Journal of Craniomandibular Function, 02/2025

Purpose: This study comprises the fifth and final part of a comprehensive investigation of the positions of the temporo-mandibular joint condyles. In this evaluation, we wanted to investigate the neuromuscular position of the mandible. Materials and Methods: The neuromuscular condylar pos-itions were recorded by four independent operators in 81 fully dentate subjects with healthy oral function using a central bearing point system and rapid closing movements. The “most frequent adduction point” was determined, and the recordings were repeated twice for each subject. The sub-jects’ maxillary casts were mounted in an articulator using an individual facebow transfer, subsequently the mandibular casts were mounted with a central-bearing-point registration on the tip of the Gothic arch, ie, in centric condylar position. A custom-made electronic measuring articulator was used to determine the spatial distance between the condyles in cen-tric relation, maximal occlusion and the newly determined neuromuscular position. Results: The reproducibility of the neuromuscular registra-tions was on average 0.52 ± 0.16 mm (range 0.04–2.53 mm) with the right and left side averaged. The spatial distances of the condyles between maximal intercuspal position and neu-romuscular positions were 0.88 ± 0.30 mm (range 0.12–5.98 mm), again averaged for the right and left sides, whereas the ones between the centric condylar position and the neuro-muscular positions were 0.83 ± 0.27 mm (range 0.10–7.89 mm). Conclusions: The neuromuscular mandibular position is nei-ther identical to maximal intercuspal position nor to centric relation. It can therefore be concluded, that the registration of the neuromuscular adduction field should not be recom-mended for prosthodontic restorations in dentate or edentu-lous patients. Int J Prosthodont 2025. doi: 10.11607/ijp.9236 Keywords: neuromuscular condylar position, TM-joint, myocentric position, field of adduction, central-bearing-point registration, Gothic arch, occlusion

In physiotherapy, bruxism and craniomandibular dysfunction (TMD) often go hand in hand. Symptoms include attrition wear facets on the teeth, lingual garlands, masticatory muscle hypertrophy, masticatory muscle pain, temporomandibular joint pain, headaches, and/or hyperkeratosis of the buccal mucosa. These signs can contribute to or maintain an influence on TMD. The primary goal of physiotherapy for TMD patients is to enhance symptomatic structures and functions. If there are indications of bruxism, patients learn to self-manage how they perceive and deal with bruxism. The work of the physiotherapist (TH) and the patient’s cooperation are equally necessary for the success of the therapy in both biological and psychosocial terms. Patient education (PE) is a central additive intervention in the treatment. Keywords: awake bruxism, communication, physiotherapy, self-management, TMD