The therapeutic effects of occlusal equilibration in patients with craniomandibular disorders

Abstract

In order to evaluate the role of occlusal factors in the etiology of CMD two groups of participants were selected for this investigation according to the value of the craniomandibular index ( CMI), Fricton and Schiffman 1975. The control group consisted of 17 participants, both male and female between 18 and 25 years of age with the preserved natural dentition, no indices of orthodontic treatment and with the value of the CMI = 0. The experimental group consisted of 15 participants, male and female, between 18 and 25 years of age with preserved natural dentition, no indices of orthodontic treatmen, but with evident signs and symptoms of CM disorders the CMI >0). The chosen participants of the control and experimental group were subject to detailed occlusal analysis which included the number of occlusal contacts in the ICP, RCP,the type of lateral guidance of the mandible and the presence of occlusal interferences during mandibular movements. Using selective grinding the occlusal interferences were eliminated in participants of the experimetal group. The CMI was calculated in this group after selective grinding. The results of the occlusal analysis in this study point to the signifficantly greater number of mediotrusive, retrusive and protrusive interferences in participants of the experimental group The values of CMI before ( CMI I) and after selective grinding (CMI II) in the experimental group confirm the assumption that occlusal interferences play a significant role in the etiology of CMD.

Da bi se ispitala uloga okluzalnih faktora u etiologiji kraniomandibularnih disfunkcija (CMD) za ova istraživanja su odabrane dve grupe ispitanika na osnovu vrednosti kraniomandibularnog indeksa prema Fritcronu i Schiffmanu 1975 (CMI). Kontrolnu grupu je činilo 17 muškaraca i žena starosti od 18 do 25 godina sa očuvanom prirodnom okluzijom koji nisu podvrgavani ortodontskom tretmanu i kod kojih je CMI bio jednak nuli. Eksperimentalnu grupu činilo je 15 muškaraca i žena starosti 18 do 25 godina sa očuvanom prirodnom okluzijom koji nisu podvrgavani ortodontskom tretmanu, ali su imali jedan ili više znakova (simptoma) CMD-a odnosno CMI je bio viši od nule. Ispitanici kontrolne i eksperimentalne grupe su podvrgnuti detaljnoj okluzalnoj analizi kojom je evidentiran broj okluzalnih kontakata u interkuspalnom položaju (IKP), retrudovanom kontaktnom položaju (RKP), tip vođenja mandibule i prisustvo okluzalnih smetnji pri kretnjama mandibule.Selektivnim brušenjem su zatim uklonjene okluzalne smetnje kod ispitanika eksperimetalne grupe i ponovo je vrednovan CMI. Rezultati ove studije ukazuju na značajno veće prisustvo mediotruzijskih, retruzijskih i protruzijskih smetnji kod ispitanika eksperimentalne grupe. Vrednosti CMI pre (CMI I) i nakon selektivnog brušenja(CMI II) kod ispitanika eksperimentalne grupe potvrđuju pretpostavku da okluzalne smetnje imaju značajnu ulogu u etiologiji CMD-a.