I'm in the category of severe clencher. I've used a full arch (upper) soft occlusal splint for five years with success. Success meaning it protected my teeth but I had a big problem with significant gum inflammation. I recently upgraded to a new soft splint because I had bitten through my old splint and was starting to chew it. (it was getting soft). I chipped a tiny piece of a lower molar cusp as a result of the chewing. The dentist took my impressions, sent them to the lab and my new splint came back with a perfect fit. No adjustments needed. However almost immediately the new soft splint caused huge problems. I still don't know why. I started clenching multiple times harder. I was getting bone damage (small bone ridges) on my lower jaw and tiny sore ulcerated bone bumps. I was shocked. I went to a second dentist for an opinion and this anterior splint came up in discussion. I decided to try the MCI splint. It caused huge problems for me. Now the severe clenching which was spread across my full arch was concentrated on my incisors and canines. My teeth were sore every morning, I developed gum sores and even more bone protrusions from the intense concentrated pressure of my clenching. I had to go back to my old splint. The literature is all so positive about these NTI/MCI devices but sorry to say that for me it was a disaster. The only positive was that my gums at the back of my mouth healed amazingly after the MCI took the masseter muscle pressure off them.I don't feel these are good for people in the category of severe clencher. I'm desperate for solution. I've now been prescribed a hard splint but it makes me very nervous after my experience with the MCI.
Hi Dave. Thanks for your comment. This channel is primarily for Dentists but happy to reply on this occassion. For a severe clencher like you, a standard NTI/MCI is NOT the best design for exactly the reasons you mentioned - it concentrates too much pressure in to small incisors. The design of choice is something like an 'omnisplint' which you can google. (for the dentists reading this - it's essentially a dual arch B splint)
Good Q Charlotte! With the leaf gauge you can quickly find the first point of contact (Centric Relation Contact Point) and to observe whether there is a large slide (vertical or horizontal) to the patient's 'normal' bite (MIP) The presence of a large slide is one risk factor for a bite change, which may manifest as an AOB The 2 other risk factors are: - Flat teeth (lack of posterior stability) - Minimal overbite to start with
I'm in the category of severe clencher. I've used a full arch (upper) soft occlusal splint for five years with success. Success meaning it protected my teeth but I had a big problem with significant gum inflammation. I recently upgraded to a new soft splint because I had bitten through my old splint and was starting to chew it. (it was getting soft). I chipped a tiny piece of a lower molar cusp as a result of the chewing. The dentist took my impressions, sent them to the lab and my new splint came back with a perfect fit. No adjustments needed. However almost immediately the new soft splint caused huge problems. I still don't know why. I started clenching multiple times harder. I was getting bone damage (small bone ridges) on my lower jaw and tiny sore ulcerated bone bumps. I was shocked. I went to a second dentist for an opinion and this anterior splint came up in discussion. I decided to try the MCI splint. It caused huge problems for me. Now the severe clenching which was spread across my full arch was concentrated on my incisors and canines. My teeth were sore every morning, I developed gum sores and even more bone protrusions from the intense concentrated pressure of my clenching. I had to go back to my old splint. The literature is all so positive about these NTI/MCI devices but sorry to say that for me it was a disaster. The only positive was that my gums at the back of my mouth healed amazingly after the MCI took the masseter muscle pressure off them.I don't feel these are good for people in the category of severe clencher. I'm desperate for solution. I've now been prescribed a hard splint but it makes me very nervous after my experience with the MCI.
Hi Dave. Thanks for your comment. This channel is primarily for Dentists but happy to reply on this occassion. For a severe clencher like you, a standard NTI/MCI is NOT the best design for exactly the reasons you mentioned - it concentrates too much pressure in to small incisors. The design of choice is something like an 'omnisplint' which you can google. (for the dentists reading this - it's essentially a dual arch B splint)
@@protrusive thank you so much for the informative reply I really appreciate it.
@@davegball wishing you the best
What information does the leaf gauge give you in order to determine if they are higher risk of AOB?
Good Q Charlotte! With the leaf gauge you can quickly find the first point of contact (Centric Relation Contact Point) and to observe whether there is a large slide (vertical or horizontal) to the patient's 'normal' bite (MIP)
The presence of a large slide is one risk factor for a bite change, which may manifest as an AOB
The 2 other risk factors are:
- Flat teeth (lack of posterior stability)
- Minimal overbite to start with
@@protrusive thank you that makes sense to me now, really good TH-cam channel and really useful videos, thank you