Pages 103-115, Language: English, GermanAlanen, Pentti
The current controversy as regards the etiology of temporomandibular disorders (TMDs) is further complicated by discussions about the connections between etiology and treatment, together with questions about the ethics of irreversible treatment modalities. However, most dental treatments are irreversible, even in cases with unclear etiology. Therefore, the ethics of treatment cannot be based on etiology alone, but call for an understanding of the possibilities available to help patients with health problems in ways that are physiologically correct and economically viable.
Keywords: ethics, etiology, evidence, irreversible treatment
Pages 117-125, Language: English, GermanSteinmaßl, Otto / Klaunzer, Florian / Ruech, Lukas / Fleischer, Florian / Stöckl, Wolfgang / Dumfahrt, Herbert / Grunert, Ingrid / Steinmaßl, Patricia-Anca
Fully digital computer-aided design/computer-aided manufacturing (CAD/CAM) complete denture fabrication systems are currently marketed by four providers: Global Dental Science (AvaDent), Merz Dental (Baltic Denture System), Ivoclar Vivadent/Wieland Dental (Wieland Digital Dentures), and Whole You (Whole You Nexteeth). Both the clinical adaptation protocols and technical production steps vary from one system to another. Each system has its own workflows for occlusal plane determination and bite registration. Therefore, both the clinician and the dental technician must overcome an initial learning curve before CAD/CAM denture systems become more efficient than conventional dentures. The current standard occlusal concept for CAD/CAM complete dentures is the bilaterally balanced occlusion, but anterior/canine-guided occlusion can also be achieved by individualizing the specified tooth position. Since neither the clinical adjustment steps nor the technical finalization steps for CAD/CAM complete dentures are fully controllable yet, they are still not superior to remounted conventional complete dentures in terms of occlusal quality. For this reason, denture remounting must also be recommended for CAD/CAM fabricated dentures.
Keywords: CAD/CAM dentures, complete dentures, occlusion, remounting
Pages 127-146, Language: English, GermanStrobel, Sabrina / Möller, Dirk / von Piekartz, Harry J. M.
Eine PilotstudieMithilfe der Elektromyografie (EMG) konnte in einigen Studien der Einfluss von Beißkräften auf die Aktivierung der Halswirbelsäulenmuskulatur festgestellt werden. Im Rahmen der vorliegenden Pilotstudie wurde erstmalig die Hypothese getestet, dass maximale und/oder submaximale Beißkräfte sowohl bei CMD-Patienten als auch bei einer Kontrollgruppe einen signifikanten Einfluss auf alle zervikalen physiologischen Wirbelsäulenbewegungen haben. 20 Frauen wurden anhand eines validierten Fragebogens in eine CMD-Gruppe (n=10) und eine Kontrollgruppe (n=10) eingeteilt.
Mit dem WinSpine-System wurde das zervikale Bewegungsausmaß (Flexion/Extension/Rotation/Lateralflexion) quantifiziert. Zur Evaluation der Beißkräfte diente das biteFork-System, wodurch eine Aufzeichnung der Kräfte an den Molaren 15/16 und 25/26 ermöglicht wurde. Die Messungen der zervikalen Wirbelsäulenbeweglichkeit erfolgten ohne sowie mit 25 %iger und 100 %iger Beißkraft. Zur Auswertung wurden die Differenzen der Bewegungsausmaße ohne und mit Beißmanövern herangezogen. Abschließend wurde eine Kiefergelenksuntersuchung durchgeführt, die eine Evaluation des Bewegungsausmaßes der Mandibula beinhaltete.
In der Kontrollgruppe wurde ein signifikanter Unterschied zwischen der Rotation nach links ohne und mit 25 %iger Beißkraft (p
Keywords: kraniomandibuläre Dysfunktion, Halswirbelsäule, Bewegungsausmaß, submaximale Beißkraft, maximale Beißkraft
https://www.relaxbogen.de
Digital extra printPages 147-159, Language: English, GermanLambers, Jochen
Two case examplesPatients with temporomandibular dysfunction (TMD) are often affected by muscular symptoms. In recent years, scientific opinion has frequently recommended collaboration with physiotherapists for TMD patients. The RelaxBogen was the result of such interdisciplinary collaboration between dentists and physiotherapists. It imitates a specific form of relaxation technique - based on the myofascial release technique - for the masseter and temporal muscles. This article describes two cases from a pilot study. The case studies were presented by the author as a lecture entitled "The RelaxBogen, a new method of treatment for bruxism and TMD - a pilot study" at the 2016 Annual Conference of the DGFDT. They demonstrate the possibilities offered by the RelaxBogen for treating myogenic TMD and headaches. After 3 months of wearing the device, patients reported considerably reduced headaches and pain on palpation. Apart from a reduction in the general pain level, pain reduction was also documented in the head/jaw, cervical spine, and neck areas.
Keywords: TMD, bruxism, myalgia, headaches, myofascial pain