Full-mouth rehabilitation following treatment of temporomandibular disorders and teeth-related signs and symptoms

The literature is replete with theories regarding temporomandibular disorders (TMD). However, there is a paucity of information concerning perceived malocclusion and other teeth-related signs and symptoms after full-mouth rehabilitation. This clinical study was designed to evaluate the perception of TMD patients concerning perceived malocclusion and other teeth-related signs and symptoms after full-mouth rehabilitation guided by the Mental Analog Scale (MAS). Among 38 patients referred for full-mouth rehabilitation, 20 were diagnosed as having TMD after reviewing a questionnaire, recording the major complaints and symptoms, in addition to performing comprehensive clinical examination. Nonsurgical therapy was performed, including fabricating an anterior programming device, a centric relation occlusal device and finally full-mouth rehabilitation by means of placing crowns on all upper and/or lower teeth. All full-mouth rehabilitation procedures were performed using a fully adjustable articulator and mandibular movements were recorded following pantographic tracings. After full-mouth rehabilitation, the patients were followed up at 1, 2, 4, 6, 9, and 12-month intervals, and the major signs and symptoms were recorded along with adjunctive teeth-related signs and symptoms. Fisher exact probability tests were applied to analyze the results (P<.05). Statistical comparisons of the MAS responses before and after treatment (at 1-month recall) showed significant improvement (P<.05) for all teeth-related signs and symptoms except for bruxism (P=.0699). Further improvement was noted at the 4-month recall period. However, these improvements were not statistically significant for all teeth-related signs and symptoms. No further change was noted after the 4-month recall period. There was a marked reduction in perceived malocclusion and adjunctive teeth-related signs and symptoms during function, only after performing occlusal equilibration of the final restorations.