Unilateral vicious mastication – The importance and resolution: a case report

Abstract

Introduction: Patients presenting Temporomandibular Disorders (TMD) are common in our daily clinical practice. One of the possible conditions that lead to TMD is the habitual chewing side syndrome. Methods: In this case report a clinical approach is presented to manage the TMD related to unilateral vicious mastication. A 42 years old woman presented reporting headaches, difficulty to open mouth, presence of sensitivity in the left ear and TMJ region, soreness on the left side temporal region and sensitivity in the anterior inferior teeth. It was noted that the patient habitually clenched and ground teeth. Patient mentioned chew more on the left side. Results: After confirming the unilateral mastication, a modified therapy based on the Neuro occlusal Rehabilitation was applied through the use of a splint. After 60 days the patient described absence of the previous symptoms and pain relief. Conclusion: The evaluation of the masticatory pattern is often neglected; however, it is of great importance since it can lead to several conditions such as condyle wear, pain, alteration of the occlusal plane, deviation of the medial line, deviation of the mandible at mouth opening, bone alterations, Temporomandibular joint (TMJ) hypofunction, headache, among others.

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“…This means that after the first occlusal contact is made, the MIP will be reached through reduction of the vertical dimension (VD). 3,4,7,[11][12][13] In the resting position (RP), that is, the position without physical tooth contact, there is free interocclusal space, and the condyles sit at their uppermost and frontmost position in the joint cavities. 13 From this RP, with mouth closure as far as the first occlusal contact, there is a reduction of the VD for the lower third of the face.…”

“…This angle is defined by the increases in the left-side and right-side VDs and the horizontal plane during lateral motion. 7,8,12,15 During functional jaw motion, it is possible to check whether the jaw motion is bilaterally equal or not by placing a marker on the lower interincisor point, just underneath the upper incisor's incisal edge, and asking the patient to move the jaw without disconnecting the dental contacts on each side. 10 These angles are the visual representation of the lateral jaw motion (►Fig.…”

The Law of Minimum Vertical Dimension: Evidence for Improvement of Dental Occlusion

“…3 10 The law of MVD forms the scope of the present study and states that “when the mandible moves to reach the maximum intercuspal position (MIP), this always involves bringing the mandible and maxilla as close together as possible.” This means that after the first occlusal contact is made, the MIP will be reached through reduction of the vertical dimension (VD). 3 4 7 11 12 13…”

“…This angle is defined by the increases in the left-side and right-side VDs and the horizontal plane during lateral motion. 7 8 12 15 During functional jaw motion, it is possible to check whether the jaw motion is bilaterally equal or not by placing a marker on the lower interincisor point, just underneath the upper incisor's incisal edge, and asking the patient to move the jaw without disconnecting the dental contacts on each side. 10 These angles are the visual representation of the lateral jaw motion ( Fig.…”

“…This means that after the first occlusal contact is made, the MIP will be reached through reduction of the vertical dimension (VD). 3,4,7,[11][12][13] In the resting position (RP), that is, the position without physical tooth contact, there is free interocclusal space, and the condyles sit at their uppermost and frontmost position in the joint cavities. 13 From this RP, with mouth closure as far as the first occlusal contact, there is a reduction of the VD for the lower third of the face.…”