Neuromuscular occlusion is discipline of dentistry based upon minimizing the need for muscle ACCOMODATION as the patient closes into a STABLE CENTRIC OCCLUSION.
These concepts are predicated upon the ability to:
- Objectively measure muscle function
- Correlate it to an optimal physiologic position and function of the temporomandibular joints and
- Correlate it to an optimal resting posture and function of the masticatory muscles.
Neuromuscular Dentististry NMD) is a protocol utilizing diagnostic instrumentation to OBJECTIVELY quantify, verify and measure biophysiologic responses of the masticatory and cervical system. It takes into consideration the status and influences of MASTICATORY MUSCLES.
How is an Optimal Physiological Mandibular Position Determined?
Instrumentation is used objectively measure and records muscle activity via electromyography (EMG), before, during and after muscle relaxation using low frequency TENS. Spastic muscles are physiologically relaxed via ultra low frequency TENS (transcutaneous electroneural stimulation) to compare normal versus abnormal muscle activity. The clinician is able to visualize a physiologic mandibular rested position via Jaw Tracking (or Computerized Mandibular Scanning CMS) instrumentation in the frontal and sagittal planes.
A bite registration is taken via Jaw Tracking, TENS and synchronous real time EMG recordings to capture an optimal physiologic maxillo-mandibular relationship in 6
A bite relationship is taken with the patient sitting up and relaxed. No manual manipulation is required neither do we touch the patient's jaw when taking the recording, which would induce potential pathology. A light weight sensor array is used with a magnet to record and track mandibular position in space both frontally and sagittally.
After the patient's mandible is relaxed and monitored for low muscle activity (EMGs) and bite registration material is used to record that maxillo-mandibular relationship. The neuromuscular clinician is able to visualize this relationship on the computer monitor and access if the jaw trajectory is correct as well as on frontal open and closing path. Optimal resting EMGs are also identified and observed "simultaneously" to establish the best position.
All jaw torque, skews, strain, distortions are minimized to prevent further jaw mis-alignments from abnormal jaw joints pathology, hyper muscle tension, mal aligned and worn teeth as well as abnormal head postures. Guesswork is eliminated. Establishing this "physiologic relationship" versus working within a "habitual" acquired bite position is what neuromuscular dentistry is about.
Dental training is required to understand how to properly interpret and assess the objective data.
Patient must understanding that there are various levels of training, skills and experience that there dentist has acquired to master these principles and techniques.
Neuromuscular dentistry is comprehensive and address the complete postural issues of the head, neck, mandibular position, muscle activity status, the joint position all which in turn impact the occlusal position and relationship of the teeth. Based on these objective and scientific recordings do we consider our beginning starting point to diagnosis and treat.