Clinical and experimental dental research · 2025
Changes of the Occlusal Relationship in Patients With Temporomandibular Disorders (TMD) After Manual Therapy: A Pilot Study.
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Pohl Tobias Dieter Peter, Harhoff Alessia Celine, Ries Johannes, Wichmann Manfred, Matta Ragai-Edward
Аннотация
OBJECTIVES: Temporomandibular disorders (TMD) are often linked to changes in dental occlusion, yet the impact of therapeutic interventions remains unclear. This pilot study investigates the effects of manual therapy on occlusion in TMD patients through quantitative analysis of intraoral scans.
MATERIAL AND METHODS: Ten individuals were diagnosed with TMD and underwent a 40-min session of manual therapy (Group MT). Ten subjects were allocated to the healthy control group (Group C) and did not receive any therapy during the 10-week control period. Occlusion measurements were obtained using the TRIOS 3 intraoral scanner (3Shape, Denmark) both before and after the therapy or control period. The digital models were analyzed regarding occlusal changes using the GOM Inspect Professional software (GOM, Germany). The differences in the individual axes dX Pat , dY Pat , dZ Pat ( mm ) ${{dX}}_{{Pat}},{{dY}}_{{Pat}},{{dZ}}_{{Pat}}{\unicode{x02007}}(\mathrm{mm})$ and Euclidean distance d X Y Z Pat ( mm ) ${dXYZ}_{{Pat}}\unicode{x02007}(\mathrm{mm})$ were computed.
RESULTS: In terms of the arithmetic mean, Group MT exhibited higher deviations across all three axes ( dX P a t M T = 0.122 ( mm ) , dY P a t M T = 0.217 ( mm ) , dZ P a t M T = 0.193 ( mm ) ${{dX}}_{PatMT}=0.122\unicode{x02007}(\mathrm{mm}),{{dY}}_{PatMT}=0.217\unicode{x02007}(\mathrm{mm}),\unicode{x02007}{{dZ}}_{PatMT}\,=\,0.193\unicode{x02007}(\mathrm{mm})$ ) as well as in the Euclidean distance ( d X Y Z P a t M T = 0.347 ( mm ) ) $({dXYZ}_{PatMT}=0.347\unicode{x02007}(\mathrm{mm}))$ than the control group ( d X P a t C = 0.060 ( mm ) , d Y P a t C = 0.063 ( mm ) , d Z P a t C = 0.043 ( mm ) , d X Y Z P a t C = 0.113 ( mm ) ) $(d{X}_{PatC}=0.060\unicode{x02007}(\mathrm{mm}),\unicode{x02007}d{Y}_{PatC}=0.063\unicode{x02007}(\mathrm{mm}),\unicode{x02007}d{Z}_{PatC}\,=\,0.043\unicode{x02007}(\mathrm{mm}),\unicode{x02007}dXY{Z}_{PatC}=0.113\unicode{x02007}(\mathrm{mm}))$ . Statistically significant differences were observed for the Y and Z axes, as well as the Euclidean distance (p < 0.05).
CONCLUSION: Considering the limitations of this pilot study, it is reasonable to suggest that manual therapy has a significant influence on occlusion in habitual intercuspidation among TMD patients.
MATERIAL AND METHODS: Ten individuals were diagnosed with TMD and underwent a 40-min session of manual therapy (Group MT). Ten subjects were allocated to the healthy control group (Group C) and did not receive any therapy during the 10-week control period. Occlusion measurements were obtained using the TRIOS 3 intraoral scanner (3Shape, Denmark) both before and after the therapy or control period. The digital models were analyzed regarding occlusal changes using the GOM Inspect Professional software (GOM, Germany). The differences in the individual axes dX Pat , dY Pat , dZ Pat ( mm ) ${{dX}}_{{Pat}},{{dY}}_{{Pat}},{{dZ}}_{{Pat}}{\unicode{x02007}}(\mathrm{mm})$ and Euclidean distance d X Y Z Pat ( mm ) ${dXYZ}_{{Pat}}\unicode{x02007}(\mathrm{mm})$ were computed.
RESULTS: In terms of the arithmetic mean, Group MT exhibited higher deviations across all three axes ( dX P a t M T = 0.122 ( mm ) , dY P a t M T = 0.217 ( mm ) , dZ P a t M T = 0.193 ( mm ) ${{dX}}_{PatMT}=0.122\unicode{x02007}(\mathrm{mm}),{{dY}}_{PatMT}=0.217\unicode{x02007}(\mathrm{mm}),\unicode{x02007}{{dZ}}_{PatMT}\,=\,0.193\unicode{x02007}(\mathrm{mm})$ ) as well as in the Euclidean distance ( d X Y Z P a t M T = 0.347 ( mm ) ) $({dXYZ}_{PatMT}=0.347\unicode{x02007}(\mathrm{mm}))$ than the control group ( d X P a t C = 0.060 ( mm ) , d Y P a t C = 0.063 ( mm ) , d Z P a t C = 0.043 ( mm ) , d X Y Z P a t C = 0.113 ( mm ) ) $(d{X}_{PatC}=0.060\unicode{x02007}(\mathrm{mm}),\unicode{x02007}d{Y}_{PatC}=0.063\unicode{x02007}(\mathrm{mm}),\unicode{x02007}d{Z}_{PatC}\,=\,0.043\unicode{x02007}(\mathrm{mm}),\unicode{x02007}dXY{Z}_{PatC}=0.113\unicode{x02007}(\mathrm{mm}))$ . Statistically significant differences were observed for the Y and Z axes, as well as the Euclidean distance (p < 0.05).
CONCLUSION: Considering the limitations of this pilot study, it is reasonable to suggest that manual therapy has a significant influence on occlusion in habitual intercuspidation among TMD patients.