Treatment of frictional dental hypersensitivity (FDH) with computer-guided occlusal adjustments

A retrospective five-year survey on the treatment outcome of disclusion time reduction (DTR) therapy in treating temporomandibular dysfunction patients

OBJECTIVE

To assess the five-year long-term quality of life of patients who were treated with Disclusion Time Reduction Therapy (DTR).

METHODS

Thirty occluso-muscular disorder patients responded to two questionnaires about their symptom intensities, frequencies, and pain levels that were given to the patients before DTR therapy and five years after. Both surveys were subjected to the Wilcoxon signed-rank test to compare differences in the reported intensities, frequencies, and pain levels.

RESULTS

A statistically significant reduction was found between the pre- and five-year post-DTR treatment intensities, frequencies, and pain scores (p < 0.05).

CONCLUSION

The chronic pain intensity and frequency observed in patients with occluso-muscular disorders can be markedly reduced by Immediate Complete Anterior Guidance Development (ICAGD)/DTR therapy, while improving the patient's overall long-term quality of life. Many pre-ICAGD/DTR daily chronic and painful, occluso-muscular symptoms were no longer present years after undergoing ICAGD/DTR treatment.

Occlusal Analysis in Natural Dentition: Systematic Review

This study aimed to evaluate the effectiveness of conventional occlusal analysis in contrast with digital occlusal analysis in natural dentition. Occlusal analysis allows the identification of normal and abnormal occlusal contact points that alter the craniomandibular cervical system. We searched for articles with keywords [[dental occlusion]], [[natural dentition]], [[occlusal adjustment]], [[Immediate Complete Anterior Guidance Development]] [[mastication]], [[bite force]], [[premature contact]], [[occlusal balance]] [[articulating paper]]], [[spray]], [[Occlusal contacts]], and [[bite strength]]. They were considered observational , odds ratio and case control studies. We found 189 items. After evaluating the abstracts and full texts of the articles, 10 papers met the inclusion criteria. It was found that occlusal analysis allows the identification of the relationship between poor occlusion and the sensitivity of the teeth due to occlusal trauma, which is also related to temporomandibular joint pain in dynamic occlusion. The contacts of greater strength were observed in nonfunctional cusps, 48%, without ruling out the functional cusps, 24%. Despite being the universal method of occlusal control to date, the use of joint paper, remains subjective compared to the digital occlusal control device. Posture is considered directly related to occlusal trauma and temporomandibular disorders; without proper occlusal analysis, a clear diagnosis of the patient's joint condition cannot be obtained. Digital occlusal analysis is more objective than traditional occlusal analysis.

Occlusal problems: Hearing symptoms in subjects with temporomandibular disorder

OBJECTIVE

This study aimed to investigate the relationship between occlusal problems and hearing symptoms.

METHODS

Electromyography, occlusion analysis, and hearing tests were performed on 24 patients with temporomandibular disorders and concurrent ear symptoms and 16 subjects in the control group.

RESULTS

The null hypothesis of no statistically significant relationship between pure tone audiometry (PTA) values and disclusion times (DT) > 0.40 s and <0.40 s was rejected. There were statistically significant correlations between 0.25, 0.5, 1, 6, and 8 kHz airways of the right and left ear and 1 and 2 kHz bone conduction for disclusion times >0.40 s.

CONCLUSION

Reducing disclusion time to <0.40 s may ameliorate ear symptoms.

A Multi-Center Disclusion Time Reduction (DTR) Randomized Controlled Occlusal Adjustment Study Using Occlusal Force and Timing Sensors Synchronized with Muscle Physiology Sensors

Objective—To perform a Randomized Controlled Trial (RCT) Disclusion Time Reduction (DTR) study at five Dental Colleges, using intraoral sensors and muscular electrodes. Methods and Materials—One hundred students were randomly assigned to a treatment group to receive the ICAGD coronoplasty, or a control group that received tooth polishing. All subjects answered symptom questionnaires: Beck Depression Inventory-II, Functional Restrictions, and Chronic Pain Symptom and Frequency. Subjects self-reported after ICAGD or placebo at 1 week, 1 month, 3 months, and 6 months. The Student’s t-Test analyzed the measured data. The Mann–Whitney U Test analyzed the subjective data (Alpha = 0.05). Results—The Disclusion Times, BDI-II scores, and Symptom Scales were similar between groups prior to treatment (p > 0.05). At 1 week, all three measures reduced in the treatment group, continuing to decline over 6 months (p < 0.05), but not for the controls (p > 0.05). Symptom Frequency, Functional Restrictions, and Pain Frequencies were higher in the treated group (p < 0.05), but declined after ICAGD compared to the control group (p < 0.05). Conclusions—ICAGD reduced Pain, Functional Restrictions, Symptom Frequency, and Emotional Depression within 1 week, which continued for 6 months. The tooth polishing did not initiate a placebo response.

Botulinum toxin type A for controlling bruxism assessed with computerized occlusal analysis: A pilot study

Objective: To assess botulinum toxin-A (BTX-A) on mandibular movements and bite force (BF%) in bruxism.Methods: Ten bruxers were divided into 2 groups based on BF% imbalance (G1: >10%, G2: <10%). BTX-A 140U was total injected into the masseter and temporalis muscles. A T-Scan® recorded BF%, occlusion time (OT), right, left, and protrusive disclusion time (DT) before administering BTX-A, as well as 15, 45, 90, and 120 days after injection.Results: The Friedman and Wilcoxon tests found significant differences in BF% in G1 subjects at 15 days (p = 0.028 s), OT at 90 (p = 0.043 s), and 120 (p = 0.027 s) days, DTR at 90 (p = 0.046 s) and 120 (p = 0.028 s) days, DTL at 15 (p = 0.043 s) and 90 (p = 0.027 s) days, and DTP 45_-90 days (p = 0.043 s).Conclusion: BTX-A induced BF% starting at 15 days post-injection and influenced lateralities later.

A digital poll of dentists testing the accuracy of paper mark subjective interpretation

AIMS

The aim of this study was to test subjective interpretation accuracy via digital polling of a large group of dentists to determine whether dentists can reliably interpret occlusal forces by visually assessing articulating paper markings.

METHODS

One hundred fifty-two dentists selected the most forceful occlusal contact in five occlusal-view photographs of articulating paper marks that were compared against T-Scan® relative occlusal levels of the same tooth contacts.

RESULTS

The mean correct response was a mere 13.13% correct (86.87% incorrect). Random chance was calculated at 16.7% correct. The cuspid contacts were the least often chosen as the most forceful contact. The Mann-Whitney U test found a significant difference between choosing the anterior teeth vs. posterior teeth. onclusions: Subjective interpretation is an inaccurate method for determining high force occlusal contacts. The reported low correct percentage fell below random chance, suggesting that dentists are unable to detect high occlusal force from looking at articulating paper marks.

Clinical protocol for occlusal adjustment: Rationale and application

BACKGROUND

Occlusal adjustment can optimize the result of orthodontics, orthognathic surgery, and comprehensive restoration, and resolve adverse forces to the dentition that affect the entire masticatory system. Mounted diagnostic casts and computerized occlusal analysis offer complementary advantages for evaluating occlusal problems. Predictable occlusal adjustment is facilitated by precise, measured documentation of occlusal force by computerized occlusal analysis.

CLINICAL PRESENTATION

A conservative, structural correction of a pronounced, chronic occlusal problem by additive and subtractive occlusal adjustment was performed after a previous failed occlusal adjustment. The patient's chief concerns were significant anterior teeth fremitus in maximum intercuspation and "pain in the teeth and a poor bite" after 30+ adjustments over 2.5 years.

CLINICAL RELEVANCE

Confirmation of specific criteria for a therapeutic occlusion resolved the anterior teeth fremitus and uneven bite. Traumatic occlusal contact on posterior teeth may elicit protective mandibular repositioning affecting anterior teeth relationships and should be considered during comprehensive diagnosis.