Effect of elimination of occlusal interferences on signs and symptoms of craniomandibular disorder in young adults. A comparison of ICAGD (immediate complete anterior guidance development) to mock ICAGD for symptom reductions in chronic myofascial pain dysfunction patients. Occlusal adjustment and the incidence of demand for temporomandibular disorder treatment. Effect of occlusal adjustment on globus symptom. Prevention of temporomandibular disorder-related signs and symptoms in orthodontically treated adolescents. A 3-year follow-up of a prospective randomized trial. Short-term effect of occlusal adjustment on craniomandibular disorders including headaches.
Sixty-two dental students judged not to be in need of treatment for craniomandibular disorder (CMD) were randomly divided into two groups, one receiving occlusal adjustment and the other mock adjustment. A double-blind study design was applied. After 2 years of education in dentistry, including courses in stomatognathic physiology, the increase in the subjective symptoms of CMD was significantly greater in the placebo control group than in the treatment group. The difference between the groups in the increase of sites tender to palpation was less clear, showing only a trend. However, the increase was statistically significant within the placebo group but not within the treatment group. Prophylactic occlusal adjustment thus appears to be effective in reducing the occurrence of symptoms of CMD, and possibly also the occurrence of clinical signs. The purpose of this study is to assess what impact shortening disclusion time to less than .5 seconds during right and left mandibular excursions has on myofascial pain(s) symptoms present in a dental student population. Twenty-five dental students, who exhibited symptomatology consistent with myofascial pains patient, were divided into a treatment, control, and an untreated group. They participated in an occlusal adjustment study which measured changes in disclusion time, as well as, myofascial pains muscular symptom remissions resultant from treatment. The treated group of ten subjects received ICAGD occlusal adjustments to shorten their disclusion time to less than .5 seconds per mandibular excursion. The goal of this therapy was to totally disclude the posterior teeth in a measurable time frame of .5 seconds or less. The control group of eight subjects received mock ICAGD with tooth polishing. The goal of this therapy was to simulate ICAGD adjustments for possible placebo effect on symptom remissions. The untreated group had their disclusion times measured but received no treatment to adjust, or to simulate adjustment to their occlusion. The goal of analyzing an untreated group was to attempt to show that mock treatment (performed on the control subjects), or no treatment (performed on the untreated subjects), resulted in no measurable change in the disclusion time in either of these two subject groups. Each subject was recalled for disclusion time measurement four to five times in a one-year period of observation, at which time, they were required to report their myofascial pains symptom status by answering an ordinal scale questionnaire. The results suggest that shortening disclusion time to less than .5 seconds per mandibular excursion can induce remissions of many muscular myofascial pains symptoms. Additionally, mock ICAGD occlusal adjustments did not appear to be a factor in the control subjects treatment response, as this group showed no statistically significant symptom remissions. Contrary to clinical opinion, the structural risk from dental occlusion in temporomandibular disorders has been questioned or considered to be insignificant in clinical practice.
                This study tested the effect of elimination of occlusal interference through occlusal adjustment, on the incidence of temporomandibular disorders.
                In a controlled clinical trial of 146 healthy children and adolescents, half of the subjects underwent occlusal adjustment aimed at elimination of the presumed structural risk, and the other half underwent mock adjustment. Adjustments were repeated every 6 months over a period of 4 years. The outcome variable was the incidence of temporomandibular disorders, operatively defined as request for treatment of symptoms characteristic of the disorders with presence of clinical signs demonstrated in the muscles of mastication and/or jaw joint.
                The cumulative incidence rate was 9/67 in the mock adjustment group and 1/60 in the real adjustment group, for a relative risk of 8.06. The difference between groups was statistically significant (p = 0.019). Conclusions: Elimination of the presumed structural risk from the dental occlusion appeared to significantly reduce the incidence of temporomandibular disorders in a select group of young subjects. Twenty-two patients seeking treatment for the globus symptom were examined for the presence of symptoms and signs of TMJ dysfunction. They were randomly divided into a treatment group (N = 13) and a placebo group (N = 9) and underwent either simple occlusal adjustment or mock adjustment, respectively. The result of occlusal adjustment was assessed immediately after completion of treatment. The effect of treatment on the globus symptom was assessed 2 to 3 months later in a double-blind study design. Binomial tests showed that there was a significant association between the success of occlusal adjustment and disappearance of the globus symptom. Three patients in the placebo group subsequently received occlusal adjustment and splint therapy. When all patients were interviewed 20 to 44 months later, only two of them reported no improvement. Both had unstable occlusion when the treatment was terminated. Recommendations about the need for occlusal adjustment after malocclusion therapy are inconclusive. A total of 123 orthodontically treated healthy adolescents (88 girls, 35 boys; 14.8 +/- 1.7 years old) agreed to participate in the present study. The subjects were interviewed and examined for signs and symptoms related to temporomandibular disorder (TMD) and were randomly allocated to intervention (n = 63) and control (n = 60) groups. At base line, occlusal adjustment was carried out for the intervention group and repeated every 6 months thereafter as needed. Mock adjustments were performed for the control group. At the end of the 3rd year 118 subjects (96%) turned up for re-examination. The number of subjects with palpatory pain of the masticatory muscles, and with occlusal centric slides decreased significantly in the intervention group but not in the control group (P < 0.001). In conclusion, occlusal adjustment therapy may prevent the occurrence of TMD signs in orthodontically treated healthy adolescents. The aim of this study was to assess the short-term effect of occlusal adjustment on craniomandibular disorders. Fifty patients were randomly selected and divided into a treatment (T) and a control (C) group. The initial clinical examination and the follow-up were made by one observer and the occlusal adjustment by another. There were no significant differences between groups with regard to frequency of headaches, facial pain, pain on mandibular function, or duration of headaches and facial pain. Fifty-two percent of the patients in the treatment group and 20% of the patients in the control group reported reduced subjective symptoms overall at follow-up examination. The improvement was statistically significant within the T group and significantly greater than in the C group. There was no significant change within or between groups with regard to frequency of headaches, facial pain, or pain on mandibular movements. There was an almost significant difference between groups after treatment with regard to changes in the number of tender muscles. The results of this study indicate that occlusal adjustment provides a general subjective improvement of craniomandibular disorders.