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Kois Deprogrammer

Achieve accurate centric relation and precise bite registration with our advanced Kois Deprogrammer technique. Essential for predictable restorative dentistry and occlusal analysis.

  • Accurate centric relation positioning
  • Diagnose occlusal dysfunction patterns
  • Reproducible bite registration

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Understanding the Kois Deprogrammer

The Kois Deprogrammer (KD) represents a breakthrough in restorative dentistry, offering clinicians a reliable, evidence-based approach to achieving accurate centric relation positioning and mounting diagnostic casts with confidence. Developed by Dr. John Kois, this innovative appliance addresses one of the most persistent challenges in dentistry: reliably achieving the true physiologic jaw position independent of muscular dysharmony, tooth interferences, and operator error.

What is Centric Relation?

Centric relation is defined as the maxillomandibular relationship in which the condyles articulate with the thinnest avascular portion of their respective disks in the complex anterosuperior position against the shapes of the articulating eminences. This position is independent of tooth contact and is clinically discernible when the mandible is directed superiorly and anteriorly. It is restricted to purely rotational movement about the transverse horizontal axis.

Achieving true centric relation is fundamental to successful restorative dentistry. When a patient's jaw position is established in true CR, the clinician can create treatment plans that are stable, functional, and predictable over the long term.

How the Kois Deprogrammer Works

The Kois Deprogrammer works by removing sensorimotor feedback from tooth-deflecting inclines that cause neuromuscular dysfunction. Proprioceptors in the periodontium provide feedback that programs the muscles to close in maximum intercuspation (MIP). When anterior appliance interferences are present, reinforcement through repeated closure causes the muscles to develop habitual patterns that move the mandible away from its physiologic rest position.

The KD eliminates this sensorimotor interference. The single point of contact on the anterior appliance removes the influence of dentition on condylar position. As the patient wears the device over several days, the muscles gradually relax and function in a coordinated manner. The tooth-deflecting inclines that previously triggered avoidance patterns are no longer present, and the condyles are free to move to their equilibrium position in centric relation.

Design and Fabrication

The Kois Deprogrammer is a palatal-coverage maxillary acrylic device with a flat plane lingual to the anterior teeth. The appliance separates the dental arches and provides a single lower-central incisor contact against the anterior bite plane. It can be described as a Hawley appliance with a modified anterior bite plane.

Importantly, the KD is not a proprietary appliance—any independent laboratory can fabricate it according to established protocols. The device features:

  • Full-Palatal Coverage - Complete acrylic coverage allows initial complete interdigitation of all teeth
  • Labial Bow Design - Extends from the most distal tooth on each side without interfering with occlusal surfaces
  • Anterior Platform - Single stop opposing lower central incisors that guides mandibular positioning
  • Minimal Vertical Dimension - Opens approximately 1mm in the molar region, creating comfort similar to natural function

Diagnosing Occlusal Dysfunction

One of the most valuable applications of the Kois Deprogrammer is its ability to diagnose three distinct types of abnormal occlusal attrition, each requiring different treatment approaches:

  • Constricted Path of Closure (CPC) - Attrition that occurs during closure into MIP when anterior interferences create a distal thrust. These patients often appear asymptomatic due to remarkable adaptation, yet require specific correction to prevent progression.
  • Occlusal Dysfunction - Excessive grinding triggered by posterofacial tooth interferences that create an escape route for closure. These patients may develop significant wear on both lingual surfaces of maxillary incisors and labial surfaces of mandibular incisors.
  • Parafunction (True Bruxism) - Excessive grinding triggered by the brain's motor centers with no functional purpose. This type has no direct occlusal cause and requires different management strategies than the other patterns.

Key Clinical Applications

The Kois Deprogrammer has numerous clinical applications that extend beyond simple CR mounting:

  • Simplifying Difficult Bite Registrations - For patients with complex muscular patterns or unclear CR positioning
  • Accurate Diagnostic Cast Mounting - Enabling true CR positioning for precise treatment planning
  • Determining Mandibular Direction - Identifying whether the jaw needs to move anteriorly or posteriorly to reach true CR
  • Facilitating Occlusal Adjustments - Maintaining deprogramming during adjustment procedures
  • Complex Case Treatment Planning - Providing accurate jaw position data for comprehensive restorative cases

Complementary Restorative Services

Dental Crowns Dental Implants Root Canal Treatment TMJ Treatment Dental Bridges

The Deprogramming Process

Understanding what to expect during your Kois Deprogrammer treatment journey

1

Consultation & Assessment

We perform a comprehensive occlusal evaluation to determine if deprogramming would benefit your case. This includes assessing your jaw position, identifying potential muscular dysharmony, and evaluating existing occlusal patterns. Digital documentation is recorded for comparison after treatment.

2

Deprogrammer Fabrication

We provide full-arch casts mounted in maximum intercuspation to our laboratory. The Kois Deprogrammer is a palatal-coverage maxillary acrylic device with a flat plane lingual to anterior teeth, designed specifically for your dental anatomy. The device can be fabricated by any independent laboratory using our established protocol.

3

Initial Deprogrammer Fitting

Your deprogrammer is delivered and fitted to ensure proper fit and contact. We establish the initial reference point—the patient marks the platform where incisor contact occurs. Instructions are provided for wearing the device up to 20 hours daily (except while eating). The patient learns proper insertion and removal technique and receives detailed care instructions.

4

Neuromuscular Deprogramming

The device works by removing sensorimotor feedback from tooth-deflecting inclines. As you wear the deprogrammer, your jaw muscles gradually relax and function in a coordinated manner. The single point of anterior contact eliminates the influence of dentition on condylar position. Most patients require 7-14 days of consistent wear to achieve full deprogramming, though individual variation exists.

5

Verification of Deprogramming

The patient is deprogrammed when they consistently reproduce the same single spot on the platform without guidance or support. The contact point must be absolutely flat with no slide whatsoever. The patient feels asymptomatic and can instinctively contact the same spot repeatedly. This reproducibility is the key criterion for readiness to proceed with bite registration.

6

Bite Registration & Treatment Planning

Once deprogrammed, accurate bite registration is recorded with the appliance in place. The patient makes the same mark that was made during initial fitting. Diagnostic casts are mounted in true centric relation, enabling precise treatment planning with confidence. We can now diagnose the specific type of occlusal dysfunction and develop appropriate treatment protocols for long-term success.

Benefits of the Kois Deprogrammer

Advanced neuromuscular conditioning for superior occlusal analysis and case mounting accuracy

Accurate Centric Relation

Achieve true physiologic jaw position independent of muscular dysharmony, tooth interferences, or operator manipulation for predictable treatment outcomes.

Gradual Neuromuscular Adaptation

Allows patients to deprogram over extended periods (typically 1-2 weeks) without forcing sudden changes that may provoke adverse reactions or discomfort.

Reproducible Positioning

Patients consistently return to the same jaw position passively and without guidance, enabling accurate and reliable bite records for diagnostic casts.

Diagnostic Accuracy

Identify three types of abnormal occlusal attrition (CPC, dysfunction, bruxism) to develop appropriate treatment protocols tailored to each patient's condition.

Self-Adjusting Design

The device requires minimal adjustment as muscles naturally relax over time, reducing the need for multiple appointments and saving valuable clinical time.

Enhanced Treatment Predictability

Enable evidence-based treatment planning with superior accuracy, leading to more stable restorations, better esthetics, and higher patient satisfaction.

Schedule Your Consultation

We welcome new patients to our Peachtree City prosthodontic practice. Feel free to request an appointment or ask us any questions about our specialized services.

Office Hours

Monday - Thursday: 8 AM–4 PM

Friday: Available on appointment only

Saturday - Sunday: Closed

Contact Information

Phone: (770) 631-0044

Fax: (770) 631-0045

Email: info@aestheticrestorativedentistry.com

Our Location

Address:
5000 Shakerag Hill
Peachtree City, GA 30269

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Dental Emergencies

For dental emergencies, please call our office immediately:

(770) 631-0044

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Kois Deprogrammer FAQs

Common questions about the Kois Deprogrammer and the deprogramming process

The Kois Deprogrammer is a palatal-coverage maxillary acrylic device with a flat plane lingual to the anterior teeth. It works by removing sensorimotor feedback from tooth interferences that cause neuromuscular dysfunction. As patients wear the device, their jaw muscles gradually relax and the condyles move to their true physiologic position in centric relation. The single point of anterior contact against the appliance guides the jaw naturally to equilibrium without operator manipulation.
Patients who benefit most from deprogramming include those with muscular dysharmony, constricted path of closure, occlusal dysfunction, or patients difficult to manipulate into centric relation. It's particularly valuable for patients experiencing jaw discomfort, difficulty achieving accurate bite records, or those requiring precise treatment planning. However, patients with temporomandibular joint pathology that won't accept loading should be excluded. A simple cotton roll test can help identify unsuitable candidates.
Most patients achieve complete deprogramming within 7-14 days of consistent wear. However, individual variation exists, and some patients may require longer periods. The device should be worn 20 hours per day (except while eating) until the patient can consistently reproduce the same contact point on the platform without guidance. The timeline depends on the degree of muscular dysharmony and individual neuromuscular adaptation rates.
Most patients find the device comfortable to wear. It's designed with a minimally opened vertical dimension (approximately 1mm in the molar region), making it more comfortable than many other appliances. Some patients may experience mild initial adjustment, but this typically resolves within a few days. The device can be worn during daytime activities, professional settings, or while working. If you experience significant discomfort, contact our office immediately, as this may indicate a joint problem.
No, you should remove the deprogrammer while eating. The device should be worn up to 20 hours per day but removed during meals. This prevents damage to the appliance and allows your natural bite function to continue. After eating, simply clean your mouth and reinsert the deprogrammer. Maintaining this schedule helps ensure consistent deprogramming without interruption.
You are deprogrammed when you can consistently reproduce the same single spot on the platform without any guidance or external force. The contact point must be absolutely flat with no sliding movement. You should feel asymptomatic and instinctively know when you're contacting the same spot on the appliance. This reproducibility is verified during follow-up appointments and is the key criterion for proceeding with bite registration and treatment planning.
The Kois Deprogrammer offers several unique advantages: it allows gradual neuromuscular adaptation over days or weeks rather than forcing immediate change; it provides reproducible positioning without operator manipulation; it's self-adjusting as muscles naturally relax; and it can be fabricated by any independent laboratory, making it accessible to all practitioners. Most importantly, it enables diagnosis of three types of abnormal occlusal attrition, allowing tailored treatment protocols rather than one-size-fits-all approaches.
No, the Kois Deprogrammer is not proprietary and is not owned by any single entity. It can be fabricated by any independent dental laboratory following the established protocol. This accessibility means patients have more flexibility in where their appliance is made and ensures the technique is available to all dental professionals committed to accurate occlusal analysis and predictable restorative dentistry.
The Kois Deprogrammer helps diagnose: Constricted Path of Closure (CPC) - attrition during closure into MIP when anterior interferences create a distal thrust; Occlusal Dysfunction - excessive grinding triggered by posterofacial tooth interferences with no functional purpose; and Parafunction (True Bruxism) - excessive grinding triggered by brain's motor centers with no functional purpose. Each diagnosis requires different treatment approaches, and accurate diagnosis enables appropriate, targeted treatment.
Yes, the Kois Deprogrammer has several additional clinical applications: it can be used to simplify difficult bite registrations for patients requiring extended deprogramming; it's helpful for diagnosing whether the mandible needs to move anteriorly or posteriorly to reach centric relation; it facilitates occlusal adjustments once deprogramming is complete; and it can be used to manage certain occlusal issues during treatment planning and execution. The device essentially simplifies the entire CR mounting and analysis process.
Handle your deprogrammer with care to avoid damage. Clean it gently with a soft toothbrush and lukewarm water after removing it. Store it in a safe place where it won't be damaged or lost. Avoid exposing it to extreme heat or cold. Never attempt to adjust or modify the appliance yourself. If you experience any damage, breakage, or discomfort, contact our office immediately. Proper care ensures the device remains effective throughout your deprogramming period.
Once you're fully deprogrammed and have provided accurate bite registration with the appliance in place, we'll mount your diagnostic casts in true centric relation. This enables us to develop a precise treatment plan tailored to your specific occlusal dysfunction type. The same deprogrammer can often be used during subsequent occlusal adjustments to maintain your deprogrammed position. This comprehensive approach ensures your treatment is based on accurate jaw positioning rather than habitual or dysfunctional patterns.