J CranioMand Func 4 (2012), No. 4 5. Nov. 2012
J CranioMand Func 4 (2012), No. 4 (05.11.2012)
Open Access Page 329-348, Language: English/German
Functional diagnostics and therapy - analysis of the patient population of a dental practice from 2008 to 2010
Objective: The aim of this study was to analyze the significance of various factors in the diagnostics and therapy of temporomandibular disorder (TMD) patients. To this purpose, the study and treatment data of 384 TMD patients who were treated by one practicing clinician from 2008 to 2010 were evaluated retrospectively. Material and methods: Data collection took place using a data sheet developed by the author: biographical data, type and duration of symptoms, diagnosis in accordance with the research diagnostic criteria for temporomandibular disorders (RDC/TMD) - axis I and axis II - diagnoses according to Ahlers and Jakstat, the treatment measures (advice: n = 110, splint therapy: n = 166, occlusal therapy: n = 108) and the success of treatment. The factors gender, duration of symptoms and axis II disability were evaluated with regard to the method and the success of treatment. Results: 71% of the patients were female (n = 274), and were represented 2.6 times more frequently than males (n = 110) in the patient population examined. The duration of symptoms (3.4 years on average) showed no direct negative correlation with the success of treatment. In the case of a high occurrence of axis II disability, the success rate of both therapeutic means dropped clearly from 86% to 21%. By restoring the occlusion (n = 108), a good success rate of treatment was achieved in over 70% of patients in therapy-resistant splint cases.Conclusions: Occlusal factors and axis II disability should always be analyzed and evaluated together before commencing treatment. In the case of mild and moderate axis II disability, occlusal therapy can be successful. Not all chronic pain is chronified pain.
Keywords: TMD, occlusion, axis II, chronic pain, evidencebased medicine, Michigan-type occlusal splint, canine guidance, systematic additive occlusal therapy