TMJ
Maxillomandibular Relationship in TMD Patients Before and After Short-Term Flat Plane Bite Plate Therapy Alexander S. Fu, D.M.D., M.S.; Noshir R. Mehta, D.M.D., M.D.S., M.S.; Albert G. Forgione, Ph.D.; Emad A. Al-Badawi, B.D.S., M.S.; Khalid H. Zawawi, B.D.S.
0886-9634/2103172$05.00/0, THE JOURNAL OF CRANIOMANDIBULAR PRACTICE, Copyright © 2003 by CHROMA, Inc. Manuscript received July 29, 2002; manuscript accepted October 17, 2002. Address for reprint requests: Khalid H. Zawawi, B.D.S. Research Associate Gelb Orofacial Pain Center Tufts University School of Dental Medicine One Kneeland Street Boston, MA 02111 E-mail:
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ABSTRACT: This study assessed the maxillomandibular relationship in temporomandibular disorders (TMD) patients, before and after short-term, flat plane bite plate therapy. It was of interest to determine the incidence and degree of mandibular deviation in a group of TMD patients and whether the mandible would shift to the midline and consequently affect reported symptoms. Seventeen female and three male subjects (age range 19-60) were included in the study. Thirteen subjects were diagnosed with myofascial pain while seven were diagnosed as exhibiting disk displacement with reduction (Research Diagnostic Criteria). After taking impressions for these subjects, casts were fabricated and mounted. Maxillomandibular relationship was evaluated by the Denar Centric Check system (Anaheim, CA). The maxillary and mandibular labial frena were used as a reference to evaluate mandibular shift. Symptom questionnaires were used to assess temporomandibular joint pain and clicking. All subjects exhibited deviation (12 subjects to the right and 8 subjects to the left) prior to bite plate therapy. After flat plane bite plate therapy, the mandibular position of all subjects shifted toward the labial frenum midline position. Based on the Binomial test, the shift was significant (p0.05) in degree of change for subjects diagnosed with myofascial pain and subjects diagnosed with disk displacement with reduction as measured on the Centric Check system (XR, YR, XL, and YL); therefore, they were treated as one group. There were no significant differences (p>0.05) in symptoms between subjects with mandibular shift from the right side towards the frenum midline and those with mandibular shift from the left side towards the frenum midline. Therefore both groups (Group A and B) were combined. All subjects shifted toward the labial frenum midline position following short-term bite plate therapy (Binomial p
