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:

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.