Immediate Complete Anterior Guidance Development (ICAGD) Applied to Post-orthodontic Patients with Temporomandibular Disorders: A Single Interventional Study of 50 Cases

Abstract

The objective was to test the efficacy of immediate complete anterior guidance development (ICAGD) treatment applied to a select group of postorthodontic temporo-mandibular disorder (TMD) patients with specified myalgic symptoms. Materials and Methods: The symptoms of a carefully selected group of fifty postorthodontic myalgic TMD patients without serious temporomandibular joint disturbances were documented with a 0-10 Visual Analogue Scale, pre and post ICAGD treatment. Bilateral masseter and temporalis muscle activity and relative bite force were measured multiple times before and after treatment. The Mann-Whitney U-test was used to analyze the anamnestic data, and Student's paired t-test was used to analyze all the measured data. Results: Disclusion times were significantly reduced (P = 0.000) as were the posttreatment subjective symptoms (P = 0.0003). The relative force levels clenching in maximum intercuspal position became more equally distributed between the left and right sides after treatment (P < 0.0002), although the total electromyography (EMG) activity during the clenching did not change (P > 0.4940). The left and right lateral excursive EMG activity was significantly reduced after treatment (P < 0.05). Conclusions: The application of ICAGD reduced: (a) the lateral excursive disclusion times, (b) the myalgic reported symptoms, (c) the left-right imbalance of forces during clenching, and (d) the amount of muscular effort during lateral excursions for this group of postorthodontic myalgic TMD patients.