edeprogrammears made sy deprogrammears made sy e · kois deprogrammer • wrap-around...

Great Lakes Splint SpecialistSupport is only a phone call away!

We will help you:• Select the deprogrammer that’s

right for your patient

• Get the results you want from the Lab

• Adjust and seat the deprogrammer

1.800.828.7626 ext. 223

[email protected]

Less chair-time

Easy adjustments

Multi-functionalRenée Zureck

Deprogrammers made Deprogrammers made

EasyEasy

SMLP

256R

ev10

1910

1.800.828.7626(U.S. & Canada)

716.871.1161(Worldwide)

Email:[email protected]

Web: www.greatlakesortho.com

21108_DeprogFamily_Document 1 10/26/10 9:08 AM

Great Lakes Mini Deprogrammer• 5x5 overlay coverage • Bite plate with centrals and laterals contacting only

- Posterior teeth just out of contact or- Open enough for no interferences during

function

Spear Mini Deprogrammer• 3x3 anterior bite plate, 1mm full occlusal

coverage• Cuspid to cuspid contacts• No guidance• Open enough for no interferences during

function

Kois Deprogrammer• Wrap-around retainer-style with

discluding element• Opposing centrals contact only• Ideal for equilibration cases

Cranham Deprogrammer• Palatal bite plate with discluding element• Opposing centrals contact only• Ideal for equilibration cases• Vaulted palate or good lingual undercuts

necessary for retention

“B” Splint – Dawson Academy, Wilkerson-Style Maxillary Only• 1.5mm invisible retainer-style full occlusal

coverage with discluding element• Opposing centrals contact only• Open enough for no interferences during function

“B” Splint Dual Arch Option(For patients who require long-term wear)

• Maxillary “B” Splint worn together with lower arch component

• Mandibular 1.5mm invisible retainer-style fullocclusal coverage

• Flat runner bar cuspid to cuspid for upper discluding element to function against

Less chair-time... Easy adjustments... Multi-functional...

EasyDeprogrammers made

Deprogrammers can be used for...

• Headache sufferers

• Bruxers and/or clenchers

• Muscle relaxation

• Determining proper joint position

• Protection against wear

• Diagnosis

How do deprogrammers work?When just the anterior teeth are in contact, the totalamount of muscle contraction force the patient canachieve is only 30% compared to MIP / CO (MaximumIntercuspation / Centric Occlusion). The lateral pterygoidmuscles relax allowing the temporal mandibular joints to seat into their most comfortable position.

Deprogrammers allow muscle relaxation by removing all occlusal interferences, and any habitual functionalmovements the patient has developed to avoid pain. If a patient has more than normal muscle tension orsoreness during a load test* or during overnight wear,this can be an indication of an intracapsular joint issue.A deprogrammer is contraindicated in these cases.

*For more information on load testing, ask about Great Lakes“Patient Screening Guide”

Records for Laboratory Fabrication

• Upper and lower models or impressions

• No bite registration is needed unless MIP / CO is difficult todetermine (very worn teeth from bruxism)

Delivery

Confirm that the deprogrammer seats properly and has proper retention.Trim any areas where the patient indicates a tight feel on teeth with a carbide bur.

Next check the contacts with articulating paper. There should be an evenlycontacting dot on each contacting tooth. For most styles, there should be nointerferences of any posterior teeth during protrusive and lateral movements.

Wear Duration & Treatment Planning

Deprogrammers should only be worn when the patient goes to bed each night (up to 12 hours per day). Make sure the patient knows not to wear the deprogrammerany longer than this as super-eruption of non-contacting teeth can occur (with theexception of the “B” Splint dual arch).

Make the patient aware that if their bite feels “unusual” in the morning after removing the deprogrammer, it should feel normal again after the patient eats breakfast. If it doesn’t, instruct the patient to come in for evaluation. This is especially true if the patient will be wearing the deprogrammer long term.

If the patient is in more pain after wearing their appliance, this can be an indication of an intra-capsular joint issue. The patient should discontinue use and contact the dental office.

Depending on the treatment plan, the time period the patient continues to wear theirdeprogrammer can vary. Patients may find relief after a couple weeks wear and canuse the appliance whenever pain reoccurs. For other patients, once the masticatorymuscles have been relaxed allowing the joints to seat in a comfortable position, atreatment plan can be developed. Instruct the patient to wear their deprogrammer for at least one hour prior to their appointment in order to take a CR bite. With themodels mounted on an articulator using the CR bite, the method to treat the occlusal-muscular problem can be discussed.

Depending on the patient’s condition and needs you may choose:

• Equilibration• Restorations

• Orthodontics• Surgery

• Full arch splint wear

Design Consideration Recommendations

Absence of undercuts Add clasps

Gag reflex Lower archMinimal palatal coverageMinimal number of teeth covered

Anterior tooth sensitivity No facial coverageIsofolan on anterior teeth onlyHard/Soft material

Upper or lower deprogrammer Class I: maxillary or mandibularClass II: maxillaryClass III: mandibularCover the arch with the most crowding or mobile teeth

Orthodontic retention “B” splint or Kois deprogrammer

Uneven or rough incisal edges Fabricate deprogrammer on that arch

Equilibration Cranham or Kois deprogrammer

21108_DeprogFamily_Document 1 10/26/10 9:08 AM

Great Lakes Mini Deprogrammer• 5x5 overlay coverage • Bite plate with centrals and laterals contacting only

- Posterior teeth just out of contact or- Open enough for no interferences during

function

Spear Mini Deprogrammer• 3x3 anterior bite plate, 1mm full occlusal

coverage• Cuspid to cuspid contacts• No guidance• Open enough for no interferences during

function

Kois Deprogrammer• Wrap-around retainer-style with

discluding element• Opposing centrals contact only• Ideal for equilibration cases

Cranham Deprogrammer• Palatal bite plate with discluding element• Opposing centrals contact only• Ideal for equilibration cases• Vaulted palate or good lingual undercuts

necessary for retention

“B” Splint – Dawson Academy, Wilkerson-Style Maxillary Only• 1.5mm invisible retainer-style full occlusal

coverage with discluding element• Opposing centrals contact only• Open enough for no interferences during function

“B” Splint Dual Arch Option(For patients who require long-term wear)

• Maxillary “B” Splint worn together with lower arch component

• Mandibular 1.5mm invisible retainer-style fullocclusal coverage

• Flat runner bar cuspid to cuspid for upper discluding element to function against

Less chair-time... Easy adjustments... Multi-functional...

EasyDeprogrammers made

Deprogrammers can be used for...

• Headache sufferers

• Bruxers and/or clenchers

• Muscle relaxation

• Determining proper joint position

• Protection against wear

• Diagnosis

How do deprogrammers work?When just the anterior teeth are in contact, the totalamount of muscle contraction force the patient canachieve is only 30% compared to MIP / CO (MaximumIntercuspation / Centric Occlusion). The lateral pterygoidmuscles relax allowing the temporal mandibular joints to seat into their most comfortable position.

Deprogrammers allow muscle relaxation by removing all occlusal interferences, and any habitual functionalmovements the patient has developed to avoid pain. If a patient has more than normal muscle tension orsoreness during a load test* or during overnight wear,this can be an indication of an intracapsular joint issue.A deprogrammer is contraindicated in these cases.

*For more information on load testing, ask about Great Lakes“Patient Screening Guide”

Records for Laboratory Fabrication

• Upper and lower models or impressions

• No bite registration is needed unless MIP / CO is difficult todetermine (very worn teeth from bruxism)

Delivery

Confirm that the deprogrammer seats properly and has proper retention.Trim any areas where the patient indicates a tight feel on teeth with a carbide bur.

Next check the contacts with articulating paper. There should be an evenlycontacting dot on each contacting tooth. For most styles, there should be nointerferences of any posterior teeth during protrusive and lateral movements.

Wear Duration & Treatment Planning

Deprogrammers should only be worn when the patient goes to bed each night (up to 12 hours per day). Make sure the patient knows not to wear the deprogrammerany longer than this as super-eruption of non-contacting teeth can occur (with theexception of the “B” Splint dual arch).

Make the patient aware that if their bite feels “unusual” in the morning after removing the deprogrammer, it should feel normal again after the patient eats breakfast. If it doesn’t, instruct the patient to come in for evaluation. This is especially true if the patient will be wearing the deprogrammer long term.

If the patient is in more pain after wearing their appliance, this can be an indication of an intra-capsular joint issue. The patient should discontinue use and contact the dental office.

Depending on the treatment plan, the time period the patient continues to wear theirdeprogrammer can vary. Patients may find relief after a couple weeks wear and canuse the appliance whenever pain reoccurs. For other patients, once the masticatorymuscles have been relaxed allowing the joints to seat in a comfortable position, atreatment plan can be developed. Instruct the patient to wear their deprogrammer for at least one hour prior to their appointment in order to take a CR bite. With themodels mounted on an articulator using the CR bite, the method to treat the occlusal-muscular problem can be discussed.

Depending on the patient’s condition and needs you may choose:

• Equilibration• Restorations

• Orthodontics• Surgery

• Full arch splint wear

Design Consideration Recommendations

Absence of undercuts Add clasps

Gag reflex Lower archMinimal palatal coverageMinimal number of teeth covered

Anterior tooth sensitivity No facial coverageIsofolan on anterior teeth onlyHard/Soft material

Upper or lower deprogrammer Class I: maxillary or mandibularClass II: maxillaryClass III: mandibularCover the arch with the most crowding or mobile teeth

Orthodontic retention “B” splint or Kois deprogrammer

Uneven or rough incisal edges Fabricate deprogrammer on that arch

Equilibration Cranham or Kois deprogrammer

21108_DeprogFamily_Document 1 10/26/10 9:08 AM Page 2






1.800.828.7626 ext. 223

[email protected]

Less chair-time

Easy adjustments



EasyEasy

SMLP

256R

ev10

1910

1.800.828.7626(U.S. & Canada)

716.871.1161(Worldwide)









1.800.828.7626 ext. 223

[email protected]

Less chair-time

Easy adjustments



EasyEasySM

LP25

6Rev

1019

10

1.800.828.7626(U.S. & Canada)

716.871.1161(Worldwide)




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