Applying neuromuscular techniques in the orthodontic setting

Savastano, Fabio

doi:10.5937/sejodr4-15529

Cited by 3 publications

(3 citation statements)

References 23 publications

(27 reference statements)

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“…In this sense, clinicians have often stressed the need to take into consideration not only the skeletal aspect and the static relationship between the maxilla and the jaw, but also the fascial, muscular, and articular aspects and the functions of other districts of the body adjacent to and far from the stomatognathic district [37][38][39][40]. In this perspective, one of the main goals of orthodontic treatment is not only to achieve satisfactory aesthetic results but also to create a functional occlusion, meaning an occlusion that does not require a neuromuscular compensation of adaptation passing from the resting position to the occlusal one and does not overload the systems mentioned above [41][42][43]. Indeed, our work seems to suggest that the discrepancy between the resting position and habitual occlusion with respect to that obtainable with TENS is often in progress in children with functional lateral deviation and that, if it is shown that the musculature and the neuro fascial system after TENS is relaxed, it is necessary to work in relation to this neuro-muscular force and not contrary to it.…”

Section: Discussionmentioning

confidence: 99%

Use of Tens in the Diagnosis of Functional Mandibular Lateral Deviation

Ortu,

Di Nicolantonio,

Mummolo

et al. 2023

Applied Sciences

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Introduction: The traditional diagnosis of functional lateral deviation is based on a clinical evaluation and dental casts, supported by an instrumental analysis through X-rays; however, these diagnostic techniques do not provide any information about the neuromuscular system. Several years ago, some authors stressed the importance of the mandibular rest position and its reproducibility as a diagnostic reference, and this became possible with the development of the Myomonitor, TENS. Aim: The aim of this study was to compare mandible position before and after the use of ultra-low-frequency transcutaneous electric nervous stimulation (ULFTENS) in children with diagnosed functional mandibular lateral deviation. Methods: This study was performed on 60 children, aged between 8 and 13 years, with a mean age of 10.1 years (SD 0.81), and with functional mandibular lateral deviation diagnosed clinically, who were referred to the dental clinic for pediatric dental care. Diagnostic neuromuscular registrations were made for all children, and their casts were mounted on a Galetti articulator at the myocentric position. These casts were then compared to those provided by a wax bite registration in the intercuspidal position. Results: Compared with the existing intercuspidal position, neuromuscular registration showed improvement in 30 (50%) patients, 18 patients (30%) showed no changes, and worsening of the tooth midline discrepancy was assessed in the remaining 12 (20%). The molar relationship did not follow the same trend of the midline because of the three-dimensional changes in the maxillo–mandibular relationship induced by TENS. After TENS, there was a significant correlation between the midline and right side deviation (r > 0.65); there was no correlation between the midline and the left side (r < 0.65). Furthermore, the right molar movement showed no correlation with the contralateral molar (r < 0.65). The posterior areas of the arch moved in a very unpredictable way, resulting in the diagnosis and prognosis of mandibular lateral deviation as absolutely individual and unpredictable. Conclusions: This study suggests that TENS-recorded occlusion is an interesting diagnostic approach in orthodontics since it allows for visualizing the trends of the neuromuscular system.

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Section: Discussionmentioning

confidence: 99%

Use of Tens in the Diagnosis of Functional Mandibular Lateral Deviation

Ortu,

Di Nicolantonio,

Mummolo

et al. 2023

Applied Sciences

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“…Neuromuscular dentistry (ND) can be defined currently as a diagnostic and treatment procedure in which the teeth, TMJ, and masticatory muscles are considered simultaneously [12]. Dr. Bernard Jankelson introduced this methodology in the late 1970s [13][14][15][16][17][18].…”

Section:  Introductionmentioning

confidence: 99%

Complete morphofunctional oral rehabilitation by physiological increase of occlusal vertical dimension according to computerized mandibular scanner

Constantinescu

Savastano²,

Perlea³

et al. 2022

Rom J Morphol Embryol

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Increasing the occlusal vertical dimension (OVD) is often indicated in complex oral rehabilitation to gain restorative space and improve the occlusal relationship and aesthetics. The effect of increasing the OVD on lower facial height and facial aesthetics is not well understood and evaluated. The authors present the philosophy of the neuromuscular concept and illustrate it through a case report of a 58-year-old female patient who presented severe deep bite, bruxism, and temporomandibular disorders (TMDs). After clinical evaluation, the extraoral examination showed a reduction of the lower facial height, protuberant lips, wrinkles, and over-closed commissures. In addition, intraoral examination showed a severe anterior deep bite articulation, and the upper incisors completely covering the lower incisors labial surfaces. Through the philosophy of the neuromuscular concept the diagnostic ability, the quality and stability of the treatment increases. A temporary long-term fixed prosthesis was made at the enlarged OVD to be used in the first stage of the rehabilitation. Compared to the initial situation, the new prosthesis was delivered at a vertical dimension (VD) higher with 7 mm. The purpose of the neuromuscular philosophy and methodology is to harmonize the facial profile, functional occlusion, the joint function, and neuromuscular control. Through the neuromuscular methodology, we can assess the patient's ability to manage a significant increase in VD and to restore a functional OVD by physiological measurements.

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“…That myth about occlusion has been translated to a paradigm with continuous discoveries and its application in treatment protocols. I have been able to reduce relapse (every orthodontist has relapse cases, just in case you smiled) and find new therapeutic strategies [8][9][10]. I have had a chance to work with doctors around the world that are part of a growing neuromuscular community, who have stimulated me and with whom I share and confront my opinions and results.…”

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confidence: 99%