Thursday, October 30, 2008

NTI

Was wondering what to tell a patient that is wearing a NTI splint for two years. She has some clicking and I do not think that will help her in the long run. She is a bit attached to it some I think it going to be hard to get it out of her hands and I do not want to approach it in the wrong way, she moved here and still likes her old dentist that gave it to her...
Hope all is well with the rest of you, I came back to a storm of fun office antics with crying and everything inbetween...
Jim T

3 comments:

Katherine Johnson said...

i actually have the same dilemma with a patient and I talked to Herb and Lee Ann about it. They said since my patient is a clencher that is why he really likes the NTI and will be difficult to switch him to a full splint. They suggested that I take some impressions and do a plastic suck down (0.08 thickness) of one arch and then air abrade the top of it in the area of the centrals and then put monomer on there and build up some acrylic in the anterior so it's like a NTI but much safer (they can't swallow that). Then slowly transition her to a full splint. They said the first step is to make a full splint but take her out of all posterior occlusion at first and just have her on her centrals (like the NTI), then start to add back the acrylic in the posterior and hopefully she can be converted. Hope that helps! I haven't tried it yet but plan to.

Dr. Mc said...

That's a great idea. I had a patient who was wearing an NTI and loved it but he really needed something he couldn't swallow. I put him in a full splint and he split it down the side. I guess it wasn't properly calibrated. I have never been able to get those NTIs tight enough to not worry about them. I'm going to use this idea for the same patient.

Herb Blumenthal said...

I have not had difficulty moving to the full coverage splint because when the patients are referred to me they are not doing well with what they have ...so it is not an issue with me.... transitioning them from the NTI to a full arch splint a little at a time sounds good and you might just tell them that they have gone as far as they can go with the NTI and that it is time to move to the next level.... don't take it away from them but I think they will find the full coverage much more comfortable... I worry about the contact with the anterior only... moving the anterior teeth or allowing the posterior teeth to move... I have seen this happen a couple of times... there is nothing wrong with the NTI if it is worn as instructed... but sometimes when the patient feels better they want to wear it all the time... hope this helps Herb