are discluded, the forces forcing them into MI contrary to the goals of ortho are out of the picture. Last edited by kcdt : 01-27-2010 at 08:11 PM.

01-29-2010, 12:30 PM	#12 (permalink)
Smilewire Senior Member Join Date: May 2009 Location: Bay Area Posts: 134 Rep Power: 1	Yoga is getting more mainstream! I teach yoga.. I have defintely improved my TMJ disorder through exercises from yoga and destressing.. we tend to store stress in different parts of our bodys shoulders neck and jaw.. Next summer Im going to be teaching a yoga class focusing on these types of disorders and as advertisement to all the Dr.s and Orthodontists I'm going to give them coupons to give there patients for the free class! hows that for thinking outside the box? holistic Class Schedule Last edited by Smilewire : 01-29-2010 at 12:31 PM. Reason: spelling

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01-27-2010, 04:48 PM	#2 (permalink)
kcdt Senior Member Join Date: Jun 2008 Posts: 507 Rep Power: 2	What about a modified NTI?

01-27-2010, 06:32 PM	#3 (permalink)
hydent Member Join Date: Dec 2009 Location: Nevada Posts: 94 Rep Power: 1	Ive seen some nti patients with some major problems with anterior splaying. what is a modified nti?

01-27-2010, 10:04 PM	#5 (permalink)
hydent Member Join Date: Dec 2009 Location: Nevada Posts: 94 Rep Power: 1	thanks Ken for your input I'm willing to try anything to speed this up.

01-28-2010, 02:42 AM	#6 (permalink)
Smilewire Senior Member Join Date: May 2009 Location: Bay Area Posts: 134 Rep Power: 1	Are you sure your teeth are not ankleous(sp?) I find it odd that clenching would prevent movement. You can go with a acrylic palate with some type of bitepad and 4 total ball clasps....I've also made sportguards for people with Braces a soft thermoformed appliance may help yet it wont prevent you from clinching, nothing will...Well except for some Yoga and other types of stress relievers here I found it: Sometimes the roots don't dissolve properly, and instead they fuse directly to the jawbone. The fusion may occur because the ligament that normally surrounds the tooth in the jawbone is lost. This condition is called ankylosis (ang-kil-LO-sis).

01-28-2010, 12:11 PM	#7 (permalink)
hydent Member Join Date: Dec 2009 Location: Nevada Posts: 94 Rep Power: 1	my orthodontist asked me if I had any trauma to these certain teeth and I didn't. the spaces all closed but my midline will not move to line up. I know my teeth are capable of moving because they already have moved now they are just at a standstill. Yoga now thats a different aproach way to think outside of the box. that might have to be a last resort if my friends found out I was doing yoga who knows what they would start to think.

01-28-2010, 03:36 PM	#8 (permalink)
kcdt Senior Member Join Date: Jun 2008 Posts: 507 Rep Power: 2	Stress reduction may help a bit, but nothing ever really stops bruxism. The occlusion gurus will tell you that all that can be done is to get the teeth into mutually protected occlusion in CR. this won't stop bruxing, but will protect the teeth from damage (MPO), and overload/ damage to the TMJ (CR). All mammals chew to relieve stress and in humans this tends to happen during sleep, and as such we have very little control over it. It is impossible to stop it by alteration of the occlusion, as was once believed, and the current thinking is more along the lines of force and damage reduction.

01-28-2010, 05:05 PM	#9 (permalink)
hydent Member Join Date: Dec 2009 Location: Nevada Posts: 94 Rep Power: 1	Ken have you attended any seminars by Frank Spear? (it seems like you have) If you haven't he is a great teacher on the subject of occlusion. The more I think about it I think something like the nti would be great for my case. I agree there is no cure for bruxism. The band aid is, as you said force and damage reduction.

01-29-2010, 07:41 PM	#15 (permalink)
hydent Member Join Date: Dec 2009 Location: Nevada Posts: 94 Rep Power: 1	ready made market for the bay area, now thats funny!!! I dont care who you are.