適正なガイドにより顎に加わる力を制御する

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  • 澤田 宏二
    新潟大学大学院歯学総合研究科摂食機能再建学分野

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  • The anterior guidance regulates the load on temporomandibular joints

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Two clinical reports are Temporomandibular disorders (TMD) due to Bruxism and clencing during sleeping. The following cases presented the symptomatology of TMD disappeared by occlusal treatment.<BR>[Case 1] The patient was an 18 years-old male with an Angle class III malocclusion who couldn't close his mouth during waking up for almost one year. Clinical inspection showed that the mandibular right second molar was guiding the mandibular eccentric movements. The TMD symptoms disappeared by shifting anteriorly the tooth guidance with splints.<BR>[Case 2] The patient was an 51 years-old female who had pain of left Temporomandibular joint (TMJ) . She could't sleep well due to the TMD symptoms. Clinical inspection showed that the left second premolar was Scissors bite. The symptomatology of the TMD disappeared by treating the contact point of the left second premolar.<BR>We recorded jaw and condylar movements of these two cases with a 6-degree-of-freedom measuring device during lateral excursions with and without wearing of the splints in order to assess the influence of shifting anteriorly the location of tooth guidance on the cure of the symptoms. We found that the direction of condylar movements changed markedly during parafunctional grinding tasks.<BR>We conclude that correction of anterior guidance is a non-invasive alternative therapy in some cases of condylar dislocation.

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