Deprogrammers made - Great Lakes Orthodontics

Transcription

Deprogrammers made - Great Lakes Orthodontics
Deprogrammers made
Easy
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”
Design Consideration
Absence of undercuts
Gag reflex
Anterior tooth sensitivity
Upper or lower deprogrammer
Orthodontic retention
Uneven or rough incisal edges
Equilibration
Records for Laboratory F
• Upper and lower models or im
• No bite registration is needed
determine (very worn teeth fro
Design Consideration
Recommendations
Absence of undercuts
Add clasps
Gag reflex
Lower arch
Minimal palatal coverage
Minimal number of teeth covered
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
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
Less chair-time...
Records for Laboratory Fabrication
Delivery
• Upper and lower models or impressions
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.
• No bite registration is needed unless MIP / CO is difficult to
determine (very worn teeth from bruxism)
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.
Easy adj
Kois Deprogrammer
Cranham Deprogrammer
• Wrap-around retainer-style with
discluding element
• Opposing centrals contact only
• Ideal for equilibration cases
•
•
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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
“B” Splint Dual Arch Option
(For patients who require long-term wear)
justments...
Multi-functional...
• 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
Less chair-time
Great Lakes Splint Specialist
Support is only a phone call away!
Easy adjustments
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
1.800.828.7626 ext. 223
[email protected]
Multi-functional
Renée Zureck
E
Deprogrammers made
Easy E
1.800.828.7626
(U.S. & Canada)
716.871.1161
(Worldwide)
Email:
[email protected]
SMLP256Rev101910
Web: www.greatlakesortho.com