UPDATE NELLA GESTIONE DEL BITE NEI DISORDINI TEMPORO MANDIBOLARI

Aim of the work.\r\nThe aim of the work is to present a new and di!erent\r\nprotocol for the management of the bite in patients\r\nsu!ering from neuromuscular pain and temporo\r\nmandibular disorders, by means of a bite that involves\r\nthe patient to perform active physical, cognitive and reeducational oral exercises.\r\nMaterials and methods.\r\nFrom a consecutive series of 536 patients with\r\nneuromuscular pain and temporo mandibular disorders\r\n“TMD”, 200 subjects were selected: 100 for the control group\r\n(CG) and 100 for the patient group (PG). The (CG) was not\r\nsubjected to any treatment but was given a calendar in\r\nwhich to record the spontaneous evolution of symptoms to\r\nbe shown to scheduled checks.\r\nThe (PG) was treated only with a new immediate device\r\nto be used at night and during the day to perform specific\r\nexercises at home. This device was chosen because it has\r\nparticular characteristics:\r\n1) it is universal, easy and immediate to use.\r\n2) it has no hooks, so it involves the patient directly in\r\nmanaging the bite with the tongue and perioral muscles.\r\n3) it is a slight mandibular-condylar protrusor therefore\r\nmodifies the levers and muscle forces.\r\n4) it is minimally invasive and well tolerated.\r\n5) it has low costs and therefore balanced between costs\r\nand benefits.\r\nResults and conclusions.\r\nIn the (PG) was achieved remission of the most important\r\nsymptoms in 94 patients, equal to 94%.\r\nIn contrast, in the control group (CG) the symptoms\r\nworsened in intensity and frequency in 51 patients, 51%,\r\nand remained stationary in 37 patients, 37%, while only 12\r\nsubjects, 12%, reported a slight improvement. Our study\r\nhas therefore confirmed that the bite is an important\r\naid in the therapy of Neuromuscular Pain and Temporo\r\nMandibular Disorders, but above all it has confirmed that the\r\nbite can be used actively by patients to perform cognitive\r\nand rehabilitative oral physical exercises to stimulate\r\nreorganization, functional dynamic and probably over time\r\nalso brain neuroplasticity