Yasuhiro Kondo

Thirty-year follow-up of a TMD case treated based on the neuromuscular concept.

Abstract Aim: Occlusal therapy is employed to alleviate the symptoms of a temporomandibular disorder (TMD) at times. However, the long-term effect of occlusal therapy in the masticatory system is not well understood. This case study aims to present a 30-year follow-up of a TMD case. Methodology: The patient developed TMD with intermittent closed lock of the left temporomandibular joint (TMJ). Chief complaints included trismus, pain, and noise of the left TMJ during function. The patient’s occlusal disharmony was assessed with use of electronic instruments and corrected based on the neuromuscular concept. A minimum-invasive and reversible approach using adhesive occlusal restorations was used. Results: The jaw movement and masticatory muscle activity assessed at the 7- and 23-year follow-ups revealed that the established occlusion was well adapted, and re-established the patient’s functional occlusion system. The patient has been free from TMD symptoms with the corrected occlusion for 30 years. Conclusions: Occlusal reconstruction based on the neuromuscular concept can be stably integrated into the patient’s functional occlusion system.

リン酸カルシウム系結晶化ガラス (CMP) の接着に有効な被着面処理法の検討

In this study we examined the shearing adhesive strength between a calcium metaphosphate glass-ceramic (CMP) and various luting materials. Two usual luting cement-zinc phosphate cement (Elite Cement 100), glass-ionomer cement (Fuji ionomer cement Type I) and three adhesive luting resin-Super Bond C & B, Panavia EX and a tentative luting resin were used as the material. We also examined the effect of three adherent surface treatments--50 microns Almina blasting, hydrofluoride etching, and sodium hydroxide etching--on the adhesive strength of the two adhesive resin, Panavia EX and the tentative luting resin, to CMP. The following conclusion were drawn: 1. The adhesive strength to CMP surface polished with #600 emery paper was higher in order of Super Bond C & B, a tentative luting resin, Panavia EX, Fuji ionomer cement Type I and Elite Cement 100. 2. Sodium hydroxide etching was the most effective for the adhesion between the adhesive luting resin and CMP among the above four adherent surface treatments. 3. Irrespective of the etching time, the stimulation of sodium hydroxide bath by supersonic waves gave an additional increase to the adhesive strength. 4. Under the stimulation by supersonic waves, increasing sodium hydroxide concentration tends to increase the adhesive strength, whereas it is little affected by the etching time within three minutes. The maximum was obtained with concentration in four or five normal (4 or 5 N) sodium hydroxide.