The NTI Appliance

from the library of Robert L. Talley, DDS.

FDA Approved for Migraine and Tension Headache Prevention

The Nociceptive Trigeminal Inhibition Tension Suppression System, an acrylic mini-splint that fits over the teeth, reduces the intensity of jaw clenching during sleep and the headache pain that comes along with it. It is completely different from any other type of mouthpiece.

Patients typically get relief from tension headaches within the first week, but with migraines, it may take a few weeks. In a clinical trial on patients who averaged two migraine headaches monthly, 82% of the patients reported a 77% average reduction in their migraine frequency.

Using the body’s natural reflex protection by preventing the parafunctional contacting of the canine and molar teeth (which is required to generated significant nocturnal muscle contraction intensity and jaw joint strain), the NTI prevents and reduces the muscular component of migraine, chronic headache and jaw disorders.

With daytime use, The NTI system takes advantage of the naturally protective nociceptive trigeminal inhibition reflex which maintains relaxation the powerful temporalis muscles. It is the protective reflex experienced when biting down, expecting something soft, but encountering something hard.

Minimal vertical opening:

Excessive vertical opening will allow for strain on a TMJ in excursive movement (e), and may encourage a clenching response. Vertical opening must be kept to a minimum, without allowing for canine or posterior occluding (f).

(e)         (f)

Diagnosis and Indications:

The NTI is indicated in those diagnosed conditions whose treatment (or prevention of) warrants/requires any combination of:

• reduced joint strain
• musculoskeletally stable condylar orientation
• reduction of intensity and normalization of trigeminally innervated musculature
• protection of tooth or restorations
  

Examples of indicated uses:

• Obtaining ideal condylar orientation prior to comprehensive occlusal therapy
• Treatment and prevention of MPD.
• Bruxism nightguard
• MIGRAINE PREVENTION– FDA Approved
• Treatment and prevention of tension headache

Above is the delivery sequence of a NTI. Please noted that the big, fat white things in the lower corners of the middle photos are a dentist's gloved fingers.

Method of Action:

Prevention of above conditions is accomplished by preventing the occluding of the canine and posterior teeth during parafunctional events. There is only one way in which an individual can generate adverse joint strain (which perpetuates an internal derangement), or maintain a less-than-optimal condylar orientation, or to perpetuate muscular dysfunction, and that is to achieve certain degrees of muscular tension. This tension is made possible by the occluding of the canine or posterior teeth. Certainly, if one were to maintain "rest position" (lips together, teeth apart), there would be none of the conditions cited above.

Only the lateral pterygoid has a direct effect on the TMJ. In order to create a strain, the LP must encounter resistance to its contraction. Resistance is provided by the occluded teeth (posterior or canine). The degree of strain generated is a function of which teeth are being occluded and the intensity of the LP's contraction. The more distal the contra-lateral contact is, the more strain the LP can exert on the ipsilateral joint.

The degree of resistance the LP encounters is a function of the intensity of temporalis jaw elevation, which is occluding the teeth in the first place. Without posterior or canine occluding (that is, incisal contacts, only), elevating (occluding) forces are only 1/3 of maximum.

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The NTI works well and quickly on face, jaw, & head pain because it directly suppresses the intensity of muscular responsible for those pains. Keep in mind that muscular activity has 3 components:

• Frequency of acts
• Duration of a given act
• Intensity of the act
  

The NTI can only suppress the intensity of an act, which has a direct effect on certain muscles, and indirect effect on others. The musculature in the neck/shoulders continues to parafunction with the same frequency and duration as before...but now to a lesser intensity, due to the NTI "taking the wind out" of the jaw's activities.

CONCLUSIONS:

Without adverse effects, the NTI:

• Prevents bruxism and chronic pericranial muscular tension;
• Prevents destructive joint strain;
• Prevents or reduces frequent migraine pain and related chronic tension-type headache.