The influence of immediate complete anterior guidance development technique on subjective symptoms in Myofascial pain patients: Verified using digital analysis of occlusion (Tek-scan) for analysing occlusion: A 3 years clinical observation

Abstract

Objectives:The purpose of this study is to evaluate the effect of occlusal equilibration using immediate complete anterior guidance development (ICAGD) technique by Kerstein and Farrell on the subjective symptoms of myofascial pain. This technique is the most advanced verifiable and measurable way of digitally analyzing the occlusion using T-scan technology. The primary objective is to reduce the anterior disclusion time to <0.4 s and the secondary objective is to reduce the signs and symptoms of myofascial pain.Materials and Methods:This study is to assess the reducing effects of subjective symptoms of 100 patients diagnosed as myofascial pain patients treated by ICAGD technique as described by Kerstein and Farrell. The common complaints of the patients were a pain in the masseter and temporal muscles, jaw tiredness in the mornings, night bruxing and difficulty in chewing. In this technique occlusal equilibration involves removal of posterior interferences and establish anterior guidance. The patients were treated over three visits 1-week apart and followed for 3 years with an interval of 3 months for the subsequent visits. A visual analog ordinal scale is used to rate the symptoms. The symptoms reduction occurred for all the patients after the first correction in about 5–10 days. In about a period of 3 years review, no recurrence was seen of the chronic myofascial symptoms.Results:In spite of the chronic nature of the patient's symptoms, symptom reduction occurred in a week's time. This was assessed by the results of the ordinal scale values. This agrees with the studies of Kerstein and Farrell.Conclusion:Equilibration of occlusion using digital analysis by T-scan in which force is quantified against time, should be done to establish free functional movements without any interference; otherwise the disturbances in the excursive movements may lead to muscle dysfunction at later years.

The reciprocal jaw-muscle reflexes elicited by anterior- and back-tooth-contacts—a perspective to explain the control of the masticatory muscles

“…An innovative treatment modality employing the T-Scan data to identify the flattened canine-canine guiding angle and to steepen the angle in relation to the guiding parallel of the paracone/protoconid 44 has been proven successful for many patients suffering from jaw-muscle dysfunctions. 45 …”

“…An innovative treatment modality employing the T-Scan data to identify the flattened caninecanine guiding angle and to steepen the angle in relation to the guiding parallel of the paracone/protoconid 44 has been proven successful for many patients suffering from jaw-muscle dysfunctions. 45 The tasks of the miniature three ANT of carnivorous mammals The "canine" of the human dental formula, the third tooth from the midline, is a misnomer. The human canine appears to be wired to stall the temporal and masseter muscles, acting unlike the fangs of the genus Canis.…”

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

“…[21] It is also probable that the shortened time of contraction requires less work from the muscles, since work = effort × time. [22][23][24][25][26] The T-Scan measures only the relative forces, not the absolute forces. However, EMG activity levels are directly proportional to the force levels.…”

Disclusion time reduction therapy in treating occluso-muscular pains

“…Occlusal interferences and occlusal surface friction present during excursive movements have been considered to be contributory etiological factors for occluso-muscular pain and symptoms observed commonly in temporomandibular disorder (TMD) patients. [ 1 2 3 4 5 ] A measurement-driven, computer-guided occlusal adjustment procedure known as immediate complete anterior guidance development (ICAGD),[ 6 ] whose primary therapeutic goal of measurably decreasing the time required for all molars and premolars to disclude from each other (known as the disclusion time) in <0.4 s during right and left mandibular excursions commenced from complete intercuspation in maximum intercuspal position (MIP). [ 6 ] The ICAGD enameloplasty is guided by the time measurement capability of T-Scan III occlusal analysis system (Tekscan, Inc., South Boston, MA, USA), where specific excursive movement time-duration, numerical end-points must be achieved to verify whether the enameloplasty was properly accomplished.…”