Pages 229-245, Language: English, GermanSchierz, Oliver / Reißmann, Daniel R. / Singer, Susanne
Personality traits and behavior can have a significant influence on the treatment success in patients with temporomandibular disorders (TMD). Chronic pain is an essential criterion in the evaluation of psychological assessment, according to the recommendations for the standardized diagnostic criteria of TMD. The aim of the study was to evaluate whether persistent pain can be applied as a diagnostic decision criterion for the evaluation of psychosocial assessment like depression, unspecific pain (somatization) and pain related disability, and to find out the correlation strength between pain, depression and somatization. In 402 patients with a TMD diagnosis according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD), pain intensity and disability were assessed using the Graded Chronic Pain Scale (GCPS), depression was assesssed using the German version of the Center for Epidemiological Studies Depression Scale ( ADS-L) and somatization (unspecific somatic complaints) was assessed using a complaints list (Beschwerdenliste, B-L). TMD patients with chronic pain have psychosocial impairments more often than patients with acute pain or without any pain. Therefore, psychosocial assessment should be applied regularly in the treatment of TMD patients with persistent or chronic pain.
Keywords: persistent pain, temporomandibular disorders, depression, pain intensity, somatization
Pages 247-264, Language: English, GermanLovrov, Sylvia / Kordaß, Bernd
The international literature on the various methods of occlusal analysis is very inconsistent and does not allow a reliable assessment of reliability and validity. No method has been proven based on scientific evidence. Objective assessment criteria are lacking for the qualitative methods (articulating paper or film; analysis of wax or silicone bite registrations). Quantitative methods such as photo-occlusion and the Dental Prescale and T-Scan systems have yielded contradictory results, ranging from reports of good reproducibility to technical difficulties. Therefore, the validity of these methods is questionable at this time. Current trends in occlusal analysis include the use of virtual articulators, or the acquisition of a virtual 3D model of the tooth surfaces directly in the patient's mouth, and time-moment analysis of occlusal contacts. At the same time, the previous mechanical notions of transferable occlusal concepts are increasingly being questioned, and attempts are being made to assess the individual occlusal relationships in the context of the entire masticatory system in order to reach undisturbed function in the individual patient.
Keywords: Occlusal contact, dental occlusion, instrumentation, methods, standards, T‑scan, virtual articulator
Pages 267-276, Language: English, GermanBicaj, Teuta / Usami, Hiroshi / Mericske-Stern, Regina / Kolgeci, Lumni / Katsoulis, Norbert Joannis / Bayer, Stefan / Enkling, Norbert
Die Okklusion der Zähne kann mittels des T-Scan-Gerätes (T Scan III, TekScan, Boston, USA) digital erfasst werden. Bedingt durch die Dicke der T-Scan-Okklusionsfolie (100 μm) könnte jedoch beim Zubeißen in maximaler Interkuspidation (MI) eine Lageveränderung des Unterkiefers resultieren. Das Ziel dieser Studie war es daher, die Auswirkung der T-Scan-Okklusionsfolie auf die Position der Kiefergelenke in maximaler Interkuspidation zu untersuchen. Zwanzig vollbezahnte Probanden mit gesunder Kiefergelenks- und Kaufunktion wurden in die Studie einbezogen. Die Position der Kondylen wurde mittels eines Ultraschall-Axiographiegerätes kontaktfrei, digital erfasst. Die Position der Kondylen wurde zehn Mal dreidimensional in maximaler Interkuspidation gemessen: Als erstes ohne Messfolie (Referenz), in Folge dreimal ohne und dreimal mit Folie; am Ende folgten drei weitere Messungen ohne Folie. Ein statistisch signifikanter Unterschied (Wilcoxon matched pairs test) bezüglich der Position der Kondylen konnte zwischen den Messungen mit und ohne Folie aufgezeigt werden (p < 0,0005). Beim Gebrauch des T-Scan- Gerätes erfolgte eine Verschiebung der Kondylen von etwa 1 mm hauptsächlich in ventraler Richtung (p = 0,005). Die Okklusionsanalyse fand somit nicht in physiologischer maximaler Interkuspidation statt. Dies muss bei der Interpretation der Okklusionsmessungen mit dem T-Scan-Gerät berücksichtigt werden.
Keywords: Okklusion, Axiographie, T-Scan-Folie, Kieferbewegung, Zebris, T-Scan III
Open AccessPages 277-294, Language: English, GermanImhoff, Bruno
For over 10 years, systematic additive occlusal therapy (SAOT) has played a valuable role as a component of an integrated approach to the diagnosis and treatment of temporomandibular dysfunction (TMD)1. SAOT is used as a therapeutic alternative to 24-hour splints, its occlusal approach being in accord with the rules of splint therapy. SAOT can be carried out by means of either a direct or an indirect procedure. Patients are able to find their own muscle-guided jaw relation and assess the effectiveness of this in terms of their symptoms. The procedure is reversible, since with correct handling the composite build-ups can be removed without damage to teeth or dental restorations. The practical implementation of SAOT is described, the indications, contraindications, and limitations of the technique are described, and the subsequent treatment is discussed.
Keywords: TMD, canine guidance, functional therapy, occlusion, stepwise approach, systematic additive occlusal therapy, therapeutic jaw relation, 24-hour splint