Monday, December 14, 2015

MiniComfort - “Best Brux Guard Ever Made”

Wearing Her MiniComfort
MiniComfort, a U.S. Patented product, is the outcome of a six-year research and development project by Dr. John C. Kline DDS, a practicing dentist of 40 years, who used both his practical experience and personal observations to create a different kind of bruxism appliance. MiniComfort sets a new standard for comfort and fit while protecting the teeth and decreasing symptoms. ROE is pleased to have been selected as the exclusive U.S. manufacturer of MiniComforts.

MiniComfort is a mandibular, self-seating, zero-adjustment, deprogramming device, light and flexible, that does not protrude from the lips. It can be worn day or night and will simply amaze your patients, particularly those who currently wear a traditional splint or NTI appliance. Due to its very thin design, it will not interfere with a person’s speech or appearance. 

Almost Invisible - no speech issues!
The secret to MiniComfort is two discluding elements (rigid 4-6mm therapeutic bands), which are placed just behind the canines to keep the teeth separated at a patient’s normal freeway space. The Elements deprogram by minimizing the patient’s bite force, similar to an NTI appliance, preventing the patient from fully occluding, and thereby maintaining a comfortable position. Due to this deprogramming design, wearing the appliance at night contributes to less clenching during the day. When worn during the day, the appliance is almost undetectable. As with any partial coverage appliance, it is important that the patient be instructed to wear the appliance only for a portion of the 24-hour day, at your discretion, depending on the stability of the patient’s dentition.

Dr. John Kline’s extensive research, patent trials and use of MiniComfort reveal:

• Almost 100% of participants in the study adopted use of the MiniComfort and continued to wear it because of its comfort and undetectability

• 98% of participants were pleasantly surprised with the excellent fit

• Participants were asked to wear MiniComfort during waking hours including work and social situations. Nearly all of the participants reported satisfaction with day time performance

• Participants who suffered from headaches reported a drastic reduction in the frequency and severity

• Upon examination, participants who wore MiniComfort on a daily basis had no damage to their teeth related to clenching or grinding

• A MiniComfort should last between 12 to 36 months, depending on the user’s severity of clenching and/or grinding

MiniComfort affords the dental practice a self-seating, five-minute-appointment appliance. Because the two therapeutic bands are the only points of occlusal contact, adjustment is a thing-of-the-past. Once seated, the appliance forms a hydro seal over the dentition and mucosa, providing very good retention and comfort. Auxiliary staff can manage the seating appointment.
2 Discluding Therapeutic Elements 

MiniComfort also offers two more unique advantages, an Instant Wear guarantee and a digital record for easy reorder. Due to the nature of the appliance, MiniComfort is designed to be replaced periodically. For this reason, we include a second complimentary appliance (Instant Wear guarantee). We also digitally archive each case to simplify the reorder appointment. Allowing appliance to be reordered without taking another impression, provided the patient’s dentition has not changed.

Order MiniComfort for your next patient suffering from bruxing, clenching, headaches and TMD. If for any reason you and your patient are not thrilled with the appliance, a conventional appliance will be made at no charge.

Best Bite Registration Materials

The correct bite position is clearly one of the most critical steps in restoring a case. Consequently, the bite registration protocol and choice of material are a continuous subject of discussion between our clients and us. When recording a bite for single crowns, or for bridges, there are a few crucial considerations. We recommend using rigid materials, avoiding ones that are rubbery with bounce that distort when articulated. Rigid materials provide a positive stop similar to that of natural teeth. It is equally important that bite materials not be brittle when set. This causes the bite to fall apart when trimmed, or after repeated use.  Three of our favorite materials are Futar Fast Bite - Kettenbach LP, Blu-Bite HP - Henry Schein Dental, Vanilla Bite – DenMat.

We suggest using small amounts of bite material in key areas, such as over the prepared teeth or edentulous areas, and where centric stops do not exist. Overuse of material can obscure the centric stops, making it difficult to confirm that the remaining teeth fully interdigitate. We find that clients who, after taking the bite registration, trim the bite down to an area just over the preparation and adjacent teeth, test in the mouth to confirm, experience the most consistent success with minimal occlusal adjustment.  When preparation involves the terminal tooth, or when multiple preparations exist, full arch impressions are highly recommended. This allows visual verification on the articulator via the contralateral side.

If you have made the leap to digital impressions, some systems offer an opportunity to digitally trim the bite. It is important that care is taken when trimming, and that a similar  method is used as described above, in order to achieve an accurate orientation of the casts.

When restoring a large case, where a patient is provisionalized and there is no natural tooth-to-tooth occlusion, bite tripodization is required to accurately capture the bite position. To maintain the newly established bite position, the provisional should be removed in small sections and bites recorded in these areas. This should be accomplished bilaterally and anteriorly, and again we suggest trimming and verifying the bite as previously explained.

We share these suggestions from our experience. By all means, if you are having great success we encourage you to maintain your current technique. Please contact us any time to discuss the best bite technique for your case.

Malocclusion - a Sign of Civilization

Click for Intriguing Lecture
UK, declares that of the 4629 mammals, only humans exhibit malaligned teeth. In the British Dental Journal, an article featuring Dr. Mew explains that “in the fields of both anthropology and archaeology, malocclusion is considered a sign of civilization. It is not present in any of our pre-civilized ancestors, who had well aligned teeth (regardless of attrition) from birth until death. The origin of malocclusion does not follow a genetic pattern but appears wherever and whenever cooking and tool-making appear, and progresses from mild imbrications to skeletal manifestations as civilization advances. There is also no evidence that we should not accommodate 32 well-aligned teeth today or that there has been any genetic change.” The causes of malocclusion, according to Mew, are environmental factors, mainly soft diet, high-nutritional/calorie foods, lowering the amount of chewing, and nasal obstructing allergies. Both lead to long-term postural lowering of the mandible, effectively shortening the space for teeth. Dr. Mew humorously suggests that the best method for young people to achieve ‘normal’ maxilla-facial architecture, is to stand up straight, chew multiple pieces of gum at the same time for 2 hours per day, and keep the mouth shut (“just like your parents taught you,” adds Mew). 

Cement Tips for Implants

During a recent CE course, ROE gained some valuable insight from Matthew Palermo DDS, Interim Chair Department of Restorative Dentistry at Temple University. One recommendation is the use of densely radiographic cement for implant seating. With the prevalence of peri-implantitus, the ability to observe and remove cement is critical, and TempBond and ZincPhosphate are ideal. He suggests checking your current implant cements for radiopacity. 

Keeping the amount of cement to a minimum is advantageous. Dr. Palermo shared a method of minimizing the amount of cement using an extra-oral technique. Apply one thickness of Polytetrafluoroethylene (PTFE) inside a crown and then fill it with bite material. Before setting, insert a cotton tip. Once set, remove this plug and fill the crown with cement. Reinsert the plug (essentially creating a duplicate of the prep) until excess cement exudes; then quickly deliver the crown. This will provide approximately 50μ of cement.

Staub Cranial Dentures - Receive a Maxillary Set-Up for the Bite Appointment

Since the 70’s Staub Cranial Dentures has delivered tooth set-ups from master casts. Fully edentulous Maxillary and mandibular casts are measured and the recordings are entered into a software. This information instructs technicians where to set the teeth, while a special Staub device articulates the maxillary cast. From these two records, doctors receive a full maxillary set-up and mandibular bite block ready for the bite registration. Once captured, doctors have the option of a full try-in or going directly to finish. This highly successful denture technique will prove itself on 
the first case. If the setup is not ideal, send reset information for another try-in or finish. You’ll agree that this is a big improvement over the traditional two bite block appointment. It is Imperative that shade, gender and age is sent with master casts!