iNterra: Fabricating Nightguards In-Office?

nightguard.jpgEven though the lab costs for nightguards are not excessive, I would like to save on this and make my nightguards in the office. I would like to train my assistants to do this. In the past we used these suck-down nightguards where we heat-softened a sheet of plastic and adapted it to the models. These are okay but do not last very long. Usually the patient wears through in the molar area. I’m looking for a better alternative. I’ve seen that Caulk Dentsply is advertising their iNterra brand nightguard kit for in office fabrication. They look like lab quality nightguards, but I can’t seem to find much information on this product . Anybody using this system? What has been your experience?

See also:
Enterra VLC
light curing unit for fabricating nightguards.

14 thoughts on “iNterra: Fabricating Nightguards In-Office?

  1. So you made “suck-down nightguards where we heat-softened a sheet of plastic and adapted it to the models”… that is quite vaque… can you be more specific? Maxillary or Mandibular? Hard or soft or hard outside laminated to soft inside? Acrylic added to perfect an occlusal scheme?

    Just how long are these unsatisfactory night guards “that do not last very long” actually lasting? And…er, um, what happened to the canine rise that should prevent wearing them out in the molar area?

    Are you suspecting the material of being inadequate?

    Spence

  2. Found this https://decs.nhgl.med.navy.mil/2QTR06/PRODUCTEVALUATIONS/eclipse.htm and this
    http://trubyte.dentsply.com/pro/prod_enterra.shtml.
    Given that the price for the older Eclipse unit is around U$16000, you may consider the cost/benefit ratio very well before buying into it. Spencer also has a point: if you are using soft plastic sheets, bruxism patients woud chew it away in no time. Hard plastic refined with acrylic works relatively well in most of my cases, and a chemical polishing unit does it job when it comes to perfecting looks of the nightguards.

  3. I no longer use a full arch night guard for my bruxing patients or patients without canine guidance. Instead I use a canine to canine or 3 to 3 splint adjusted to give canine guidance only. Posterior over-eruption does not occur (provided the splint is for night use only) and with the posterior segments OUT OF CONTACT with each other masseter and the medial pterygoids do not fire – thereby significantly reducing the bite force of the patient while they are sleeping. I pressure form my splints on 2 or 3 mm acrylic.

  4. I bought the Enterra about 1 year ago, and I use (more my assistant than myself) it not only for nightguards, but also to make base plates, flippers, temps and custom trays. For the night guards, you can do all hard or a soft inside and hard outside, you can do the shape you want, like canine to canin, or a Nti type. It cost me about 4000$ for the machine with materials. It has been paid off this year already… but I am a prosthodontist, so I do a lot of it.
    Many labs are using it as well. I can only recommand it.

  5. The issue most dentist face with in office nightguards is the lack of understanding by the fabricator in regards to function. Perforation of the third molar could be due to lack of canine guidance, without the guidance a posterior interference may exists leading to a perforation. Every patient has a different occlusal scheme and thats where we run into trouble. Issues such as a large ccurve of spee, a long lingual cusp and deep intercuspation are factors that must be identified before the appliance is made and adjustments made to the design so that it will function properly. I the Splint Dept manager for Artistic Dental Studio in Illinois and we actualy free hand wax all of our appliance so it would be easier to make the adjustments. Don’t forget about condylar inclination. Hope this helps.

  6. My dentist wants me to learn how to make night Guards for his patients.
    I am a one man Lab and I would like to purchase the system to learn how to make night guards.
    Please help.

  7. This is what I’ve heard: the system is flexible enough that you can easily achieve the occlusion you desire. It doesn’t matter if you want centric occlusion, centric relation, edge-to-edge, flat plane, anterior 6, anterior guidance, cuspid rise, etc. Interra is a light cured resin that you hand form directly in the mouth, have the patient bite into it, and cure.

    You can find it spoofed on the DentalBuzz website: DentalBuzz: a jolt of current

  8. We recently started using this product in our office and have less than satisfactory results. We have not had a patient who can tolerate wearing the nightguard as they are painfully tight once cured. We also cannot achieve a labquality esthetic appearance. We had the Dentsply rep come out to troubleshoot but she had a very poor dental background and knew very little beyond what was given to her in her training.
    Has anyone had this problem? Perhaps the curing unit is not calibrated correctly? How can we achieve a smooth, esthetically pleasing appearance?

  9. I am the only assistant who has been using the interra/eclipse nightguard system. i haven’t run into any complications and consider myself to be managing this wonderful product quite well.

    The Oven cost us approximately $4500 plus materials. It is not a large amount, considering the amount of nightguards I have been producing for my office. (Approx 3/wk).

    I BELIEVE THAT MOLAR PERFORATION IS A RESULT OF OVER EXTENDING THE ACRYLIC RESIN AND IT MAY ALSO BE THE RESULT OF SALIVA CONTACT.

    IF YOU OVER-ADAPT THE RESIN MATERIAL, YOU WILL GET A WEAKER PRODUCT AROUND THE MOLARS AND CANINES.

    I RECOMMEND SALIVA FLOW CONTROL USING CHEEK RETRACTORS, AN AIR SYRINGE AND WIPING OFF THE TEETH WITH GAUSZE PRIOR TO INSERTION OF THE RESIN TO BE MOULDED.

    Despite the success I’ve had with the system, I have not mastered mandibular guards…the lingual saliva glands are impossible to control as cotton rolls and such only get in the way of the resin material. I do not fabricate mandibular guards. Those requests go to our lab associates.

    If you have any questions and I can be of help please feel free to email me at stushess@hotmail.com

  10. Also, once the nightguard comes out the oven it more than likely will need to be adjusted along the interproximal contacts and incisal points due to oven shrinkage.

    I use an acrylic bur to do this with the patient chairside. You will also need bite paper to check the occlusion of the patient when the guard is inserted.

    YOU CAN’T JUST TAKE THE GUARD OUT THE OVEN AND HAND IT TO THE PT…IT MUST BE ADJUSTED ALONG THE OCCLUSAL PLANE AND WITHIN THE INTERPROXIMAL SPACES. Labs usually block out undercuts and what have you so they don’t worry about tight fits.

    🙂

  11. As a patient, I went from soft full arch (pre dental student) to hard acrylic full arch (lab tech) to NTI lined with thermoplastic button (dentist of 4 years). NTI route is great because:
    1. cheap and incredibly quick chairside fabrication
    2. same reason of reduced muscle activity as explained by John Clark in May of 2008 on this site.
    3. heck, I’ve treated “cold sensitivity” successfully.
    I don’t sell for them or have any benefit with them, but I HIGHLY RECOMMEND you take the time to investigate it.
    Happy Treating,
    DrH

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