I think you will want to read that particular study in full before accepting
what it says at face value. There were some problems as I recall.


--
/

Amatus

/
"Mac" <> wrote in message
news:_7s1i.10342$ link.net...

> "The stabilization splint was judged superior."
> I think this is what I wanted to hear. I know that in medicine there are
> rarely easy answers, or inexpensive treatments. I suppose, after reading
> too much internet-info, that I was feeling duped (whether intentionally or
> not).
> I'll give this a try, following recommendations, etc. and see where I am
> with this in four months.
> Thanks very much,
> -Mac
>
>
>
>
> "Triclinic" <> wrote in message
> news: ps.com...

>
>

I have been making NTI splints instead of the horseshoe splints for over ten
years now. I have never had a patient want to go back to the horseshoe!
Compliance........ About 70% of the NTI's I make are worn every single day.
About 10% of the horseshoe's I made were every worn regularly. The
horseshoe would help about 40% of the time, while the NTI helps about 95% of
the time. I takes me 45 minutes to deliver a horseshoe that is properly
adjusted (assuming a staff person made the impressions and sent them to the
lab). The occlusion then changed on the splint every week or two,,,,,, so
the patient had to return 8-10 times to have the occlusion adjusted as the
joint settled into a more normal position eventually (for the 40% who got
better). The NTI settles the joint into position in a couple of weeks and
requires *almost* no adjustment after delivery.

TMJ dysfunction is basically due to:
1) trauma (fractures and the like)
2) growths and tumors (the dreaded "C" word)
3) improper development (bad chromosomes)
4) muscle spasm (the other 99% of cases)

The horseshoe does very little to help (4). The horseshoe does a fine job
of protecting teeth from further damage.

Once we start talking about headaches, sore necks, clicking, popping,
soreness when chewing, strange phantom pains in the lower first molar
regions, teeth that hurt to chewing or cold only sometimes,,,,,, then we are
dealing with problem (4). It has been theorized that those patients who do
better with the horseshoe (that 40%), improve only because they have
something in their mouth which disrupts their normal routine. This leads to
remarks about ping pong balls because someone called this the ping pong ball
syndrome which means that even placing a ping pong ball in these particular
mouths would have seen the same results. [How they fit the ping pong ball
inside those mouths,,,, I have no idea :-) ]

The NTI therapy, takes what was previously thought to be a complex difficult
issue that required a lot of time and expense to treat, and makes it simple
and predictable. The **"TMJ Specialists" ** [remember that there is not
such specialty], hate this. They prefer to charge thousands for splints and
adjustments, followed by restoring all the teeth, over placing a "new"
device for a few hundred dollars.

The interesting thing is this. Every dentist I have ever encountered who
was willing to look at the NTI with an open mind and was willing to try a
few, became a convert. The only ones who tried it and gave up, never
studied the technique to learn what they were really trying to achieve.
They were stuck doing what they learned in dental school, even if that was
learned 35 years ago.

--
/

Amatus

/
"Tim Dixon" <> wrote in message
news:RjZ1i.22667$%...

> Mac- This might interest you. This is what the inventor of the NTI
> therapeutic protocol has to say:
> ************************************************** ************************
> What is it about the acrylic placed on the teeth that is therapeutic?
> Nothing.
> What is it about the effect of the shape of the acrylic on the activity of
> the masticatory musculature? Everything.
>
> What are the goals of nocturnal splint therapy?
> 1--To minimize tooth wear during parafunctional occluding activity;
> 2--To minimize joint strain and disc load during parafunctional occluding
> activity;
> 3--To minimize intensity of muscular activity during parafunctional
> occluding activity.
>
> What are the accepted criteria for splint design to achieve the desired
> therapeutic result? (which are the same as that for a "good occlusion")
> A--Bilateral even posterior contact in COR, with light anterior contact.
> (statisfies 1 and 2 above)
> B--Immediate posterior disclusion in the event of excursive occluding
> movement, made possible by:
> --opposing canine contact during the excursive occluding movement, with
> transition to;
> --incisal contact. (satisfies 1, 2 and 3)
>
> But how do we know that these splint design criteria provide the desired
> therapeutic goals? Through prior EMG research and force/load studies.
>
> There are abundant EMG studies and force/load models of A which support
> its intended provision of 1 and 2.
> There are abundant EMG studies and force/load models of B which support 2
> and 3.
> (Unfortunately, there are abundant EMG studies to show that A cannot
> prevent 3).
>
> We expect that a properly made splint or occlusal scheme should minimize
> joint strain and disc load and minimize muscular activity in excursive
> occluding events, based on the data from EMG and force/load models.
>
> The only difference between an ideal full-coverage occlusal splint and an
> NTI-type device is that an NTI-type designed splint can minimize the
> intensity of muscular activity in a centric, as well as excursive,
> parafunctional act.
>
> So when a study compares a Michigan splint to an NTI on a group of
> patients with jaw disorders, (excluding those "primary clenchers" who
> don''t have any jaw/joint symptoms but present primarily with
> headache/migraine) you''d expect the efficacy to be the same, and in fact,
> in the Norwegian study, (one of two studies specifically observing the
> NTI), that is exactly what was found.
>
> Knowing what a properly designed Michigan splint and NTI device are
> supposed to provide is what makes the Swedish study so curious. If both a
> Michigan splint and a properly made NTI provide the same instant posterior
> disclusion in excursive movements and incisal-only contact in protrusion,
> but the Swedish study showed that nearly ALL Michigan splint subjects saw
> significant improvement, while nearly half of the NTI subjects had no
> improvement at all, what is one to conclude?
>
> -El There''s-something-fishy-in-Sweden-O~
>
> James P. Boyd, DDS, Developer of the NTI Therapeutic Protocol and Website
> The Headache Center of Southern California Clincial Associate
> Son of USC Hall of Fame Basketball Coach Bob Boyd
> ************************************************** ***********
> And from a well known Swedish dentist (Hans Lennros) that has
> participated extensively in this newsgroup over the years.
> ************************************************** ***********
> Toofy wrote in response to "-El There's-something-fishy-in-Sweden-O~": >
> So what is this Swedish "properly made Michigan splint??? Yes, what is it?
> Good question! Let's see how they properly made Michigan splints in the
> Swedish study (Magnusson et al, 2004):
> http://www.ncbi.nlm.nih.gov/entrez/q...=pubmed_docsum
> To prove that the NTI-splint is clinically worthless they not only
> investigated its efficay but also cost-effectiveness measured in minutes.
> They did not calulate that the Michigan splint needs TWO visits, that
> patients cancel and re-schedule (which costs money), they disregarded cost
> of impression material, packaging and stamps/delivery to send to dental
> technician and the extra time spent on the Michigan splint compared to the
> NTI-splint. In their world dental assistants do not want any sallary and
> everything around the office is free of charge! Including the dental
> laboratory fee. The result showed that the Michigan splint took a total of
> 17 minutes and the NTI-splint 27 minutes. The time consumed for the
> NTI-splint can be explained by lack of experience (which indicates a risk
> of not getting optimal clinical effect). What is more interesting,
> however, is the time Magnusson and his fellow investigator Helkimo needed
> to make the Michigan splint. In the Swedish textbook "Bite splints in the
> clinic and laboratory" ("Bettskenor i kliniken och på laboratoriet", 1987)
> Magnusson writes about the normal time needed in average to make a
> Michigan splint in the public dental care system: (quote) "It is
> interesting that the new government insurance for a splint is based on 34
> minutes. During that time the dentist must during one appointment make
> impressions of both jaws and make a jaw registration to obtain
> inter-occlusal records. The next appointment, which is also included in
> this just over half-an-hour, the splint should be fitted and checked. We
> sure must have effective methods to make this work!" (end quote) So he
> complains that 34 minutes is not really enough time to do a Michigan
> splint and all of a sudden, in the scientific NTI-study, the Michigan
> splint is made in half that time! Only to show that the Michigan splint is
> 10 mintues clinically faster than the NTI-splint! This can be compared
> with doping in sports when pride and honor is sold out to beat someone
> with seconds or minutes. In this study he sold his scientific integrity
> for 10 minutes! The obvious question that arises are: in how many
> scientific studies has he done similar cheating before? And to what degree
> do results in his previous career depend on concious bias, i.e. academic
> dishonesty? I think it is really sad to have to watch how two outstanding
> and former respected scientists (Magnusson & Helkimo) are compromising
> their reputations in that way. What actually made them to choose to commit
> scientific suicide over the NTI-splint? Hans
> ************************************************** *
> More from Hans
> ************************************************** *
> Hi Jim, The Magnusson picture is a mystery ! If you enlarge it enough you
> will see the following: The lower jaw can go to the patient's left as far
> as the mandibular midline (between the two lower front teeth) is aligned
> with the distal surface on the upper left front tooth. But the patient can
> go to the right further, in fact half the width of a lower tooth further.
> Most likely if the patient has not an unilateral restricted jaw movement
> the patient could go just as far to the left, and then would slide off the
> discluding element. So they made the patient stop the excursive movement
> at that fixed point that looks good on the picture certifying they were
> following the NTI-protocol. Hence this is an arranged picture! Either this
> is a model patient for presentation purposes only, or it shows to what
> extent they actually paid attention to the NTI protocol. Besides, the NTI
> does not seem to have a correct horisontal position from front to back as
> the back of the discluding element seems lower than the front part. If
> this is the best they could do in an educational model picture they knew
> would be scrutinized, what does that tell you about the probability of
> high, respectively low, quality of the actual NTI-splints used on patients
> in the study? I have repeatedly asked to see those they used in the study
> but the only answer I get is a legal mumble that they are not required by
> law to show me anything. Which per se is wrong! They are obliged by law to
> show their basic data so that clinical trials can be examined. So there is
> no doubt they are lawbreakers. For a study to be scientific they must let
> out information that can be evaluated. Also, the study should be possible
> to repeat. If not it is no serious science. When I offered $150 to every
> patient that I was allowed to examine, they responded they did have not
> time to arrange that. Anyone ever wondered why Magnusson consistently
> excluded headache in the study? Especially strange since Magnusson has
> stated that is a common TMD symptom and over 25 years ago stated that
> clenching of teeth is correlated to the severity of headache!
> http://www.ncbi.nlm.nih.gov/entrez/q...=pubmed_docsum
> and that TMD treatment are beneficial for many patients who suffer from
> recurrent headaches:
> http://www.ncbi.nlm.nih.gov/entrez/q...=pubmed_docsum
> Real strange that this large group of typical TMD patients wasn't included
> in the study ... maybe fear of the NTI would prove to be far more
> effective than the other splint ... Hans the NTI-CSI
> (crime-scene-investigator)
> ************************************************** ************
> Mac here is some recent research you should take the time to read.
> http://www.nti-tss.com/RESEARCH.html
>
> Just because someone posts an abstract that apparently contradicts what
> other clincians are seeing in their practices doesn't mean you should hang
> your hat on it. Research, research, research, research. I am sorry you
> already paid for the splint, but that doesn't mean you have to actually
> use it. In fact the frequency and severity of your migraines will likely
> increase by using the full coverage design. It simply gives you more
> surface area to achieve maximum clenching ability while asleep.
>
> Perhaps some of the others will weigh in on this issue and give you some
> sound clinical advice from their perspectives.
>
> "Mac" <> wrote in message
> newsmY1i.10750$ link.net...

>
>

My experience has been the same, but for only 8 years <G>.

And though I think I have said this before, I am most thankful that you
had tried them and gave me the recommendation that I trusted to try
some myself.

I never would have dreamed that they could work like they do.

D

Amatus Cremona wrote:

> I have been making NTI splints instead of the horseshoe splints for over ten
> years now. I have never had a patient want to go back to the horseshoe!
> Compliance........ About 70% of the NTI's I make are worn every single day.
> About 10% of the horseshoe's I made were every worn regularly. The
> horseshoe would help about 40% of the time, while the NTI helps about 95% of
> the time. I takes me 45 minutes to deliver a horseshoe that is properly
> adjusted (assuming a staff person made the impressions and sent them to the
> lab). The occlusion then changed on the splint every week or two,,,,,, so
> the patient had to return 8-10 times to have the occlusion adjusted as the
> joint settled into a more normal position eventually (for the 40% who got
> better). The NTI settles the joint into position in a couple of weeks and
> requires *almost* no adjustment after delivery.
>
> TMJ dysfunction is basically due to:
> 1) trauma (fractures and the like)
> 2) growths and tumors (the dreaded "C" word)
> 3) improper development (bad chromosomes)
> 4) muscle spasm (the other 99% of cases)
>
> The horseshoe does very little to help (4). The horseshoe does a fine job
> of protecting teeth from further damage.
>
> Once we start talking about headaches, sore necks, clicking, popping,
> soreness when chewing, strange phantom pains in the lower first molar
> regions, teeth that hurt to chewing or cold only sometimes,,,,,, then we are
> dealing with problem (4). It has been theorized that those patients who do
> better with the horseshoe (that 40%), improve only because they have
> something in their mouth which disrupts their normal routine. This leads to
> remarks about ping pong balls because someone called this the ping pong ball
> syndrome which means that even placing a ping pong ball in these particular
> mouths would have seen the same results. [How they fit the ping pong ball
> inside those mouths,,,, I have no idea :-) ]
>
> The NTI therapy, takes what was previously thought to be a complex difficult
> issue that required a lot of time and expense to treat, and makes it simple
> and predictable. The **"TMJ Specialists" ** [remember that there is not
> such specialty], hate this. They prefer to charge thousands for splints and
> adjustments, followed by restoring all the teeth, over placing a "new"
> device for a few hundred dollars.
>
> The interesting thing is this. Every dentist I have ever encountered who
> was willing to look at the NTI with an open mind and was willing to try a
> few, became a convert. The only ones who tried it and gave up, never
> studied the technique to learn what they were really trying to achieve.
> They were stuck doing what they learned in dental school, even if that was
> learned 35 years ago.
>

In article <>,
Dartos <> wrote:

> My experience has been the same, but for only 8 years <G>.
>
> And though I think I have said this before, I am most thankful that you
> had tried them and gave me the recommendation that I trusted to try
> some myself.
>
> I never would have dreamed that they could work like they do.
>
> D

Hi D. Can you estimate how long it might have taken for the NTI to have
made its way into your practice had the internet not have played a role
in your professional communications? AC and Newbie may have something
to say about the way they brought the NTI into their practices.

Webby (who doesn't have any money to be made from these posts)

>
> Amatus Cremona wrote:
>

On Mon, 14 May 2007 13:56:19 -0700, The Webby <> wrote:

>In article <>,
> Dartos <> wrote:
>

>
>Hi D. Can you estimate how long it might have taken for the NTI to have
>made its way into your practice had the internet not have played a role
>in your professional communications? AC and Newbie may have something
>to say about the way they brought the NTI into their practices.
>

AC made an NTI for me, was skeptical at first and until I wore one myself
for about 4 weeks. Am now a convert and haven't made another horseshoe
in years. Guessing about 3 maybe 4 yrs. AC would more likely know
the time frame.

>Webby (who doesn't have any money to be made from these posts)

> Hi D. Can you estimate how long it might have taken for the NTI to have
> made its way into your practice had the internet not have played a role
> in your professional communications? AC and Newbie may have something
> to say about the way they brought the NTI into their practices.
>
> Webby (who doesn't have any money to be made from these posts)

Difficult to say. I had heard of them without the internet, but I
was very skeptical. I'm sure it would have been 'years', but whether
2,5, or what, I don't know.

Virtually nothing in the magazines and journals, so unless I had run
into a friend at a convention, it is very possible I would have remained
a scoffing outsider.

I have said for years, that the internet has helped me a great deal in
the practice of dentistry.

:-)
D

BTW, I don't think I make any money here either.

June of 2003.

--
/

Amatus

/
"Newbie" <> wrote in message
news:...

> On Mon, 14 May 2007 13:56:19 -0700, The Webby <>
> wrote:
>

>
> AC made an NTI for me, was skeptical at first and until I wore one myself
> for about 4 weeks. Am now a convert and haven't made another horseshoe
> in years. Guessing about 3 maybe 4 yrs. AC would more likely know
> the time frame.
>

>

At the time, Jim Boyd was practicing 15 minutes from my office, and I would
not have heard of Jim without SMD. Like Dartos, I had seen the NTI in an
advertisement, but it did not make sense at the time, so I dismissed it.
Debating Jim Boyd on SMD for 2-3 months, followed by him sending me a free
kit to try, convinced me. Those months of hard debate on the topic were
very educational. It also, showed me how much of our education we take at
face-value without checking to see if the concept is actually supported by
any research.

--
/

Amatus

/
"Dartos" <> wrote in message
news:...

>
>
>

>
>
> Difficult to say. I had heard of them without the internet, but I
> was very skeptical. I'm sure it would have been 'years', but whether
> 2,5, or what, I don't know.
>
> Virtually nothing in the magazines and journals, so unless I had run into
> a friend at a convention, it is very possible I would have remained
> a scoffing outsider.
>
> I have said for years, that the internet has helped me a great deal in
> the practice of dentistry.
>
> :-)
> D
>
> BTW, I don't think I make any money here either.
>

Amatus Cremona wrote:

> Debating Jim Boyd on SMD for 2-3 months, followed by him sending me a free
> kit to try, convinced me.

Since we aren't lawyers, it's hard for us to win an argument while
being wrong.

<G>
D