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NTI-tss Plus and NTI-tss Plus Soft

Keller Laboratories, Inc.

Consultants’ Comments

  • “The lab fabricated them so well that they required little to no adjustment upon delivery.”
  • “The appliance is very effective at relieving my patients’ headaches and facial pain symptoms.”
  • “I feel that NTI-tss Plus is great to add to the armamentarium to treat TMJ symptoms.”
  • “Useful for a patient who is a severe gagger and cannot tolerate coverage of the posterior teeth being.”
  • “Very effective appliance. Patients noted a reduction of symptoms almost immediately.”
  • “When the patients bring their NTIs to their regular appointments, check for changes in occlusion.”


NTI-tss Plus is a small acrylic appliance that is worn over the mandibular or maxillary anterior teeth; a discluding element over the incisors prevents occlusion in the posterior. NTI-tss Plus is designed to reduce clenching intensity thereby protecting teeth, muscles, and joints while minimizing chair time. It is indicated for therapeutic treatment of the following: tooth wear resulting from bruxism and clenching, migraines and tension headaches, muscle pain associated with parafunction, TMD, and for aiding in diagnostic treatment planning. There are several design options to choose from in order to increase patient compliance. The NTI-tss Plus Soft extends coverage to the 2nd bicuspids for added retention and is fabricated with a softer inner layer for increased patient comfort. Its indications are the same as above and more specifically for patients with extreme crowding, veneers, worn restorations or natural dentition, and sensitive teeth. NTI-tss Plus and NTI-tss Plus Soft are laboratory-fabricated appliances. Records from the dentist include accurate maxillary and mandibular models and a measurement of the patient’s maximum protrusion. NTI-tss Plus and NTI-tss Plus Soft were evaluated by 16 consultants who delivered over 150 appliances to patients. These occlusal appliances received an 89% clinical rating.

Product Features

NTI-tss Plus and NTI-tss Plus Soft fit accurately and have a nice finish. Delivery appointments are typically very quick since occlusion is limited to the incisors. The appliances were reported to be used for a variety of indications and were most useful for treatment of acute TMD symptoms. NTI-tss Plus and NTI-tss Plus Soft were reported to be effective in reducing clenching; some patients with chronic headaches reported improvement. The biggest concern of consultants was the potential for unwanted tooth movement, such as anterior open bite, with prolonged use. The discluding element naturally protruded over the lip; patients varied in their tolerance of this. Overall, this small appliance was well accepted by patients.

Clinical Tips

  • If the patient has a severe class II occlusion, make a maxillary appliance. 
  • Include the maximum protrusive measurement on the RX.  Upon delivery, mark the limit of protrusion and trim to furthest mark.  This is now the perfect appliance for the patient.”