Journal of Craniomandibular Function, 04/2011

The purpose of this study was two-fold: (a) to evaluate articulator hinge axis precision, and (b) to study the effect of removing and replacing mounted casts on occlusion. One Artex^® AL (AR) and one Whip Mix^® (WM) articulator was selected. Impact-resistant resin study models were mounted in maximum intercuspation position on the magnetic plate of AR (randomly selected): (a) for hinge axis precision, AR was opened and closed 10 times with the casts secured and 10 records were made, and (b) for the effect of repositioning mounting plates, mounted models with their respective plates were removed and repositioned 10 times and 10 records were made. Upon completion, models were dismounted and remounted on WM with screw-retained mounting plates and the whole procedure was repeated. Areas of interest were the second premolars and first molars bilaterally. Light transmitted through records was analyzed by a computerized image analysis program. WM showed greater deviation in hinge axis precision; AR was significantly more consistent. For AR, removing and replacing the mounting plates introduced statistically significant differences at the right second premolar, first molar, and left second premolar areas (t = 3.846, P = 0.001; t = 3.540, P = 0.002; t = 2.395, P = 0.028; respectively); for WM, differences were observed at the first molar area (t = 143.000, P = 0.005). AR reproduced cast positions more consistently than WM. Removal and replacement of plates introduced a difference causing further occlusal changes. Keywords: articulator, hinge axis, interocclusal recording material, mounting plates

Background information and objective: The objective of this cross-sectional study was to compare diagnoses obtained by sonographic findings, with the results of magnetic resonance imaging (MRI), in the case of displacement of the articular disc and degenerative alterations of the temporomandibular joint (TMJ). Material and methods: A total of 22 test subjects (44 temporomandibular joints; 16 women and 6 men aged between 20 and 70 years) were subjected to sonographic and MRI examination and the results were then compared. Results: Agreement with regard to the position of the articular disc can be considered as good, with a value of κ = 0.62 (sensitivity: P = 1.0; specificity: P = 0.63). Agreement with the degenerative alterations can be regarded as poor, due to inadequacies, with κ = 0.24 (sensitivity: P = 0.83; specificity: P = 0.25). It was significant that all examinations were characterized by a high rate of false positive findings. Conclusion: The sonographic findings of the TMJ with regard to the diagnosis of articular disc displacement were viable in comparison to the MRI findings. Sonography is suitable for the rough depiction of intra-articular structural changes. The greatest disadvantage is the fact that transversal and rotatory discrepancies of the articular disc can only be insufficiently depicted. A detailed medical case history and functional examination still remain indispensable. Keywords: craniomandibular dysfunction, magnetic resonance imaging (MRI), sonography, temporomandibular joint

Introduction: The purpose of this study was to examine whether a unilateral occlusion block, using a 1 or 2 mm thick silicone panel, can significantly change the upper part of the body posture. Materials and methods: This study was carried out with 38 adults without remarkable discomfort in the temporomandibular system or body movement apparatus. The measurement of the upper part of the body posture was performed with a three-dimensional back scanner. Every test person placed the 1 or 2 mm thick silicone panel systematically between the left/right premolars. The statistical comparison of the measuring data was carried out between the reference measurement and the provoked lower jaw position. Results: If the occlusion was changed dextrally (to the right) or sinistrally (to the left) by the silicone panel, the rotation in the shoulder area improved (right 1 or 2 mm: P = 0.00; left 1 mm: P = 0.00) in comparison to the habitual starting position. With a dextral occlusion disruption by 1 mm of silicone, the pelvic rotation also changed (P = 0.05). Conclusion: A unilateral occlusion block in the premolar region has an influence on the upper body rotation in the standing position, particularly in the shoulder area. Thus the results demonstrate functional relationships between the chewing and the movement system, which may explain complaints in one of the subsystems influenced by therapeutic measures in an otherwise unaffected system. Keywords: asymmetrical occlusion blocking, three-dimensional back scan, upper body posture

Medical hypnosis is a proven psychotherapeutic intervention for pain management and cognitive modification of behavioral patterns associated with temporomandibular dysfunction (TMD). The scientific evidence documenting its efficacy is steadily growing. On the other hand, hypnotherapy should never be regarded as a stand-alone treatment for temporomandibular dysfunction, but should always be used in combination with other proven treatment modalities. The present article will briefly review the literature describing the scientific basis for using medical hypnosis for the treatment of temporomandibular disorders, and will present two case studies illustrating the clinical approach to hypnotherapy for temporomandibular pain and dysfunction. Keywords: cognitive behavioral therapy, medical hypnosis, temporomandibular dysfunction