Evidence-Based Occlusal Management for Temporomandibular Disorders


by

Kengo Torii

DOI: 10.2174/97816080578321130101
eISBN: 978-1-60805-783-2, 2014
ISBN: 978-1-60805-784-9



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"Current main stream treatments for temporomandibular disorders (TMDs) are mainly conservative therapies. However, these conservative...[view complete introduction]

Table of Contents

Foreword

- Pp. i

Noshir R. Mehta

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Preface

- Pp. ii-iii (2)

Kengo Torii

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Prevalence of Temporomandibular Disorders

- Pp. 3-19 (17)

Kengo Torii

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Causes and Contributing Factors of Temporomandibular Disorders

- Pp. 20-34 (15)

Kengo Torii

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Occlusion and Temporomandibular Disorders

- Pp. 35-53 (19)

Kengo Torii

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Reference Position for Occlusal Analysis and Equilibration

- Pp. 54-74 (21)

Kengo Torii

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Reproducibility of the Muscular Contact Position

- Pp. 75-97 (23)

Kengo Torii

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Various Therapies Prior to Occlusal Equilibration

- Pp. 98-122 (25)

Kengo Torii

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Occlusal Equilibration in the Muscular Contact Position

- Pp. 123-149 (27)

Kengo Torii

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Possible Mechanism of Temporomandibular Disorders

- Pp. 150-171 (22)

Kengo Torii

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Various Symptoms of Temporomandibular Disorders

- Pp. 172-185 (14)

Kengo Torii

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Treatment Outcome of Temporomandibualr Disorders

- Pp. 186-196 (11)

Kengo Torii

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Index

- Pp. 197-206 (10)

Kengo Torii

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Foreword

Professor Torii has put together a well-balanced treatise on the concept of an occlusal basis as a risk indicator while still keeping the evidence for a bio psychosocial intervention in patients with T.M. disorders.

I am particularly impressed that the concepts put forward by Professor Torii have been supported by the literature he has reviewed.

This treatise is a must for students and practitioners who wish to successfully treat patients with Temporomandibular Disorders by combining dental and medical concepts into an effective management philosophy.

Noshir R. Mehtaold
Tufts University School of Dental Medicine
Boston
Massachusetts
USA


Preface

Although the role of occlusion in the manifestation of the signs and symptoms associated with temporomandibular disorders (TMDs) remains controversial, occlusal adjustment or occlusal reconstruction therapies have been undertaken for the treatment of TMDs. However, a joint conference of the National Institute of Health (NIH) and National Institute of Dental Research (NIDR) held in May 1996 in the USA concluded that occlusion and TMDs were not related, and this decision has definitely affected clinicians and researchers. Since then, many wellknown TMD clinicians and researchers have not alluded to any relation between occlusion and TMDs, and treatment for TMD has shifted to more conservative modalities. However, we have never been convinced that all the evidence completely rules out a possible relation between occlusion and TMDs. Recently, the relation of a discrepancy between the habitual occlusal position (HOP) and the bite plate-induced occlusal position (BPOP) to TMD has been reported. Thus, the possible effect of the occlusal equilibration of the BPOP on TMD signs and symptoms has also been inferred. We previously reported the transient effects of conservative therapies on TMD and highlighted the need for occlusal equilibration of the BPOP.

Here, our description, together with the colored pictorial representation, covers the following points:

  1. When do the signs or symptoms of TMD appear?
  2. Should the signs or symptoms be left untreated?
  3. When should treatment start?
  4. How should the occlusal discrepancy be examined?
  5. How should occlusion at the BPOP be equilibrated?

The aim of this study is to provide a better understanding of the importance of occlusal equilibration in the masticatory muscles-guided position for TMD. We will demonstrate how to equilibrate the patient’s occlusion according to the magnitude of the occlusal discrepancy and how to use an articulator for the occlusal equilibration. Although TMD is not a fatal disease, the quality of the patient’s life is affected because of the associated headaches, aural symptoms, masticatory dysfunction and posture. Since the expert’s panel of the NIDR was met in 1996, an ugly conflict has arisen and persists between the occlusal treatment school and the conservative treatment school. Conservative treatments are reversible, therefore, the treatments are thought to benefit TMD patients at present. However, we have reported that the effects of these conservative treatments for TMD are transitory and recurrence inevitably occurs. We have obtained a good outcome using causal treatment (occlusal equilibration in the BPOP) based on the evidence of a relation between occlusal discrepancy and TMD. Therefore, our clinical data should be shared with many clinicians throughout the world.

ACKNOWLEDGEMENTS

Declared none.

CONFLICT OF INTEREST

The author confirms that this ebook content has no conflict of interest.

Kengo Torii
General Dentistry of the Infirmary
School of Life Dentistry
Nippon Dental University
Tokyo
Japan
E-mail:wbs89508@mail.wbs.ne.jp

List of Contributors

Author(s):
Kengo Torii
General Dentistry of the Infirmary, School of Life Dentistry
Nippon Dental University
Tokyo
Japan




Reviews

British Dental Journal , Volume 216, Issue 8a, p443 – April 25, 2014 – Nature Publshing Group

http://www.nature.com/bdj/journal/v216/n8/pdf/sj.bdj.2014.314.pdf


“… This range of information should be helpful to someone newly entering the TMD treatment arena… … Recommended for the information within. “ – Dan Jenkins, CRANIO, Volume 32, Issue 3 (July 2014), pp. 235-235, Maney Publishing

http://www.maneyonline.com/doi/full/10.1179/0886963414Z.00000000049


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