Treatment of condylar osteophyte in temporomandibular joint osteoarthritis with muscle balance occlusal splint and long-term follow-up:A case report

BACKGROUND Condylar osteophytes,a remodeling form of temporomandibular joint osteoarthritis(TMJ OA),mainly manifest as marginal angular outgrowths of the condyle.Previous researchers have advocated surgical removal of condylar osteophytes.Reports on the effect of occlusal splint on TMJ OA patients’joints have mostly focused on treatment with this splint,which can reduce the absorption of the affected condyle and promote repair and regeneration.However,the effect of the splint on the dissolution of condylar osteophytes has not yet been reported.CASE SUMMARY A 68-year-old female patient suffered from occlusal discomfort with left facial pain for 2 years.Cone beam computed tomography showed a rare osteophyte on top of her left condyle.She was finally diagnosed with TMJ OA.The patient refused surgical treatment and received conservative treatment with a muscle balance occlusal splint.The pain experienced by the patient on the left side of her face was relieved,and her chewing ability recovered after treatment.The osteophyte dissolved,and the condylar cortex remained stable during long-term follow-up observations.CONCLUSION The muscle balance occlusal splint could be a noninvasive means of treating condylar osteophytes in TMJ OA patients.

Evaluation of Premature Contacts Using the T-Scan Ⅲ

Objective: The aim of study is to evaluate premature contacts and occlusal forces for each tooth in complete dentures before occlusal adjustment. Material and methods: The study population was comprised of 30 subjects (aged 50 - 75). The measurements were performed using the T-Scan. The occlusion was analyzed before and after frames which from the T-scan “Force Movies” are Centric Relation bite recordings. Several practices closures were made until a repeatable pattern of contacts was seen on the video monitor and sensor was calibrated. Each subject was asked to bite on the sensor in a position of maximum intercuspation thus obtaining the location of each tooth contact. Premature contacts and percentage distribution of forces per tooth were obtained before and after occlusal adjustment. Results: The worst occlusal balance was recorded in a patient (F/74) by occlusal force values at right 5.9% and left 94.1% before occlusal adjustment. After occlusal adjustment, all patients’ percentage of occlusal balance values was adjusted at average of 48.8%, left 51.1%. The percentage distribution of forces per tooth results showed that premature contacts had been observed at posterior teeth either right or left side of occlusion. Conclusions: Occlusal adjustment is requested for all complete dentures to prevent patients from muscular pain and/or temporomandibular disorders for further terms.