Occlusal dysesthesia: a topical narrative review

Melis, Marcello; Zawawi, Khalid H.

doi:10.1111/joor.12309

Cited by 30 publications

(33 citation statements)

References 22 publications

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“…All participants in this study had been diagnosed with PBS by a specialist in psychosomatic dentistry, based on the criteria suggested by Melis, as follows: (a) complaints of an uncomfortable sensation while biting; (b) significantly associated emotional distress; (c) symptoms lasting more than 6 months; (d) history of failures of various bite‐altering dental procedures; (e) absence of dental occlusion discrepancies or those disproportional to the complaint; and (f) not attributed to another disorder (dental, pathology, muscle, temporomandibular joint or neurological disorder). Our data included patients who had been analysed in one of our former studies .…”

Section: Methodsmentioning

confidence: 99%

“…“Phantom bite syndrome” (PBS), sometimes referred to as “occlusal dysesthesia”, is characterised by an uncomfortable sensation mainly affecting a corrected dentition in which no abnormality can be clinically explained. Despite repeated failures of dental surgery, affected individuals persist in seeking bite correction from a succession of dentists .…”

Section: Introductionmentioning

confidence: 99%

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Comorbid depressive disorders and left‐side dominant occlusal discomfort in patients with phantom bite syndrome

Shinohara

Umezaki

Minami

et al. 2019

J of Oral Rehabilitation

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BackgroundPhantom bite syndrome (PBS) is characterised by occlusal discomfort without corresponding dental abnormalities. Despite repeated, failed dental treatments, patients with PBS persist in seeking bite correction. PBS has been regarded as a mental disorder. However, we have reported that PBS patients with a dental trigger tend to have less psychiatric history than those without. Hence, the symptoms of PBS cannot be explained by a mental disorder alone, and it is unclear if mental disorders affect occlusal sensation.ObjectiveTo elucidate the pathophysiology of PBS, we analysed the dental history, PBS symptom laterality and psychiatric history of patients.MethodsIn this retrospective study, we reviewed outpatients with PBS who presented at our clinic between April 2012 and March 2017. Their medical records were reviewed for demographic data, medical history and laterality of occlusal discomfort.ResultsApproximately half of the 199 enrolled patients had bilateral occlusal discomfort. In the others, the side with occlusal discomfort generally tended to be the one that had received dental treatment. There was no significant relationship between the side chiefly affected by occlusal discomfort and whether dental treatment had been received; however, the affected side differed depending on whether the patient had comorbid psychiatric disorders (P = .041).ConclusionsThe distributions of the side with symptoms of PBS were different between those with and without comorbid psychiatric disorders, suggesting that psychiatric disorders might affect occlusal sensation due to a subtle dysfunction in brain areas central to sensory integration. Central dysfunction might play an important role in PBS.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comorbid depressive disorders and left‐side dominant occlusal discomfort in patients with phantom bite syndrome

Shinohara

Umezaki

Minami

et al. 2019

J of Oral Rehabilitation

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“…The following factors have been discussed as aetiological factors of OD: Psychopathological influences Neuroplasticity and phantom phenomena Changes in proprioceptive stimuli and their transmission …”

Section: Aetiologymentioning

confidence: 99%

Occlusal dysesthesia—A clinical guideline

Imhoff¹,

Ahlers

Hugger

et al. 2020

J of Oral Rehabilitation

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Background The diagnosis and management of patients suffering from occlusal dysesthesia (OD) remain a major challenge for dental practitioners and affected patients. Objectives To present the results of a literature‐based expert consensus intended to promote better understanding of OD and to facilitate the identification and management of affected patients. Methods In 2018, electronic literature searches were carried out in PubMed, Cochrane Library and Google Scholar as well as in the archives of relevant journals not listed in these databases. This approach was complemented by a careful assessment of the reference lists of the identified relevant papers. The articles were weighted by evidence level, followed by an evaluation of their contents and a discussion. The result represents an expert consensus. Results Based on the contents of the 77 articles identified in the search, the current knowledge about clinical characteristics, epidemiology, aetiology, diagnostic process, differential diagnosis and management of OD is summarised. Conclusions Occlusal dysesthesia exists independently of the occlusion. Instead, it is the result of maladaptive signal processing. The focus should be on patient education, counselling, defocusing, cognitive behavioural therapy, supportive drug therapy and certain non‐specific measures. Irreversible, specifically an exclusively dental treatment approach must be avoided.

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“…Based on proposals by Melis and Zawawi [1], the study population included OD patients who persistently complained of uncomfortable bite sensation for at least 6 months in the absence of dental occlusal discrepancies, such as centric prematurity or nonworking interference, or when the complaints were disproportionate to those conditions [14]. Fifteen OD patients, 8 males and 7 females, with a mean age of 49.9 ± 16.1 years were investigated, and the results were compared to those obtained from 15 age-and gender-matched (Fisher's exact test and Z test) HC subjects (8 males, 7 females; age 39.3 ± 15.3 years).…”

Section: Participantsmentioning

confidence: 99%

“…Persistent occlusal discomfort is a common complaint among occlusal dysesthesia (OD) patients [1][2][3][4] who, in the presence of depression, schizophrenia, panic, or somatoform disorders [5][6][7][8], present with numerous neuropsychological associations. From a clinical standpoint, Tsukiyama et al [2] recommended a psychosomatic evaluation for diagnosis, and Reeves JL and Merrill RL [5], and Toyofuku et al [7] also recommended cognitive behavioral therapy and antidepressants for the treatment of OD patients.…”

Section: Introductionmentioning

confidence: 99%

Prefrontal modulation during chewing performance in occlusal dysesthesia patients: a functional near-infrared spectroscopy study

et al. 2018

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Objectives Neuropsychological associations can be considerable in occlusal dysesthesia (OD) patients who routinely complain of persistent occlusal discomfort, and somatization effects in the superior medial prefrontal cortex and the temporal and parietal regions are also present. However, the relationship between physical activity, i.e., chewing, prefrontal cognitive demand, and psychiatric states in OD patients remains unclear. We investigated this relationship in this study. Materials and methods OD patients (n = 15) and healthy control (n = 15; HC) subjects were enrolled in this study. Occlusal contact, chewing activities of the masticatory muscles, prefrontal activities, and psychiatric states such as depression and somatization, of the participants were evaluated. Functional near-infrared spectroscopy was used to determine prefrontal hemodynamics and the Symptom Checklist-90-R was used to score the psychiatric states. Results We observed a significant association between prefrontal deactivation during chewing and somatization subscales in OD patients. Further, there were no significant differences with regard to the occlusal state and chewing physical activities between the OD patients and HC subjects. Conclusions Chewing-related prefrontal deactivation may be associated with somatization severity in OD patients. Clinical relevance fNIRS is a functional imaging method that uses the principal of neuro-vascular couplings. It is applicable for evaluation of psychiatric state based on prefrontal cortex blood flow in patients with psychiatric disorders.

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Occlusal dysesthesia: a topical narrative review

Cited by 30 publications

References 22 publications

Comorbid depressive disorders and left‐side dominant occlusal discomfort in patients with phantom bite syndrome

Comorbid depressive disorders and left‐side dominant occlusal discomfort in patients with phantom bite syndrome

Occlusal dysesthesia—A clinical guideline

Prefrontal modulation during chewing performance in occlusal dysesthesia patients: a functional near-infrared spectroscopy study

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