Dear Dr. Manalili, 

We see so many implant cases being completed nowadays with immediate placement. Why was that method not adopted in your full-arch implant rehabilitation (Chairside^® magazine, Vol. 17, Iss. 2)? 

DDS, Salt Lake City, Utah 

Dear Doctor, 

For complicated full-arch implant cases like this one, I always utilize Glidewell’s Digital Treatment Planning (DTP) team. Although they gave me the confidence and the resources I needed to immediately load this case, I decided to delay implant placement.

Immediate implant placement is a valuable treatment option, but dentists should never feel pressured to complete an immediate full-arch implant case unless they have the capacity to do so. It is also important to consider the well-being of the patient who may not be able to physically comply with the demands of a full-arch rehabilitation in one appointment. 

Sincerely, 

Taylor Manalili, DDS 

Dear Dr. Johnson, 

You mentioned two migraine prevention devices in your article: the NTI-tss Plus^® and the NTI OmniSplint^® (Chairside magazine, Vol. 17, Iss. 2). Which one should I prescribe in my practice? 

DDS,

Scranton, Pennsylvania

Hello Doctor,

The NTI-tss Plus follows the original style of the first nociceptive trigeminal inhibition tension suppression system, which was created by Dr. Jim Boyd over 30 years ago. It is backed by decades of research that shows its efficacy in reducing tension-type headaches and migraines. The small, anterior style of the NTI-tss Plus is ideal for patients who struggle with gag reflex. I more commonly prescribe the device for the lower arch, unless the patient presents with an overbite greater than 50% or an overjet greater than 4 mm.

The NTI OmniSplint was created by Glidewell in 2021 and offers the same clinical success as its predecessor. It mimics the same anterior pointstop (the small resin nodule at the front of the device) but offers full occlusal coverage. Unlike the NTI-tss Plus, the NTI OmniSplint covers both arches. This style is ideal for patients who are used to wearing retainers or bite splints and for patients worried about aspirating a smaller device — though such concerns are unfounded. 

Regards, 

Eric Johnson, DDS