Favorite Deprogrammer for FMR

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Starting a full upper/lower fixed case for a newer Dr. Dont have any pics yet, but the pt has moderately severe wear.

What is everyones go-to deprogrammer to open a bite 2-3mm and record excursions. Im thinking of doing a splint like a Tanner, but not sure if the worn teeth in posterior will allow it. Also considering an NTI style appliance but not sure what the Drs preference is. Meeting with him today. I want something comfortable that the pt can wear until we get some temps done, not sure she will want to fool with an NTI.

What say ye DLN?
 
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at aurum we used to make removable orthotics out of eclipse, with ball clasps, to be worn on a 6-9month maximum basis, before making bonded orthotics (putty matrix style) to the new movements.

i never bothered to learn any other method.
 
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Deprogrammers:
Lucia
PAD
Kois
Even a leaf gauge.

The sole use is to seat the condyles.
To program long term, you need to capture CR when then condyles seat and produce your orthotic to that.

NTI is a pain management device. It is not a deprogrammer.
 
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So youre saying theres a difference between a lucia and an nti? The ramp angle or length of use? They look the same.
 
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To be specific , I want something the Dr can use chairside to find a repeatable CR and lateral excursions, then take a bite, then make MX waxup/temps. Melkers uses an NTI to do this, I know it can be used nightly for pain, but why cant it be used to eliminate excursive contacts and test if PT is comfortable? Basically a gothic arch tracing. Becuase the teeth are so worn, im not sure I want to use the lower incisors to mark the anterior NTI or lucia, so I might just do a lower splint/guard with a flat plane, the PT can wear while she is in mx temps along with a lucia upper. Maybe I will do a small node on the lower to mark an upper lucia jig.
 
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Also KCDT, the NTI website even considers their NTI device a 'winged deprogrammer' but this is what I would like to do, probably with just bite splints.:
 
2thm8kr

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To be specific , I want something the Dr can use chairside to find a repeatable CR and lateral excursions, then take a bite, then make MX waxup/temps. Melkers uses an NTI to do this, I know it can be used nightly for pain, but why cant it be used to eliminate excursive contacts and test if PT is comfortable? Basically a gothic arch tracing. Becuase the teeth are so worn, im not sure I want to use the lower incisors to mark the anterior NTI or lucia, so I might just do a lower splint/guard with a flat plane, the PT can wear while she is in mx temps along with a lucia upper. Maybe I will do a small node on the lower to mark an upper lucia jig.
Lucia type jig. When the patient is 'deprogrammed' have the clinician give you a CR registration. Do your DX to that relation. You are going to determine the patients guidance when you fabricate the upper and lower arches. Do them in PMMA and let the patient test drive them. Keep this as simple as possible for yourself
and the doc and you both will sleep better.
 
kcdt

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Lucia type jig. When the patient is 'deprogrammed' have the clinician give you a CR registration. Do your DX to that relation. You are going to determine the patients guidance when you fabricate the upper and lower arches. Do them in PMMA and let the patient test drive them. Keep this as simple as possible for yourself
and the doc and you both will sleep better.
Couldn't have put it better.
 
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Also KCDT, the NTI website even considers their NTI device a 'winged deprogrammer' but this is what I would like to do, probably with just bite splints.:

You could do it with an NTI.
All you really need is a way to get to CR and capture a bite.
Make your orthotics on an acticulator.
If you think you need to open or close the pin, have dr take a facebow.
 
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Yes thanks, I thought that was what I said, or meant anyways. Find the centric position at the tip of the 'arrow' scribed in sharpie. I have a candulor gothic tracing kit, but I dont think it will fit a PT that isnt edentulous.

I am going to take a facebow and mount on a panadent opening it maybe 1.5mm, probably at the bite splint appt.

This patient has crossbite on one side so this will be tricky, I will try and post some pics, thanks again.
 
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Anyone have an .stl for a lucia jig?? Ciao
 
kcdt

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To be specific , I want something the Dr can use chairside to find a repeatable CR and lateral excursions, then take a bite, then make MX waxup/temps. Melkers uses an NTI to do this, I know it can be used nightly for pain, but why cant it be used to eliminate excursive contacts and test if PT is comfortable? Basically a gothic arch tracing. Becuase the teeth are so worn, im not sure I want to use the lower incisors to mark the anterior NTI or lucia, so I might just do a lower splint/guard with a flat plane, the PT can wear while she is in mx temps along with a lucia upper. Maybe I will do a small node on the lower to mark an upper lucia jig.
I forgot to mention bimanual manipulation.
Haven't seen it since my Pankey days.
But a trained clinician can seat the condyles by hand. They didn't need a deprogrammer for that.
 
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I forgot to mention bimanual manipulation.
Haven't seen it since my Pankey days.
But a trained clinician can seat the condyles by hand. They didn't need a deprogrammer for that.
That's my favourite method - ala Pete Dawson, but also would make a anterior deprogrammer with green stick compound
routinely. Not hard to use SuperT resin to make one either once you get the hang of manipulation resin.
My 2 cents.
LCM
 
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