Journal of Craniomandibular Function, 02/2020

Background: The diagnosis and management of patients suffering from occlusal dysesthesia (OD) remains a major challenge for dentists and affected patients. Objectives: To present the results of a literature-based expert consensus intended to promote better understanding of OD and to facilitate the identification and management of affected patients. Methods: In 2018, electronic literature searches were carried out in PubMed, Cochrane Library, and Google Scholar as well as in the archives of relevant journals not listed in these databases. This approach was complemented by a careful assessment of the reference lists of the identified relevant articles. The articles were weighted by evidence level, followed by an evaluation of their contents and a discussion. The result represents an expert consensus. Results: Based on the contents of the 77 articles identified in the search, the current knowledge about the clinical characteristics, epidemiology, etiology, diagnostic process, differential diagnosis, and management of OD is summarized. Conclusions: OD exists independently of the occlusion. Instead, it is the result of maladaptive signal processing. The focus should be on patient education, counseling, defocusing, cognitive behavioral therapy, supportive drug therapy, and certain non-specific measures. Irreversible treatment, specifically an exclusively dental treatment approach, must be avoided. Keywords: facial pain, malocclusion, phantom bite syndrome, somatic symptom disorders, temporomandibular disorders

Digitalization originally appeared to have a very limited potential for dentistry and was viewed with skepticism for many years. In the last few years, however, it has become an undisputed fact that new digital technologies are fundamentally changing many processes in the diagnostic and treatment chain. All areas of dentistry are being affected by these developments. The industry is now investing heavily in appropriate developments, and many research groups are studying the effects of digital technology on various areas of treatment concepts. The goal is not only to replace the conventional work processes with new procedures, but also, and above all, to realize the potential for achieving new and better diagnostic and therapeutic techniques. This article discusses the advantages, possibilities, and current limitations of digital technology with regard to functionally relevant aspects in various applications. Keywords: electronic bite registration, jaw movement, articulator, intraoral 3D scan, occlusion, temporomandibular joint

This article describes how the Tooth Wear Evaluation System (TWES) can be used to diagnose existing tooth wear in a structured manner. Since its introduction, the TWES has been used by many dental clinicians in different countries. The collected feedback has been analyzed by the developers and users, resulting in an adapted version – the TWES 2.0. The adaptations and the newly introduced taxonomy have resulted in a smoother use in daily practice, a more straightforward diagnostic system, and a structured management. Keywords: tooth wear, Tooth Wear Evaluation System, European Consensus Statement, classification, diagnosis, management, pathological tooth wear, physiological tooth wear, taxonomy

Inflammatory rheumatic temporomandibular joint (TMJ) diseases often present a challenge for the dentist. Initially, the symptoms and the course of the disease are similar to other forms of inflammatory TMJ diseases (eg, osteoarthritis with articular disc displacement). It is often the case that only slight occlusal interferences are observed initially. These are then mistakenly considered to be the cause of the TMJ symptoms. If untreated, however, rheumatoid arthritis can lead to massive destruction in the region of the TMJs, which can then lead to major changes in the occlusal area and even to pronounced dysgnathia. Therapies initiated in good time can prevent consequential damage or enable partial remodeling in the area of the TMJs. Keywords: inflammatory temporomandibular joint diseases, rheumatoid arthritis, juvenile idiopathic arthritis, classification scheme