MSC - Page 43

FUNDAMENTALS OF OCCLUSION AND MASTICATORY FUNCTION Figure 8. Left: an untreated, natural upper molar. Right: an amalgam filling with distinctly pronounced abrasionabraded facet, which may be a trigger of CMD Figure 10. As a possible risk factor, a poorly designed amalgam filling was found at a lower molar Figure 9. This patient had tremors in the area of masseter muscle, which he willingly could not influence Figure 11. According correction of amalgam filling gave the patient a spontaneous “better feeling” to. The tremor did not occur since then Figure 12. A patient with muscle-related restricted mouth opening shows as single risk factor this amalgam filling on an upper molar of frequent head pain within the interdisciplinary diagnostic must also include an investigation of the dental causes. The same applies to the tinnitus, as very recent studies show. In summary it can be stated that craniomandibular dysfunction (CMD) can be used as an expression of the dysfunctional masticatory system. It may have diverse risk factors which may, in part, have to be classified to be far outside the scope of our art (Fig. 7). From the perspective of STOMA.EDUJ (2014) 1 (2) dentistry, when diagnostics and therapy of CMDbased diseases are concerned you will have to think primarily of occlusal interferences, including traumatic amalgam fillings and other fillings (Fig. 8). Clinical patient cases First case This patient had for some time twitching activities periodically occurring on both sides in the masseter muscles, that he deliberately could not control. 119