Open AccessPages 99-113, Language: German, English
Occlusal dysesthesia – a clinical guidelineBackground: The diagnosis and management of patients suffering from occlusal dysesthesia (OD) remains a major challenge for dentists and affected patients.
Objectives: To present the results of a literature-based expert consensus intended to promote better understanding of OD and to facilitate the identification and management of affected patients.
Methods: In 2018, electronic literature searches were carried out in PubMed, Cochrane Library, and Google Scholar as well as in the archives of relevant journals not listed in these databases. This approach was complemented by a careful assessment of the reference lists of the identified relevant articles. The articles were weighted by evidence level, followed by an evaluation of their contents and a discussion. The result represents an expert consensus.
Results: Based on the contents of the 77 articles identified in the search, the current knowledge about the clinical characteristics, epidemiology, etiology, diagnostic process, differential diagnosis, and management of OD is summarized.
Conclusions: OD exists independently of the occlusion. Instead, it is the result of maladaptive signal processing. The focus should be on patient education, counseling, defocusing, cognitive behavioral therapy, supportive drug therapy, and certain non-specific measures. Irreversible treatment, specifically an exclusively dental treatment approach, must be avoided.
Keywords: facial pain, malocclusion, phantom bite syndrome, somatic symptom disorders, temporomandibular disorders
Pages 115-132, Language: German, EnglishMehl, Albert
Lange Zeit erschien das Potenzial der Digitalisierung für die Zahnmedizin sehr eingeschränkt und wurde kritisch gesehen. Seit ein paar Jahren ist es unbestritten, dass die neuen digitalen Technologien viele Prozesse in der Therapie und Diagnostik grundlegend verändern werden. Dies hat Auswirkungen auf alle Bereiche der Zahnmedizin. Die Industrie investiert derzeit stark in entsprechende Entwicklungen, und viele wissenschaftliche Arbeitsgruppen beschäftigen sich mit den Auswirkungen auf die unterschiedlichsten Behandlungsfelder. Es geht dabei nicht nur darum, bisherige Arbeitsprozesse zu substituieren, sondern vor allem das Potenzial für neue und bessere diagnostische und therapeutische Verfahren zu erkennen. Dieser Beitrag soll die Vorteile und Möglichkeiten, aber auch die aktuellen Grenzen der digitalen Technologie in Bezug auf funktionsrelevante Aspekte für verschiedene Einsatzgebiete aufzeigen.
Keywords: elektronische Registrierung, Unterkieferbewegung, Artikulator, intraoraler 3-D-Scan, Okklusion, Kiefergelenk
Pages 133-143, Language: German, EnglishWetselaar, Peter
This article describes how the Tooth Wear Evaluation System (TWES) can be used to diagnose existing tooth wear in a structured manner. Since its introduction, the TWES has been used by many dental clinicians in different countries. The collected feedback has been analyzed by the developers and users, resulting in an adapted version – the TWES 2.0. The adaptations and the newly introduced taxonomy have resulted in a smoother use in daily practice, a more straightforward diagnostic system, and a structured management.
Keywords: tooth wear, Tooth Wear Evaluation System, European Consensus Statement, classification, diagnosis, management, pathological tooth wear, physiological tooth wear, taxonomy
Pages 145-154, Language: German, EnglishBias, Frank
Significance for the dental practiceInflammatory rheumatic temporomandibular joint (TMJ) diseases often present a challenge for the dentist. Initially, the symptoms and the course of the disease are similar to other forms of inflammatory TMJ diseases (eg, osteoarthritis with articular disc displacement). It is often the case that only slight occlusal interferences are observed initially. These are then mistakenly considered to be the cause of the TMJ symptoms. If untreated, however, rheumatoid arthritis can lead to massive destruction in the region of the TMJs, which can then lead to major changes in the occlusal area and even to pronounced dysgnathia. Therapies initiated in good time can prevent consequential damage or enable partial remodeling in the area of the TMJs.
Keywords: inflammatory temporomandibular joint diseases, rheumatoid arthritis, juvenile idiopathic arthritis, classification scheme