Which NTI-tss device to choose?

The choice of the most suitable NTI-tss device for a the specific patient will mainly be made based on two criteria:
– The height of vertical opening required / wanted
– The width of the NTI-tss device required (for sufficient retention)

To determine the « correct » vertical opening the following points should be taken into account :
– For the inhibition reflex to function it is necessary to exclude all contact between canine and posterior teeth as well as the NTI-tss device and the opposing teeth in all positions of the jaw, including lateral, protrusive and retrusive movements. Therefore always choose an NTI-tss model creating sufficient and necessary vertical opening to avoid all canine and posterior contact.
– At the same time it is strongly recommended to reduce the vertical opening to the minimum necessary to ensure free movement without posterior or canine contact in order to avoid excessive translation for the condyles in extreme lateral movements of the mandible. In an effort to make the fabrication as easy and quick as possible the NTI-tss product range offers two different heights (“Standard” and “Reduced”).
The NTI-tss cover typically the two front incisors:

■ The “Standard” device (device is marked “STD” internally) has the highest “discluding element” of all NTI-tss devices and should be used when a high vertical opening is required. It also comes in very handy, when the discluding element needs to be adapted to specific situations such as to provide for a specific occlusal angle (where the DE of the reduced versions may not have sufficient material for alteration). In many cases, though, the discluding element can and should be reduced (using a standard resin bur) to bring it down to a sufficient and necessary vertical opening to avoid all canine and posterior contact.

■ The “Vertically Reduced” NTI-tss device (device is marked “RV2” internally) allows for a smaller vertical opening, which will be sufficient for most patients while still avoiding all canine and molar interferences. Its particular geometry features a convex discluding surface (more than a clearly protruding “discluding element” element and is very much appreciated both by practitioners and patients, because it allows for very smooth movements of the mandible. For patients in need of a higher vertical opening the “standard” model is the better alternative.