Hans Jürgen Schindler - Occlusal Splints for Painful Craniomandibular Dysfunction

Occlusal Splints for Painful Craniomandibular Dysfunction

Occlusal Splints for Painful Craniomandibular Dysfunction

Hans Jürgen Schindler, Prof Dr Med Dent

Professor

Department of Prosthodontics

University of Würzburg

Würzburg, Germany

Jens Christoph Türp, DDS, Dr Med Dent, MSC, MA

Professor

Department of Oral Health and Medicine

University of Basel

Basel, Switzerland

With contributions from

Lydia Eberhard, Nikolaos Nikitas Giannakopoulos, Daniel Hellmann, Alfons Hugger, Bernd Kordaß, Martin Lotze, and Marc Schmitter

First published as Konzept Okklusionsschiene: Basistherapie bei schmerzhaften kraniomandibulären

Dysfunktionen in 2017 by Quintessenz Verlags-GmbH, Berlin, Germany.

Library of Congress Cataloging-in-Publication Data

Names: Schindler, Hans Jürgen, author. | Türp, Jens Christoph, author.

Title: Occlusal splints for painful craniomandibular dysfunction / Hans Jürgen Schindler, Jens Christoph Türp.

Other titles: Konzept Okklusionsschiene. English

Description: Batavia, IL : Quintessence Publishing Co, Inc, 2021. | Includes bibliographical references and index. | Summary: “This book offers readers with a professional interest a clear guide to help them address the issue of temporomandibular disorders in theory and practice and provide their TMD patients with the best possible treatment”-- Provided by publisher.

Identifiers: LCCN 2020008037 | ISBN 9780867157956 (hardcover)

Subjects: MESH: Craniomandibular Disorders--therapy | Occlusal Splints | Facial Pain--therapy

Classification: LCC RK523 | NLM WU 140.5 | DDC 617.6/43--dc23

LC record available at https://lccn.loc.gov/2020008037

A CIP record for this book is available from the British Library.

ISBN: 978086757956

©2022 Quintessence Publishing Co, Inc

Quintessence Publishing Co, Inc

411 N Raddant Road

Batavia, IL 60510

www.quintpub.com

5 4 3 2 1

All rights reserved. This book or any part thereof may not be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, or otherwise, without prior written permission of the publisher.

Editor: Lori Bateman

Design: Sue Zubek

Production: Angela Kreeger and Sue Robinson

Printed in Croatia

Contents

Foreword

Preface

Contributors

Part A Practice of Occlusal Splint Therapy and Coordinative Training

1INTRODUCTION

Jens C. Türp

Craniomandibular Dysfunction

2STRUCTURED TREATMENT APPROACH IN PRACTICE

Hans J. Schindler

Diagnostics

Treatment of Painful CMD

Typical Painful CMD Case Studies: From History Taking to Treatment

3INTEROCCLUSAL REGISTRATION IN SPLINT THERAPY

Daniel Hellmann, Jens C. Türp

Method of Closing Movement onto a Frontal Plateau

4SPLINT FABRICATION

Daniel Hellmann

Model Fabrication

Model Mounting

Modular Rehabilitation Splint System

MRS Basic Splint (MRS 0)

Modular Modification of the MRS 0

Fabrication of an Efficient MRS 1 (Michigan Concept) Using CAD/CAM

5COORDINATIVE TRAINING FOR FUNCTIONAL REHABILITATION

Daniel Hellmann

Pain and Motor Adaptation

Pain Adaptation and Rehabilitation

Rehabilitation of the Craniomandibular System

Practice of Coordinative Training in Functional Rehabilitation

Case Study

Indication for Coordinative Training and Monitoring Outcome

Part B Aspects of Painful CMD and Splint Therapy Explored in Depth

6RISKS

Jens C. Türp, Hans J. Schindler, Alfons Hugger, Marc Schmitter

Definition of Risk

Jens C. Türp

Definition, Calculation, and Interpretation of Odds Ratio

Jens C. Türp

Myoarthropathies of the Masticatory System

Jens C. Türp

Occlusion and CMD

Jens C. Türp

TMJ Compression and Distraction

Jens C. Türp, Hans J. Schindler, Alfons Hugger

Bruxism

Marc Schmitter

7DIAGNOSTICS

Lydia Eberhard, Nikolaos Nikitas Giannakopoulos, Hans J. Schindler

Staged Model of CMD Diagnostics

Hans J. Schindler

Differential Diagnoses

Hans J. Schindler

Criticism of Classic Taxonomies

Nikolaos N. Giannakopoulos

Quantitative Sensory Testing and Its Practical Relevance

Lydia Eberhard

Criticism of Samples Included in Treatment Studies

Nikolaos N. Giannakopoulos

8TREATMENT

Hans J. Schindler, Alfons Hugger

Effectiveness of Treatment Options for Painful CMD

Possible Mechanisms of Physiotherapy in Painful CMD

Treatment Results from Dental Practices

Rehabilitation in Functional Therapy

Alfons Hugger

9NEUROBIOLOGIC BACKGROUND OF OCCLUSAL SPLINT THERAPY

Hans J. Schindler

Muscle Physiology

Temporomandibular Joints

Jaw Muscle Pains

TMJ Pains

Explanatory Models of Chronification of Pain

Motor Adaptation to Pain

Muscle Regeneration Potential

10NEUROBIOLOGY AND BIOMECHANICS OF OCCLUSAL SPLINT THERAPY

Hans J. Schindler

Traditional Hypotheses

Current Hypotheses

Pathophysiologic Effects of Postural Changes: Is Occlusal Splint Therapy a Cross-Segmental Treatment Modality?

11CEREBRAL REPRESENTATION OF OCCLUSAL SPLINT THERAPY: FUNCTIONAL MRI STUDIES

Martin Lotze, Bernd Kordaß, Hans J. Schindler

Cerebral Representation of Neuromuscular Activity

Modification of Cerebral Activation Patterns by Occlusal Splint Therapy

Cerebral Activation Patterns and Pain

INDEX

Foreword

It is a great challenge for any teacher to write a book with the aim of presenting the theory and practice of a particular dental clinical specialty. To accomplish this task successfully requires extensive clinical experience and excellent knowledge of the scientific principles underlying the specialty. Writers engaging in such an endeavor—like the authors of this book—usually have a clear goal in mind: to improve dental health care, which means making innovations in diagnostics and treatment accessible to dental practitioners.

Achieving this goal is a particular challenge given the subject of this book. Therapy for painful craniomandibular dysfunction (CMD) is a field of dentistry that undoubtedly differs greatly from traditional subjects in dental medicine, such as periodontics, restorative dentistry, or oral surgery. In these subject areas, innovation essentially means adapting clinical procedures to new technologies, such as the use of digital resources. The objective of adaptive processes has hardly changed in the past 100 years: to enhance the mechanical perfection of treatment methods while simultaneously increasing the efficiency and safety of the working materials being used. Generations of dentists in education, research, and practice have pursued this objective—in some cases with great success. This was accompanied by a concentration on the results of mechanical working procedures. Every step toward perfection was regarded as clinical progress. Michael Heners coined the term “technomorphic model of dentistry” for this orientation of dental medicine. Based on this model, the mechanically defined actions of the clinician determine the quality of the dental therapy provided. Accordingly, better dental care can only be achieved by optimizing the dental intervention in terms of technique.