By. Dr. Richard Drake
THERMA
The 8th Wonde
By Dr. Richard Drake
I remember delivering my first TAP appliance
lined with Thermacryl like it was yesterday. It
wasn’t yesterday; it was 13 years ago,
and truthfully, it was mostly angst and
sweat and perhaps even a foul word
or two. The patient, a friend of the
family, had that deer in the headlight
look as I was “coached” on how to do
it over the speakerphone by a lab
technician. What in the world is
Thermacryl? Why would anyone
EVER want to use this stuff?
OK. I’ll admit; it does have a learning
curve. But once you’re over the hump,
and you feel comfortable, you will have
an amazing trick up your sleeve to
solve problems that might leave other
practitioners baffled. I’ve now delivered well
over a thousand dental devices lined with
Thermacryl, and we have the process down to
just a few minutes of chair time, and seldom
do we actually sweat anymore (except
perhaps in August here in South Texas!).
More than one dental device can be made
utilizing Thermacryl-like materials, but Keith
Thornton and TAP have
popularized it and I believe he has the
term ‘Thermacryl’ trademarked. It is
always an option when you order a TAP
device, but we have used it successfully
in EMA’s also. I know that Dynaflex Lab
will put it into a dorsal device as well.
They call it their “Accufit” device.
So what is this mystery material? It is a
thermoplastic and you can get it in bulk
in small beads that you heat in a 160
degree water bath. When it goes from
very hard and opaque white to clear and
pliable, then you know it is ready to be
manipulated. It’s sort of like sticky silly
putty. Outside the hot water and into a
patient’s mouth, you have a couple of
minutes’ working time. As it cools, it
hardens
Advantages:
-We’ve found a few situations where it
makes the most sense to utilize
ThermAcryl:
-Patients who have pending restorative
work or who are in the process of
getting dental work done make good
candidates. You can heat and retro-fit
the device to their current situation.
Let’s say they come in and you do a
couple of crowns, mill them, seat them
the same day. Wait a bit,
then reheat the device,
reseat and refit, and presto; a custom fitted device
without
having to cut or grind or
otherwise deface their
device, let alone send it
back to the lab to be
remade. We have had
patients die because they
postponed having their
MRD fabricated because
they were waiting for the
dental work to be completed. No,I am not kidding.
Severe sleep apnea requires a sense of urgency about it, so
don’t put off treatment of their apnea
while you work on their teeth.
-Patient’s who have very short clinical
crowns and straight teeth. One of the
most challenging things we have to do
in dental sleep medicine is to get our
devices to fit comfortably. “Too tight” or