TMD management with full digital workflow: a beneficial clinical protocol

• Published in: Journal of dentistry Vol. 147; p. 105187
• Main Authors: Pittari, Laura, Paniura, Ljubicca, Bosco, Floriana, Tecco, Simona
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 01-08-2024
• Subjects: Digital protocol; gnathology; therapeutic position; TMD; Digital protocol; therapeutic position; TMD; gnathology
• ISSN: 0300-5712; 1879-176X
• DOI: 10.1016/j.jdent.2024.105187

Temporomandibular joint disorders (TMDs) are often studied because of the difficulty in managing symptoms and the complexity in finding and stabilizing the therapeutic position. The purpose of this study is to define a digital gnathological protocol for identifying a personalized therapeutic position for the patient's rehabilitation.
A digital protocol approved by the IRCCS San Raffaele Hospital (Milan) ethics committee (GNATHOLOGY, cod: opinion09/int/2023) was introduced in the dentistry department of the hospital for the treatment of TMD patients. The protocol includes a digital workflow which, starting from the compilation of a gnathological anamnesis and the acquisition of the 3D scans and photos of the arches and the face, includes the acquisition of the mandibular kinematics with ModJaw®, the cervical ROM (Range of Motion) with an accelerometer, electromyography, and MRI (if required). The mandibular therapeutic position is thus obtained and transmitted to the technician who proceeds with the 3D printing of the gnathological splints.
Digital acquisitions facilitate the clinician's work by allowing the development of a diagnosis and a customized treatment plan for patients, with a precise therapeutic position.
Digital evaluation offers the possibility of memorizing the digital therapeutic position and of virtually checking the device, even before its production, on the patient's actual kinematics. This allows a careful diagnosis to be performed even in complex cases and a more effective treatment plan to be developed, also improving interdisciplinary communication between colleagues.