Deprogrammers made. Deprogrammers can be used for... How do deprogrammers work?

Transcription

1 Deprogrammers made asy

2 Easy Deprogrammers made Deprogrammers can be used for... Headache sufferers Bruxers and/or clenchers Muscle relaxation Determining proper joint position Protection against wear Diagnosis How do deprogrammers work? When just the anterior teeth are in contact, the total amount of muscle contraction force the patient can achieve is only 30% compared to MIP / CO (Maximum Intercuspation / Centric Occlusion). The lateral pterygoid muscles relax allowing the temporal mandibular joints to seat into their most comfortable position. Deprogrammers allow muscle relaxation by removing all occlusal interferences, and any habitual functional movements the patient has developed to avoid pain. If a patient has more than normal muscle tension or soreness during a load test* or during overnight wear, this can be an indication of an intracapsular joint issue. A deprogrammer is contraindicated in these cases. *For more information on load testing, ask about Great Lakes Patient Screening Guide

3 Design Consideration Absence of undercuts Gag reflex Recommendations Add clasps Lower arch Minimal palatal coverage Minimal number of teeth covered Great Lakes Mini Deprogrammer 5x5 overlay coverage Bite plate with centrals and laterals contacting only - Posterior teeth just out of contact or - Open enough for no interferences during function Spear Mini Deprogrammer 3x3 anterior bite plate, 1mm full occlusal coverage Cuspid to cuspid contacts No guidance Open enough for no interferences during function Anterior tooth sensitivity No facial coverage Isofolan on anterior teeth only Hard/Soft material Upper or lower deprogrammer Class I: maxillary or mandibular Class II: maxillary Class III: mandibular Cover the arch with the most crowding or mobile teeth Orthodontic retention B splint or Kois deprogrammer Uneven or rough incisal edges Fabricate deprogrammer on that arch Equilibration Cranham or Kois deprogrammer Less chair-time... Easy adj Records for Laboratory Fabrication Upper and lower models or impressions No bite registration is needed unless MIP / CO is difficult to determine (very worn teeth from bruxism) Delivery Confirm that the deprogrammer seats properly and has proper retention. Trim any areas where the patient indicates a tight feel on teeth with a carbide bur. Next check the contacts with articulating paper. There should be an evenly contacting dot on each contacting tooth. For most styles, there should be no interferences of any posterior teeth during protrusive and lateral movements.

4 Kois Deprogrammer Wrap-around retainer-style with discluding element Opposing centrals contact only Ideal for equilibration cases Cranham Deprogrammer Palatal bite plate with discluding element Opposing centrals contact only Ideal for equilibration cases Vaulted palate or good lingual undercuts necessary for retention B Splint Dawson Academy, Wilkerson-Style Maxillary Only 1.5mm invisible retainer-style full occlusal coverage with discluding element Opposing centrals contact only Open enough for no interferences during function ustments... Multi-functional... B Splint Dual Arch Option (For patients who require long-term wear) Maxillary B Splint worn together with lower arch component Mandibular 1.5mm invisible retainer-style full occlusal coverage Flat runner bar cuspid to cuspid for upper discluding element to function against Wear Duration & Treatment Planning Deprogrammers should only be worn when the patient goes to bed each night (up to 12 hours per day). Make sure the patient knows not to wear the deprogrammer any longer than this as super-eruption of non-contacting teeth can occur (with the exception of the B Splint dual arch). Make the patient aware that if their bite feels unusual in the morning after removing the deprogrammer, it should feel normal again after the patient eats breakfast. If it doesn t, instruct the patient to come in for evaluation. This is especially true if the patient will be wearing the deprogrammer long term. If the patient is in more pain after wearing their appliance, this can be an indication of an intra-capsular joint issue. The patient should discontinue use and contact the dental office. Depending on the treatment plan, the time period the patient continues to wear their deprogrammer can vary. Patients may find relief after a couple weeks wear and can use the appliance whenever pain reoccurs. For other patients, once the masticatory muscles have been relaxed allowing the joints to seat in a comfortable position, a treatment plan can be developed. Instruct the patient to wear their deprogrammer for at least one hour prior to their appointment in order to take a CR bite. With the models mounted on an articulator using the CR bite, the method to treat the occlusalmuscular problem can be discussed. Depending on the patient s condition and needs you may choose: Equilibration Restorations Orthodontics Surgery Full arch splint wear

5 Great Lakes Splint Specialist Support is only a phone call away! We will help you: Select the deprogrammer that s right for your patient Get the results you want from the Lab Adjust and seat the deprogrammer Renée Zureck Less chair-time Easy adjustments Multi-functional E ext. 223 reneez@greatlakesortho.com

6 Deprogrammers made asy (U.S. & Canada) (Worldwide) Web: E SMLP256Rev101910