Study on TMJ & Headaches


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.




 

          * 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:








____________________________________________________________________________


Printed Name



___________________________________________                   ________________________


Signed Name                                                                                    Date


____________________________________________________________________________