Journal of Craniomandibular Function, 02/2024

Rapid developments in digital dentistry, such as digital workflows and CAD/CAM systems, have led to questions about digital occlusion, including the capabilities of occlusal analysis. There is a need for clear definitions and terminology. What do we mean when we talk about “occlusion” in the context of digitization, especially in the case of digital models? What are the capabilities of digital occlusal analysis? The following article presents our initial thoughts on this important topic, which may be useful in the development of future guideline. Keywords: digital occlusion, digital occlusion analysis, virtual articulator, digital articulator, digital patient, digital functionally generated path technique (FGP technique)

The aim of this cross-sectional survey was to evaluate pain and quality of life in outpatients with painful temporomandibular disorder (TMD) and bruxism and to explore the effects of an occlusal splint therapy. Materials and methods: 54 patients from the CMD Center Coburg (36 women, average age 40.4 ± 13.2 SD years) with symptomatic TMD and bruxism were surveyed. Pain assessment was conducted using modules of the German Pain Questionnaire with calculation of pain intensity (PI, 0–100), pain disability (PRD, 0–100), and grading of the severity of pain according to v. Korff (0–IV). The questionnaire SF-12 delivered information about the health-related physical (PCS) and mental (MCS) quality of life. Furthermore, patients were asked for prior pain interventions as well as actual self-applied relaxation methods. Results: 34 of the 54 enrolled TMD patients (63%) suffered for more than 2 years from pain. 48 (89%) of them were treated successfully with dental splint therapy. The mean PI was 25.4 ± 23.6 SD, and the mean PRD was 15.5 ± 20.1. Females showed a lower MCS than males (42.4 ± 10.7 vs 50.7 ± 6.4; P ≤ 0.01). Higher PI was associated with lower PCS (rs = -0.49, P = 0.001) and MCS (rs = -0.35, P = 0.05), as was a higher PRD (PCS: rs = -0.5, P = 0.001; MCS: rs = -0.27, P = 0.05). Patients with dental splint therapy had significantly less pain and a better quality of life (PCS and MCS than patients without splint therapy (all P values < 0.05). Half of the patients (n = 27; 50%) practiced gehörelaxation techniques, mostly yoga, mindfulness exercises, and meditation. Discussion: The results point to a relationship between pain, dental splint therapy, and physical and psychological quality of life. Due to the small and heterogeneous sample and the uncontrolled design, however, the results should be viewed as preliminary. Conclusion: Patients with symptomatic TMD may benefit from interdisciplinary therapeutic approaches such as occlusal splint therapy complemented by psychotherapy and relaxation techniques. Keywords: TMD, pain, quality of life, dental splint, health promotion