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OCCLUSION Figure 13. Immediately after correction of the amalgam filling, there occurred a relaxation of the muscles. Within a few days an unrestricted oral opening was possible Figure 14. Massive centric and eccentric series contacts on a ceramic restoration Findings 1. Mouth opening asymmetrical Yes No   2. Mouth opening restricted   3. Traumatic excentric movements   4. TMJ noises, pain  5. Muscle palpation (M. masseter/temporalis) asymmetrically positive finding    Evaluation max. 1 pos. finding: health probable 3 or more pos. findings: disease probable Supplemental finding Yes No 6. Physiological centric position unequal max. intercupation “Cotton-Roll-Test” (early contacts, occlusal gliding, enamel chipping, grinding facettes, wedge-shaped defects, tooth mobility, tongue impressions etc.)   Evaluation With pos. finding: disease probable Figure 15. Correction of these ceramic restorations gave the patient a balanced-fit-feeling General medical and neurological examinations were unsuccessful and ultimately relaxation therapies were recommended. A mere-chanceconversation lead to an inspection that showed a single occlusal risk factor: distinct wear facets on an amalgam filling at a lower molar. At the same consultation this filling was corrected by grinding using magnifying spectacles and using 10-micron thin occlusal foil. These fissures were so engrossed and moved that the maximum intercuspation and all eccentric movements were possible (Fig. 9, 10, 11). Spontaneously releasing the patient, he would now have an even bite together, and he felt much more relaxed. The muscle irritations were now no longer on. Second Case This patient came to our clinic because of restricted mouth opening of about 25 mm interincisal distance (IID). As a risk factor, an amalgam filling was found on an upper molar, which had a massive abrasionfacet. 120 mod.n Ahlers / Jakstat Figure 16. The Ahlers and Jakstat clinical summary report for CMD risk identification was extended by a test of physiological centric position The amalgam filling was remodeled according to the natural model. The patient was spontaneously changed to a pleasant- fit-feeling. Because of photo documentation the session took a total of about 45 minutes. In the end, the patient was able to achieve an opening of 38 mm IID, which was apparently due to a spontaneous relaxation of the muscles. Within a few days they then reached an unrestricted mouth opening of about 40 millimeters IID (Fig. 12, 13). Third case This patient was referred by a neurologist due to severe tension headaches of unknown origin. It had to be clarified whether dental risk factors may be identified that could causally contribute to this disease. In clinical occlusion diagnostics centric and eccentric premature contacts were found on a ceramic restoration in a mandibular molar. Immediately after correction the patient showed a balanced-fit-feeling of all the teeth of the maxilla STOMA.EDUJ (2014) 1 (2)