Does anterior guidance with canine maxillary contact relieve facial pain?
Study overview:
Study does anterior guidance with maxillary canine contact in TMD relieves TMD and a host of other symptoms?
Detailed description:
Occlusion is very poorly defined. Usually occlusion is defined as a "static" relationship. Dynamic occlusion is rarely mentioned. If we instead define ideal occlusion as a "dynamic"occlusion with anterior guidance and maxillary contact from centric occlusion, will it relieve or cure TMD, bruxism, clenching, temporalis tension headaches? Will whole mouth sensitivity vanish after treatment, too?
Eligibility Criteria:
Patients over 18 of age
A thorough medical history including EDS and HSD, using the Beighton Score
Exclusion Criteria:
History of head or facial trauma
Neurological or oncological disease
Study population:
Patients with TMD, and have teeth for dental occlusion
Patients with morning temple headaches
Patients who grind and clench
Design details:
Observational model: cohort
Time perspective: Cross-sectional
Target Follow-up Duration: 4 weeks
Intervention/Treatment
Dynamic occlusion will be equilibrated and composite bonding may be added so there is anterior guidance with maxillary canine contact. There will be no group function or balancing side interferences. Also anterior guidance must be protrusive, too.
What is the Study measuring?
Relief of TMD, clenching, bruxism, tension headaches and morning headaches.
Sensitive teeth will also be looked at.
Secondary Outcome:
Will patients with EDS and HSD also get relief?
Publications
These publications are provided voluntarily.
** Seifi M, Nodehi D, Ghahramanloo A, Ahmadi Z, Farhangnia A, Saedi M, Mozaffari HR, Sharifi R. Comparing the Electromyographic Features of the Masseter and Temporal Muscles in Patients with full Mouth Implant-supported FDPs and Natural Dentition. Acta Inform Med. 2017 Mar;25(1):49-53. doi: 10.5455/aim.2017.25.49-53. PMID: 28484298; PMCID: PMC5410628.
* Hylander WL. The human mandible: lever or link? Am J Phys Anthropol. 1975 Sep;43(2):227-42. doi: 10.1002/ajpa.1330430209. PMID: 1101706.
CONSENT FORM
Purpose of this study:
To see if occlusal equilibration will relieve and cure the following symptoms:
(1) Many teeth that are sensitive to cold having little or no decay---unable to eat ice cream or drink cold drinks.
(2) Tension headaches from the temporalis muscles. These people wake up with tension headaches.
(3) Aching TMJ or TMD with vague pain in the their face
(4) Grinding and/or clenching teeth.
Treatment goals:
Occlusal equilibration will be performed with anterior guidance with upper canine contact at centric occlusion.
No balancing side and no group function. Anterior guidance with protrusion.
Occlusal adjustment and Bonding will be used to help achieve these goals. No other restorative work will be performed except for bonding.
Purpose of this study:
To see if occlusal equilibration with upper canine contact eliminates all or most of these problems.
Follow up will be 1 month
NO COST FOR EQUILIBRATION AND BONDING IF NEEDED
NO COST FOR EQUILIBRATION AND BONDING IF NEEDED
Medical and dental questionnaires must be filled out.
Dental x-rays are preferred but necessary. X-rays that may need to be taken will be at No Charge to the patient.
This is only a study. Dr. David DiBenedetto will not necessarily accept you as a patient into the practice. The doctor will only accept you into the study.
A medical questionnaire and dental questionnaire must be filled out.
Secondary goals of the study will include screening for EDS and HSD.
acceptance into the study:
Not looking for people with many problem teeth, or many broken teeth or heavy decayed. Not looking for people who need many teeth extracted.
The Procedure:
Occlusal bite adjustment is a procedure that requires grinding or smoothing of the teeth to make the bite more uniform and eliminate areas that are causing trauma to the teeth and supporting structures. No loss of vertical dimension will occur.
Possible Side effects:
Inherent risks with any procedure, tooth sensitivity may occur and may last for a short period of time. If sensitivity persists, then the patient must notify the dentist as there may be more serious problems.
There may be a need for restorations, which will not be covered and would then be required by a dentist.
Some misalignments cannot be corrected by a simple occlusal adjustment and may need to be referred out.
This therapy may not treat noises, pops or clicks.
An occlusal equilibration may only last for a few years because the jaws, bones and teeth continue to change.
All results will be confidential.
Your identifiable data will not be released to other parties without your consent. Any research data released or published will not identify you.
Statement of Consent
I have read the information in this consent form including the risks and possible benefits. All my questions have been answered to my satisfaction. I am free to withdraw at any time without penalty.
I consent to participate in the study.
Your signature below indicates your permission to take part in this research and to the use and disclosure of your protected health information:
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Printed Name
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Signed Name Date
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