UPDATE NELLA GESTIONE DEL BITE NEI DISORDINI TEMPORO MANDIBOLARI

Aim of the work. The aim of the work is to present a new and di!erent protocol for the management of the bite in patients su!ering from neuromuscular pain and temporo mandibular disorders, by means of a bite that involves the patient to perform active physical, cognitive and reeducational oral exercises. Materials and methods. From a consecutive series of 536 patients with neuromuscular pain and temporo mandibular disorders “TMD”, 200 subjects were selected: 100 for the control group (CG) and 100 for the patient group (PG). The (CG) was not subjected to any treatment but was given a calendar in which to record the spontaneous evolution of symptoms to be shown to scheduled checks. The (PG) was treated only with a new immediate device to be used at night and during the day to perform specific exercises at home. This device was chosen because it has particular characteristics: 1) it is universal, easy and immediate to use. 2) it has no hooks, so it involves the patient directly in managing the bite with the tongue and perioral muscles. 3) it is a slight mandibular-condylar protrusor therefore modifies the levers and muscle forces. 4) it is minimally invasive and well tolerated. 5) it has low costs and therefore balanced between costs and benefits. Results and conclusions. In the (PG) was achieved remission of the most important symptoms in 94 patients, equal to 94%. In contrast, in the control group (CG) the symptoms worsened in intensity and frequency in 51 patients, 51%, and remained stationary in 37 patients, 37%, while only 12 subjects, 12%, reported a slight improvement. Our study has therefore confirmed that the bite is an important aid in the therapy of Neuromuscular Pain and Temporo Mandibular Disorders, but above all it has confirmed that the bite can be used actively by patients to perform cognitive and rehabilitative oral physical exercises to stimulate reorganization, functional dynamic and probably over time also brain neuroplasticity