StomatologyEduJournal1-2015 | Page 33

BASICS OF FUNCTIONAL CLINICAL AND INSTRUMENTAL DIAGNOSTICS AND PRETREATMENT BEFORE FINAL ORAL REHABILITATION Figure 7. Intraoral findings were normal. The dentition was well cared-for, a few restorations were present, and there was an almost ideally-shaped maxillary dental arch Figure 8. The mandible also exhibited a few restorations, but occlusal ab-normalities (facets, fracture) could be seen on molars 37 and 47 in the same area, where she had shown severe preliminary contacts after the “cotton-roll-test” Figure 9. After touching preliminary contacts on her molars the patient could finally assume an evenly supported maximal intercuspation position Figure 10. Since the clinical findings for the TMJ alone do not allow a definite diagnosis, electronic registration of the movement pathways was carried out learn not to clench his/her teeth at such times, because this can cause the muscle tension which triggers symptoms. To help patients recognize and avoid clenching their teeth, we give them 3 small, red adhesive dots as “reminders”, for instance, to stick on their computer screen at work.27 For many patients, it has proven helpful to lend them a video on relaxation exercises, muscle massage, and movement training.14 It is also a means of testing a patient’s willingness to cooperate. Figure 11. To conduct electronic registration in daily practice, we prefer the easy-to use Cadiax Compact system 1. c) Intraoral findings and clinical occlusal diagnostics Intraorally, this patient exhibited tongue impressions, wear facets/attrition, enamel cracks, and pronounced wedge-shaped defects in the maxilla and mandible.26 On the whole, these are clear clinical signs of stress and/or parafunctions 123