Clinical management of temporomandibular disorders : controlling bruxism and tmj load 1 Clinical management of temporomandibular disorders : controlling bruxism and temporomandibular joint load

The first step of clinical management of the temporomandibular disorders (TMD) is to distinguish the origin of problem, to classify into myogeneous and joint problems, which have been regarded to be an important process. Although the precise mechanisms for the symptoms or pathology of these conditions have not yet been clarified, muscular parafunction or hyperfunction has been regarded to play an important role in the etiology of TMD. Excess mechanical loading to the temporomandibular joint (TMJ) has been reported to be one of the possible causes for the development of osteoarthritis. These forces might be exerted through mandibular parafunctions like sleep bruxism or tooth contacting habit. For clinical control of sleep bruxism, a thick palatal appliance which fills the palate and does not cover the occlusal surface have been developed. In this review article, clinical implication of the relationship between occlusion, mastication and bruxism have also been discussed.

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