Dental Blog

About Brookline Cosmetic Dentistry

Make an Appointment

  • This field is for validation purposes and should be left unchanged.

Robert B Kerstein DMD Completes Another TMJ Treatment Study

Dr. Robert Kerstein of Boston, MA and Mr. John Radke of Milwaukee WI, have recently completed a 2-year long study of 45 TMJ patients that have undergone the non-mouthguard, non-appliance based TMJ treatment, known as Disclusion Time Reduction.

The 2 researchers investigated the statistical likelihood that when a TMJ patient has their disclusion time reduced with the ICAGD enameloplasty (which is not Occlusal Equilibration), their hyperactive muscles will be markedly relaxed during the 1st treatment appointment.

The Abstract of the manuscript, which has been submitted to the Jounal of Craniomandibular Practice, can be seen below:

Purpose – To determine if a statistically significant reduction in muscle activity (p < 0.05) occurs when prolonged disclusion time (> 0.4 sec/excursion) is shortened to < 0.4 sec/excursion with the Immediate Complete Anterior Guidance Development (ICAGD) enameloplasty.

Methods – 45 symptomatic fully informed subjects (29F, 16M) had their right and left disclusion times recorded with T-Scan III while simultaneously the bilateral masseter and anterior temporalis muscle activity was recorded electromyographically with BioEMG III ( n = 180 muscles). This recording was done twice, once pre treatment and again post treatment (same day) after undergoing the ICAGD enameloplasty on the same day without changing electrodes. Student’s paired t test was utilized to detect any significant change in the muscle activity levels between the pre and post treatment lateral excursive muscle contractions.

Results – Highly significant reductions were found in all 4 muscles’ activities after shortening the pretreatment prolonged Disclusion Time to less than 0.4 seconds (p < 0.0014); after Bonferroni correction (p < 0.006).

Conclusion – When properly performed, such that the post treatment disclusion time is < 0.4 sec per excursion, the ICAGD enameloplasty predictably reduces excursive muscle activity levels in the bilateral anterior temporalis and masseter muscles.

Clinical Implication – Excursive muscle hyperactivity can be a source of lactic acid accumulation, muscular ischemia, and chronic muscular TMD symptoms. The ICAGD enameloplasty significantly reduces excursive muscle contractions within the first ICAGD treatment session.

This study’s results agree with the findings of the many previously published studies involving ICAGD and disclusion time reduction that Dr. Kerstein has published since 1991. The results indicate that performing ICAGD and creating short disclusion time reduces pre treatment elevated levels of excursive masticatory muscle function. The very low p values suggest that hyperactive excursive muscle activity levels, when they exist, can be predictably reduced by using the ICAGD enameloplasty.

The treatment effect of ICAGD and disclusion time Reduction can be seen below:

This is an Electromyogram of a TMJ patient who was a subject in the study. The hyperactivity in the muscles can be seen to the right of the vertical thick white line. This high level of electrical activity is what causes muscluar TMJ symptoms like jaw fatigue, chewing tiredness, facial pain, temporal headaches, and clenching and grinding of the teeth.

Labano pre op EMG

Below is the post Treatment Electromyogram of the same patient who had th Disclusion Time Reduction performed with the ICAGD Enameloplasty. Note how the excess muscle contracrtions are removed almost completely (after the vertical white line).

Labano post op EMG

This removal of the hyperfunction is permanent because the Disclusion Time is changed down to such high-precision tolerances with the T-Scan computer, the muscular TMJ symptoms are readily treated.

  • As the new study points out, the muscle activity is lessened during the 1st treatment appointment so symptoms begin to lessen very quickly.
  • The statistical findings in the study were so profound, they indicate that a TMJ patient who undergoes the ICAGD procedure to have their Disclusion Time reduced, stands a very high liklihood of having their muscular TMD predictably treated.
  • And no appliances or mouthguards are required to have the treatment effect take hold.

Comments are closed.