My Favorite Occlusal Deprogrammers 

October 13, 2023 Lee Ann Brady DMD

Deprogramming of the lateral pterygoid muscle is generally done by placing something in the anterior that eliminates posterior occlusal contact. I have two “go-to” deprogrammers. One is a leaf gauge or what is often referred to as a Lucia jig, and the other is a little device developed by Dr. Keith Thornton, who invented the TAP appliance. This second favorite is called a “Pankey Bite Stop” and is sold at The Pankey Institute store.

Using a Leaf Gauge

Every time you have a leaf gauge in the patient’s mouth and the patient is instructed to slide their jaw forward, then back and squeeze, the back teeth can’t touch. As the elevator muscles fire, they pull the condyle up into centric relation, stretching the lateral pterygoid and eliminating proprioception across the teeth.

I try to find the first point of contact on the forward motion and ask the patient to slide back and squeeze. By the time I do this 10 to 15 times, the pterygoid muscle has fully deprogrammed.

Using a leaf gauge to do occlusal deprogramming works especially well when the patient is already sleeping in a quick splint at night or wearing a full coverage appliance or an anterior-only appliance that has done the deprogramming for us.

Using a Pankey Bite Stop

I use a Pankey Bite Stop when I judge a leaf gauge will not suffice. The device is relined with Bite Ridge, placed over the upper incisors, and left to set. The patient is instructed to “sit on it.” I usually set a timer for 15 minutes. My instructions to my patient are not to try to touch their teeth together. The teeth may or may not touch. I instruct them to relax and try to NOT think about their teeth.

Using this device, you do not need to have the patient move forward, back, and squeeze if you allow 15 minutes. Because the posterior teeth do not touch, the proprioceptive message that normally tells the patient’s brain to activate the pterygoid muscles is eliminated and the lateral pterygoid starts to release.

What if the patient needs more?

With some patients, I realize that they will need to sleep in a QuickSplint for a couple of weeks. In our Essentials One course at Pankey, we use the Quicksplint as an overnight deprogrammer to allow us to capture very accurate diagnostic records. In my practice, we use this device as a durable deprogrammer, in addition to all the other things that it does. They are easy to fabricate chairside. You can read more about their use here. In our Essentials One course at Pankey, we use the Quicksplint as an overnight deprogrammer to allow us to capture very accurate diagnostic records. In my practice, we use this device as a durable deprogrammer, in addition to all the other things that it does.

Related Course

E1: Aesthetic & Functional Treatment Planning

DATE: November 2 2023 @ 12:00 pm - November 5 2023 @ 7:30 pm

Location: The Pankey Institute

CE HOURS: 39

Dentist Tuition: $ 6100

Per night with private bath: $ 290

This Course Is Sold Out Transform your experience of practicing dentistry, increase predictability, profitability and fulfillment. The Essentials Series is the Key, and Aesthetic and Functional Treatment Planning is where your…

Learn More>

About Author

User Image
Lee Ann Brady DMD

Dr. Lee Ann Brady is passionate about dentistry, her family and making a difference. She is a general dentist and owns a practice in Glendale, AZ limited to restorative dentistry. Lee’s passion for dental education began as a CE junkie herself, pursuing lots of advanced continuing education focused on Restorative and Occlusion. In 2005, she became a full time resident faculty member for The Pankey Institute, and was promoted to Clinical Director in 2006. Lee joined Spear Education as Executive VP of Education in the fall of 2008 to teach and coordinate the educational curriculum. In June of 2011, she left Spear Education, founded leeannbrady.com and joined the dental practice she now owns as an associate. Today, she teaches at dental meetings and study clubs both nationally and internationally, continues to write for dental journals and her website, sits on the editorial board of the Journal of Cosmetic Dentistry, Inside Dentistry and DentalTown Magazines and is the Director of Education for The Pankey Institute.

Leave a Reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.

FIND A PANKEY DENTIST OR TECHNICIAN

I AM A
I AM INTERESTED IN

VIEW COURSE CALENDAR