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There is plenty of research on TMD, but the problem with this TMD research is many professionals can’t seem to agree on whether TMD is a psychosocial (stress, tension or emotional upset) issue or whether it is a muscular issue based on a perspective on muscle balance. Some have examined pain patterns from trigger points and tight muscles lead to altered TMJ mechanics in the joints and occlusion and or whether it is a malocclusion issue with a focus on the cause of premature contact due to trigger points in the muscles, relieving muscles before splinting, prolonged dental work, stress or trauma (malocclusion can perpetuate trigger point activity) and proprioception/muscle disturbance can cause malocclusion and altered TMJ mechanics.
Research within the dental profession has been done extensively on all these various 3 main areas relating to TMD. The problem is with our profession not agreeing which of these 3 areas lends the greatest credance to TMD as a problem. I can tell you that a mass majority of research has not focused their investigations on the “physiologic” and objective measurement responses of what is an optimal mandibular positioning relative to the maxilla and the associated musculature before and after muscle relaxation therapy.
Very little objective scientific data has been acknowledged by these theorist, thus a lot of drawn conclusions about TMD with very little awareness as to how occlusion/ the teeth, the muscles and joints effect the CNS and their responses after relaxation therapy as it relates to mandibular positioning before and after muscle relaxation. Only those within the neuromuscular NM and GNM community have even considered using scientific ADA and FDA approved technologies in their offices to measure these responses. Other TMD and occlusal oriented philosophies have not used these computer aided technologies such as low frequency TENS and Jaw Tracking devices to begin to measure mandibular jaw positioning changes before and after TENSing (muscle relaxation) before, during and after.
Since the psychosocial orofacial community are typically antii instrumentation and more pro pharma and stress related they have concluded with their traditional biases about what TMD is about. Those who recognized malocclusion as a possible valid TMD theory also have bantered against the use of objective measuring instrumentation but are just now barely getting on board with the use of EMG measuring and or measuring joint sounds (JVA), but once again they have not yet gotten on board with accurately measuring mandibular POSITIONing of their patients mandibles relative to the maxilla before and after muscle relaxation techniques, so they really haven’t accurately quantified their occlusal results…so we get a diverse group of opinions of success responses with non reported TMD occlusal failures as reported on these TMD forums.
What is wrong with using objective measuring tools that are ADA and FDA recognized to do research?
- LITERATURE REVIEW OF SCIENTIFIC STUDIES SUPPORTING THE EFFICACY OF MANDIBULAR TRACKING IN and the use of T.E.N.S. in THE DIAGNOSIS AND TREAMENT OF TMD/ MSD
http://nmdfacts-mandibulartracking.blogspot.com/
NM and GNM are doing our best to stay cutting edge to better understand these issues by using TENS to relax muscles, measuring muscle activity before and after any occlusal treatment with EMGs and even more importantly use accurate and precise computerized mandibular scanning (jaw Tracking) to measure our patients mandibular location, positionings and functional abilities before, mid and after any occlusal interventions. That is how we do our research objectively.
The GNM dentist doesn’t just use TENS to relax muscles only, neither do they just use EMGs to measure muscle activity and balance only but used a combined approach using all 4 modalities of TENS, EMGS, ESG (joint analysis – electrosonography) as well as CMS – computerized mandibular scanning/ jaw tracking to objectively measure and quantify our patients resting and functional status of where our patient’s mandibles function whether their bites are on the right healthy functional path mandibular closure or whether the patients bites are functioning on some other abnormal functioning path that may be pathologic. 0.1-0.3 mm difference whether the mandible is closing on an optimal path of off an optimal path of closure makes a difference to those of us who measure and and realizes these micron differences do matter to how the body functions and responds to postural issues.
How else can anyone (any clinician) within this profession or outside this profession adequately do objective reliable research without proper measuring tools to logically and scientifically arrive at the cause and or solutions to these multifaceted problems involving teeth/occlusion, muscles, and joints?
DR. CLAYTON CHAN'S BLOG NOTES 