Myofascial pain dysfunction syndrome (MPDS) is a stomatognathic system disturbance, which consists of pain, jaw movement irregularities, and muscle spasm. Hyperexcitation of peripheral sensory neurons causes a reaction of induction in the motor neuron and then spasms of the masticatory muscles follow. Long-term spasm causes muscular pain and irregular mandibular motion. Pain is the most important inducer and therefore must be managed firstly in order to manage the muscle spasms. Symptomatic treatment approaches may be useful, but after symptom elimination, etiologically based treatment must be provided to the patient. The neurophysiology of the stomatognathic system must be well understood to determine a proper treatment for the MPDS condition. Both symptomatic and etiological treatment methods have been proposed by differing authors as potential solutions for MPDS. Occlusal splints are a commonly used treatment for relieving MPDS symptoms. Alternatively, some forms of occlusal adjustment (not all) have been shown to be an effective, permanent treatment course for myofascial pain dysfunction syndrome. This chapter describes the neural controls over the stomatognathic system and how that system can neurologically promote the MPDS disease state. It then details the computer-guided MPDS occlusal adjustment treatment known as disclusion time reduction that has been shown in many published studies to be a highly effective myofascial pain dysfunction syndrome (MPDS) therapy.

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Temporomandibular joint disorder (TMJ) is a complex and multifactorial functional disorder. Best approach in the treatment of TMJ disorders needs in detail proper diagnostic study. Joint vibration analysis (JVA) device, a new age technology and one of the most important diagnostic tools, is used for detecting intra-articular sound vibrations. Every type of vibration in different frequencies shows us the status of joint. Evaluation can be made after analyzing the results applying to a diagram. Like Combining of the sound vibration diagnostic techniques with other examination methods may be very meaningful in efforts of treating TMJ problems. Another diagnosis method is the evaluation of chewing movements. Best chewing efficiency is the most important purpose of masticatory system. Final product is a very important indicator for the efficiency of the mastication, and chewing pattern. T-Scan digital occlusal analyzing system is another important occlusal diagnostic instrument. Digital occlusal analysis system is currently the most powerful method of TMD clinics for treatment of patients with muscle pain dysfunction syndrome. Digital occlusal analysis system allows us to perform the MPDS treatments, splint and occlusal rehabilitation. The three important diagnostic systems are described in this chapter.

Objectives: It shows that patients receiving orthodontic treatment may have a risk of developing temporomandibular disorder symptoms. The aim of this study is to examine the changes in the chewing system of occlusal contact parameters related to joint vibrations, chewing patterns, and measured excursive movements in fixed and non-extractive orthodontic treatments. Material and Methods: A total of 43 individuals with premolar extraction (n = 23) and without extraction (n = 20) who applied to the Department of Orthodontics, Dentistry Faculty of Istanbul Aydin University and needed orthodontic treatment were included in the study. In this study, 43 active fixed orthodontic treatment patients were conducted at the beginning (T0) and 6th month (T1) and 12th month (T2) on the parameter recorded during chewing. For occlusion analysis, T-Scan® computerized occlusion analysis recording and examination of the chewing pattern were used for JVA and JT temporomandibular joint parameters. Depending on whether the data showed normal distribution or not, differences between groups were evaluated using the Mann–Whitney or independent t-test, and intragroup differences were evaluated using the Wilcoxon sign test or paired t-test. Results: At the beginning, 6th month and 12th month of orthodontic treatment, it was observed that the opening, closing, and occlusion times and joint vibration frequencies in the chewing pattern in cases with and without tooth extraction, the integral value differences of total integral, and frequencies below 300 Hz and above 300 Hz were statistically significant (P < 0.001). In digital occlusion analysis values, the right-left differences were not found statistically significant in the measurements made in cases with and without extraction (P > 0.05), while there were statistically significant differences in disclusion values at the beginning, 6th and 12th months (P < 0.05). Conclusion: At the beginning of the orthodontic treatments with or without extraction, it was observed that the values at the joint level changed significantly in the 6th month. However, the changes in the joints during the treatment, when they return to their ideal values at the end of the 12th month, are more than the change in occlusion.

Objective: This study aimed to investigate the effect of the disease on the middle ear resonance frequencies with wide-band tympanometry in the people with temporomandibular disorder (TMD). Methods: A total of 40 individuals (24 patients, 16 control groups), 18 years of age and older, 25 females and 15 males, were included in the study. For the patients who came to the Oral Diagnosis Department of XXXX University with the complaint of TMD, the patient’s history and detailed examination were taken by the specialist dentist. Pure tone audiometry (125-8000 Hz air-way, 250-4000 Hz bone conduction thresholds) and speech audiometry, acoustic immitance and middle ear resonance measurements, outer ear resonance test were applied. Results: TMD ipsilateral and contralateral middle ear resonance values for each individual of the study group and control group and statistical data were determined. No difference was observed in the mean values of the 3 groups for middle ear resonance. However, there was a significant difference between the middle ear resonance values of the TMD ipsilateral and control groups. Conclusion: In a patient population with TMD the increase in middle ear RF values in the ipsilateral ears of the lesion may provide evidence of an increase in the stiffness of the middle ear system, offering a new perspective on the pathophysiology of the disease. KEY POINTS 1) Middle ear canal resonance frequency can be determined with wideband tympanometry (WBT). 2) There was no difference in the mean values of the three groups for the ipsilateral of the temporamandibular disorder, the contralateral of the temporamandibular disorder and the middle ear resonance values of the control group. 3) It was observed that there was a significant difference between the ipsilateral resonance values of the TMD patient group and the middle ear resonance values of the control group. 4) This study aims to present additional findings and methods for differential diagnosis by showing the differences between clinical tests applied to individuals with TMD and middle ear findings of normal individuals. 5) This study will also provide the first findings of minor middle ear pathology in patients with TMJ disorders by WBT.

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Hydrostatic splint increased maximum biting force. Relative percentage of left and right bite forces changed in the direction of neurophysiological position of the muscles. Hydrostatic splint can be a viable option for occlusal adjustments.