Change in bite

[Guest guest]

I was wondering if any of you have used an NTI device and then found

you had an open bite. Sorry for the long email, but I'm pretty

frustrated right now!

About two years ago I was fitted with an NTI to help w/morning

headaches. The device fits on the two top front teeth. A while

after, I noticed my bite had changed.

The doctors (dentist, orthdontist and orthognathic surgeon) didn't

think the NTI was the cause of the open bite. I also have limited

opening (2 fingers width most of the time) and had some light pain

on the right side. Before my opening was totally limited, I could

move my jaw back and forth and then have a normal opening. The

doctors still can't tell me what has caused my bite to change. The

surgeon later suggested I discontinue use of this device.

I've been doing some reading on the web that said the appliance may

cause an open bite. I found this just now!! I am so damned mad. The

dentist who fit me for the device NEVER mentioned the possibility of

an open bite or any other problems. I was fit for the device to

alleviate morning headaches due to nighttime grinding. If I would of

known this would of happened, I NEVER would of used it.

Unfortunately for me, it only occurs in about 5% of people!! I

better go buy a lottery ticket.

Now, I'm stuck w/a $12 - $20,000 surgery and $5,000 in braces that

the insurance probably won't cover, at least not w/o a huge fight.

Short of hiring an attorney, I'm probably stuck! ARGHH.

I've posted some unflattering pictures under Diane, if you'd like a

preview.

Here's what I just found:

One of the specific scenarios of the above description is the

development of an anterior open bite (and is also described on the

Frequently Asked Questions page), which can occur as a result of the

seating of the condyles following normalization of the musculature.

This can only happen if the condyle(s) were in a position anterior

and inferior to their optimal musculo-skeletally stable position,

and then seat to a more posterior-superior position. This causes

the mandible to pivot/rotate at the most posterior molars (thus

giving the appearance of posterior supra-eruption), allowing the

condyles to seat more posterior and superiorly, while the anterior

mandible rotates posterior-inferiorly, which, depending on the

original degree of incisor overlap, may present as an anterior open

bite.

This is a rare development, and clinically can be observed to

varying degrees in approximately 5% of those patients using the NTI-

tss for pain relief and prevention. Additionally, if this does

develop, it does so following a relief of the patient's symptoms.

There is no method in advance to predict if any condylar seating

will occur, or how much.

The vast majority of these occurrences can be restored to provide

incisal biting by performing occlusal reduction of the interfering

posterior cusp tips while the patient is in a protrusive incisal

bite relationship. However, in a small number of cases this will

not be adequate to close the anterior incisal bite. If the patient

desires to regain a functional incisor occluding relationship (many

times the patient is so satisfied with their symptomatic resolution

that they elect to do nothing more), a more involved restorative

treatment plan may be required, including fixed restorations,

orthodontic or orthognathic treatment.

As with any procedure, where a variety of outcomes is possible, all

reasonable outcome scenarios should be disclosed. For the patient,

the NTI-tss may prove to be both a symptomatic treatment device, and

a diagnostic device which demonstrates that the condyles were not in

their optimal seated positions. However, the treating dentist may

not desire to be involved in the treatment modalities necessary to

provide a occlusal scheme to the patient's satisfaction, in which

case the dentist may elect to not provide treatment with the NTI-

tss.