Abstract
BackgroundAlthough the discrepancy between the habitual occlusal position (HOP) and the flat bite plate-induced occlusal position (BPOP) (regarded as the muscular physiological reference position) has been recently reported to be related to symptoms of temporomandibular disorders (TMDs), it still remains unclear whether the occlusal equilibration in the reference position is effective to resolve TMD-related discrepancy and symptoms. Aural symptoms (otalgia, tinnitus, vertigo et cetera) have been included under TMD symptoms.MethodsTo examine the effect of occlusal equilibration for the treatment of TMDs, occlusal equilibration was performed for a patient with aural symptoms (otalgia, tinnitus and vertigo) of unknown etiology in the right ear. An occlusal analysis was performed on this patient with dental models mounted on an articulator after relieving painful symptoms by an appliance therapy and a discrepancy was identified (p < 0.005). Occlusal equilibration in the BPOP was then performed for the patient by selective tooth grinding, because it was estimated that the interocclusal space between upper and lower occlusal surfaces would be rectified by selective grinding.ResultsAt completion of treatment, the discrepancy was not significant (p > 0.25), and the patient's right condyle had shifted 2.8 mm posteromedially in the horizontal plane, and the left condyle had shifted 1.0 mm laterally in the voluntarily closed position from the previous HOP. The aural symptoms of the patient were resolved, and there has been no recurrence to date after a two-year follow-up period.ConclusionAn occlusal analysis should be performed in patients exhibiting TMD symptoms to identify the presence or absence of any discrepancy between the HOP and the BPOP. If a discrepancy exists, occlusal equilibration should be attempted in the reference position.
Highlights
The discrepancy between the habitual occlusal position (HOP) and the flat bite plate-induced occlusal position (BPOP) has been recently reported to be related to symptoms of temporomandibular disorders (TMDs), it still remains unclear whether the occlusal equilibration in the reference position is effective to resolve TMD-related discrepancy and symptoms
Occlusal equilibration in the BPOP was found to be effective against aural symptoms, and it might be effective against other TMD symptoms
There have been many reports of relief or complete elimination of otalgia, tinnitus, vertigo, and deafness by various treatments for TMDs [3,4]. The outcomes of these various conservative therapies for TMDs in relation to the aural symptoms have always been an improvement in symptoms rather than a cure, because they were not established on the basis of the pathogenic mechanism underlying the development of the aural symptoms
Summary
The discrepancy between the habitual occlusal position (HOP) and the flat bite plate-induced occlusal position (BPOP) (regarded as the muscular physiological reference position) has been recently reported to be related to symptoms of temporomandibular disorders (TMDs), it still remains unclear whether the occlusal equilibration in the reference position is effective to resolve TMD-related discrepancy and symptoms. (HOP) and the flat bite plate-induced occlusal position (BPOP) is associated with TMD symptoms [7]. The HOP is obtained by voluntary jaw closing while a patient is sitting in the upright position. The BPOP is obtained during voluntary jaw closing while the patient is sitting in the upright position and after wearing an anterior flat bite plate that covers the 6 upper anterior teeth and both first premolars for a brief time, and removing it. Occlusal equilibration in the BPOP was found to be effective against aural symptoms, and it might be effective against other TMD symptoms
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call