Prafulla Thumati

The effect of reduced disclusion time in the treatment of myofascial pain dysfunction syndrome using immediate complete anterior guidance development protocol monitored by digital analysis of occlusion

Abstract Statement of problem: Chronic myofascial pain dysfunction syndrome (MPDS) has been a nightmare for patients suffering from it, who have been treated with various treatment options with varied outcomes. This population of patients has been neglected, due to nagging revisits to a clinician and decreased percentage of success. Objective: T-Scan-based immediate complete anterior guidance development (ICAGD) has been shown by a researcher to reduce the muscle hyperactivity consistent with MPDS. The purpose of this study is to evaluate the effect of reduced disclusion time in lateral excursions in treating the MPDS symptoms. Materials and methods: Fifty-one myofascial pain patients with symptoms in the area of the head and neck region were treated with ICAGD. The quantified force and time data from T-Scan records were used to correct the prolonged disclusion time, and the subjects were assessed for the symptom relief. The Wilcoxon Signed Ranks Test was used for statistical analysis (P<0·05 denotes significant changes). Results: The changes in disclusion time and intensity of various symptoms were found to be statistically significant (P<0·05) from Day 1 onwards, and patients were relieved of their symptoms after reduction of disclusion time of less than 0·5 seconds. Conclusion: The results clearly indicated that ICAGD protocol reduces musculoskeletal-based symptoms of MPDS patients, and this protocol can prove beneficial for the clinical treatment success.

Force Finishing and Centering to Balance a Removable Complete Denture Prosthesis Using the T-Scan III Computerized Occlusal Analysis System

Obtaining bilateral balance of removable complete denture prostheses is the occlusal goal of the restorative dentist or prosthodontist. Despite our best clinical efforts, and the using of advanced mechanical devices like semi-adjustable articulators and face bow transfer mounting of dental casts, it is a struggle to provide accurate occlusal force balance. Some of the advocated reasons for the clinical difficulty of obtaining reliable occlusal balance are that stone casts lack soft tissue resiliency, and articulators only approximate human occlusal functional movements. However, modern technology offers clinicians a digital answer to this clinical force balance problem. It is known as computerized occlusal analysis. The T-Scan III system can be employed with complete removable denture prostheses to perform computer-guided occlusal force-finishing corrective adjustments that measurably improve the installed prosthetic occlusal balance.

Temporomandibular joint vibrations from totally asymptomatic subjects

Objective: Precisely characterize the TMJ vibrations of a youthful, adult and completely asymptomatic population. Methods:TMJ vibrations were recorded from 237 asymptomatic subjects (163 f, 74 m) at Dayananda Sagar Institute in India. The subjects were selected, examined and informed (WMA Helsinki Declaration). TMJ vibrations were recorded bilaterally during maximal open - close. 6 parameters of the vibrations were analyzed between the left and right sides, between genders and with respect to age. Results:Mean vibration intensity was greater for females (p < 0.01) than males. A portion of the frequency spectrum < 300 Hz was also more intense for females (p < 0.022). Females 18 - 20 years old exhibited higher Peak Amplitude than 27 - 30 year olds (p < 0.025) and lower Median Frequency (p < 0.005). Conclusions:A significant difference in TMJ vibrations was present between males and females, increased with age in females but not in males.OBJECTIVE Precisely characterize the TMJ vibrations of a youthful, adult and completely asymptomatic population. METHODS TMJ vibrations were recorded from 237 asymptomatic subjects (163 f, 74 m) at Dayananda Sagar Institute in India. The subjects were selected, examined and informed (WMA Helsinki Declaration). TMJ vibrations were recorded bilaterally during maximal open - close. 6 parameters of the vibrations were analyzed between the left and right sides, between genders and with respect to age. RESULTS Mean vibration intensity was greater for females (p < 0.01) than males. A portion of the frequency spectrum < 300 Hz was also more intense for females (p < 0.022). Females 18 - 20 years old exhibited higher Peak Amplitude than 27 - 30 year olds (p < 0.025) and lower Median Frequency (p < 0.005). CONCLUSIONS A significant difference in TMJ vibrations was present between males and females, increased with age in females but not in males.

The effect of disocclusion time-reduction therapy to treat chronic myofascial pain: A single group interventional study with 3 year follow-up of 100 cases.

Purpose: The purpose of this study is to evaluate the longevity of reduced disclusion time in treating and removing myofascial pain dysfunction symptoms following the T-Scan-based, immediate complete anterior guidance development (ICAGD) coronoplasty. This measured occlusal adjustment has been shown to reduce the muscle hyperactivity of myofascial pain. Methods: Myofascial pain symptomatic patients were recruited as per the diagnostic criteria for temporomandibular disorders (TMDs), including the clinical protocol and assessment instruments outlined by the international RDC/TMD consortium network (version: January 20, 2014) to assess the efficacy of reduced disclusion time in left and right lateral excursions to resolve the myofascial pain symptoms. As per the inclusion and exclusion criteria, 100 cases were treated with ICAGD in three visits, each 1 week apart. Recall disclusion time measurements were recorded every 3 months over 3 years. The RDC/TMD questionnaire was used for symptom assessment at every recall visit. ICAGD brought pretreatment prolonged disclusion time down to <0.4 s, as quantified from T-Scan force and time data records, while the subjects were assessed for symptom relief. The Wilcoxon signed-rank test was used for statistical analysis (P < 0.05). Results: Changes in the intensity of many symptoms from reducing the disclusion time to <0.4 s were statistically significant from treatment day 1, and onward through the 3-year period of observation (P < 0.05). Conclusion: The results indicate that ICAGD reduces the musculoskeletal symptoms of myofascial pain, such that this methodology increases clinical therapeutic success.

Disclusion time reduction therapy in treating occluso-muscular pains

Disclusion time reduction (DTR) is an objective treatment protocol using T-Scan III (digital analysis of occlusion) and electromyography for treating occlusally activated orofacial pains. Chronic occluso-muscle disorder is a myogenous subset of temporomandibular disorder symptoms. These muscular symptoms are induced within hyperactive masticatory muscles due to prolonged disclusion time, occlusal interferences, and occlusal surface friction that occur during mandibular excursive movements. This case report describes a patient treated by DTR therapy, whereby measured pretreatment prolonged disclusion time was reduced to short disclusion time using the immediate complete anterior guidance development enameloplasty, guided by T-Scan occlusal contact time and force analysis synchronized with electromyographic recordings of four masticatory muscles.

Digital analysis of occlusion using T-Scan III in orthodontics

Disclusion Time Reduction (DTR) is an objective treatment protocol using T-Scan III (Digital Analysis of Occlusion) for Force Finishing in Orthodontics. Chronic Occluso-muscle Disorder is a myogenous subset of Temporomandibular Disorder symptoms (TMD) can occur to most of post orthodontic cases, if they are not force finished. These muscular symptoms are induced within hyperactive masticatory muscles due to prolonged Disclusion Time, occlusal interferences, and occlusal surface friction that occurs during mandibular excursive movements. This article describes a gadget T-Scan III which can be used for this purpose; whereby measured pretreatment prolonged Disclusion Time can be reduced to short Disclusion Time using the ICAGD enameloplasty, guided by T-Scan occlusal contact time and force analysis.

Clinical outcome of subjective symptoms in myofascial pain patients treated by immediate complete anterior guidance development technique using digital analysis of occlusion (Tek-scan) and electromyography

Objectives: The purpose of this study is to evaluate the effect of occlusal equilibration using immediate complete anterior guidance development (ICAGD) technique by Kerstein. This technique is the most advanced verifiable and measurable way of digitally analysing the occlusion using T-scan technology and muscle activity using electromyography. Materials and Methods: This study is to assess the subjective symptoms of 75 patients diagnosed as myofascial pain patients and who were treated by ICAGD technique as described by Kerstein. The common complaints of the patients were pain in the masseter and temporal muscles, jaw tiredness in the mornings, night bruxing and difficulty in chewing. This technique involves occlusal equilibration to remove all posterior interferences and establish anterior guidance. The patients were treated over three visits 1-week apart and followed for 3 years. The symptoms reduction occurred for all the patients after the first correction in about 5-10 days. In about a period of 3 years review, no recurrence was seen of the chronic myofascial symptoms. Results: Regardless of the chronic nature of the patient′s symptoms, symptom reduction occurred in a week′s time. This agrees with the studies of Kerstein and others. Discussion: If free excursive mandibular movements are not established, may lead to muscle dysfunction at later years. Thus, equilibration should be done to establish good and free functional movements without any interference. Clinical relevance to interdisciplinary dentistry Using biometric tools like T scan helps dentists to 100% accurate diagnosis of TMD/ occlusion problems and to treat the case objectively. In the area of interdisciplinary practices, these gadgets help us to identify the issues precisely. Thus, a clinician will be at an advantage to locate the causative factor immediately with accuracy and treat the patient.

The influence of immediate complete anterior guidance development technique on subjective symptoms in Myofascial pain patients: Verified using digital analysis of occlusion (Tek-scan) for analysing occlusion: A 3 years clinical observation

Objectives: The purpose of this study is to evaluate the effect of occlusal equilibration using immediate complete anterior guidance development (ICAGD) technique by Kerstein and Farrell on the subjective symptoms of myofascial pain. This technique is the most advanced verifiable and measurable way of digitally analyzing the occlusion using T-scan technology. The primary objective is to reduce the anterior disclusion time to <0.4 s and the secondary objective is to reduce the signs and symptoms of myofascial pain. Materials and Methods: This study is to assess the reducing effects of subjective symptoms of 100 patients diagnosed as myofascial pain patients treated by ICAGD technique as described by Kerstein and Farrell. The common complaints of the patients were a pain in the masseter and temporal muscles, jaw tiredness in the mornings, night bruxing and difficulty in chewing. In this technique occlusal equilibration involves removal of posterior interferences and establish anterior guidance. The patients were treated over three visits 1-week apart and followed for 3 years with an interval of 3 months for the subsequent visits. A visual analog ordinal scale is used to rate the symptoms. The symptoms reduction occurred for all the patients after the first correction in about 5-10 days. In about a period of 3 years review, no recurrence was seen of the chronic myofascial symptoms. Results: In spite of the chronic nature of the patient′s symptoms, symptom reduction occurred in a week′s time. This was assessed by the results of the ordinal scale values. This agrees with the studies of Kerstein and Farrell. Conclusion: Equilibration of occlusion using digital analysis by T-scan in which force is quantified against time, should be done to establish free functional movements without any interference; otherwise the disturbances in the excursive movements may lead to muscle dysfunction at later years.

Full Mouth Rehabilitation by Minimally Invasive Cosmetic Dentistry Coupled with Computer Guided Occlusal Analysis: A Case Report

Evidence of dentistry dates back to 7000 B.C. and since then has come, indeed a long sophisticated way in treatment management of our dental patients. There have been admirable advances in the field of prosthodontics by the way of techniques and materials; enabling production of artificial teeth that feel, function and appear nothing but natural. The following case report describes the management of maxillary edentulousness with removable complete denture and mandibular attrition and missing teeth with onlays and FPD by the concept of minimally invasive cosmetic dentistry. Computer guided occlusal analysis was used to guide sequential occlusal adjustments to obtain measurable bilateral occlusal contacts simultaneously.

Evaluation of function and esthetics for creating a beautiful smile in dental practice using digital smile designing

Appropriate application of principles of smile designing for any restorative work can drastically improve the esthetics of the patients. This case report describes the treatment for the hypoplastic teeth with generalized wear out facets using digital smile designing (DSD) technique rather the conventional approach. Much Literature is available on conventional smile designing, but discussion on DSD is sparse. The treatment plan included DSD and measurements using digital ruler, diagnostic wax-up and fabrication of crowns. DSD is a promising treatment option for good esthetic outcomes. Clinical Relevance To Interdisciplinary Dentistry Aesthetic value and Functional efficiency to be provided in any restorative dentistry case, can be diagnosed and assed in advance by using digital gadgets. How far can we integrate such protocol like DSD-Digital Smile Designing in our routine practice-a case demonstration?