Journal of Craniomandibular Function, 03/2014

To minimize neuromuscular adaptations, the centric relation established in reconstructive dentistry should ideally represent the anterior-superior, non-laterally displaced position of the condyles in the glenoid fossa. In 35 healthy volunteers without temporomandibular dysfunction, the Jaw Motion Analyzer (JMA) jaw-tracking system was used to measure the spatial coordinates of defined condylar and incisal points during manual guidance in the posterior-superior direction and during fast and slow closure movements (neuromuscular techniques), and to compare these positions with those measured during physiological jaw-closing movement ending in intercuspal position (ICP). At small incisal edge distances, condylar displacement relative to ICP was approximately 0.3 mm in the posterior-superior direction with manual guidance, and about 0.3 mm in the anterior-superior direction during the neuromuscular techniques. With large incisal edge distances, the neuromuscular techniques resulted in anterior displacement of the condyles in an anterior-superior position against the slopes of the articular eminences; in contrast, condylar position remained relatively stable with posterior-superior guidance. In summary, it can be concluded that, at small incisal edge distances, the neuromuscular techniques resulted in an anterior-superior orientation of the condyles in the glenoid fossa. This corresponds to the idealized notion of an anterior- superior physiological condylar position. Keywords: methods of determining centric relation, centric relation recording, reliability of methods of determining centric relation

Temporomandibular disorders (TMDs) are the most common non-odontogenic causes of pain in the maxillofacial region. Like nonspecific musculoskeletal pain in other parts of the body, they have a multifactorial etiology. Occlusal splint therapy is one of the best-studied treatment options for the management of TMDs. Intraoral appliances usually result in satisfactory short- and long-term pain relief or reduction in the majority of patients with acute or persistent acute TMD. This can, for the most part, be attributed to neuromuscular and biomechanical characteristics of the masticatory system that promote functional reorganization processes in the affected muscle and joint structures, which are reflected in cortical activity. Temporary changes in the position of the mandible within the physiologically tolerable range that decrease stresses on the affected tissues and encourage their regeneration trigger such functional adaptations. Cases in which TMD pain has become chronic and is causing significant psychosocial impairment show limited response to splint therapy alone and therefore require interdisciplinary multi- modal treatment. Keywords: Temporomandibular disorders (TMDs), myogenous and arthrogenous, myalgia, myofascial pain, treatment recommendations

This paper appears in German only, because it is a commented summary of the following original article: Schiffman E et al. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: recommendations of the International RDC/TMD Consortium Network and Orofacial Pain Special Interest Group. J Oral Facial Pain Headache 2014;28:6-27.

This paper appears in German only, because it is a commented summary of the following original article; Peck CC et al. Expanding the taxonomy of the diagnostic criteria for temporomandibular disorders. J Oral Rehabil 2014;41:2-23 (Wiley & Sons Ltd.). Permission to translate and use parts of the original text was kindly granted by Wiley & Sons Ltd.