The molar and premolar pulp fibers and periodontal ligament mechanoreceptors are part of the peripheral nervous system (PNS). Peripheral nerves lie outside of the brain and spinal column, such that they usually make their initial synapse outside of the central nervous system (CNS). However, the molar pulpal fibers and the periodontal ligament (PDL) mechanoreceptors are unique in that despite being peripheral nerve afferents, they are the sole human peripheral nerves that enter the CNS directly (into the mesencephalic nucleus) and travel further within the CNS to the trigeminal motor nucleus, where they make their first synapse with the efferent motor fibers to the four muscles of mastication, the tensor tympani, the tensor veli palatini, the mylohyoid, and the anterior belly of the digastric muscles (the swallow mechanism muscles). These same fibers also travel within the brain directly to the reticular formation (without any intervening synapses), which is a major neural center that controls functions like swallowing, sleep, posture, and breathing.
Published in Chapter:
Employing the T-Scan/BioEMG III Synchronized Technologies to Diagnose and Treat Chronic Occluso-Muscle Disorder
Robert B. Kerstein, DMD (Tufts University School of Dental Medicine, USA & Private Dental Practice Limited to Prosthodontics, USA)
Copyright: © 2020
|Pages: 153
DOI: 10.4018/978-1-5225-9254-9.ch007
Abstract
This chapter discusses chronic occluso-muscle disorder, which is a myogenous subset of temporomandibular disorder (TMD) symptoms resultant from occlusally activated muscle hyperactivity. It also describes the computer-guided occluso-muscle disorder treatment known as disclusion time reduction (DTR), that studies repeatedly show reduces many common muscular temporomandibular disorder symptoms. T-Scan-based research since 1991 has determined that a significant etiologic component of occluso-muscle disorder is prolonged (in time) occlusal surface friction shared between opposing posterior teeth during mandibular excursions, that occurs in both normal chewing function and during parafunction. This friction results in prolonged compressions of the periodontal ligament (PDL) fibers of the involved teeth, which when in excursive opposing occlusal contact, also experience pulpal flexure that leads to pulpal neural activation, which together with the periodontal ligament compressions, trigger excess muscle contractions within the masticatory muscles. It is this unique neuroanatomy that incites and perpetuates many chronic muscular TMD symptomatology, that can be readily resolved in patients that meet the diagnostic criteria for DTR candidacy, using the ICAGD coronoplasty that is performed in the maximum intercuspal position (MIP), without employing treatment splints, deprogrammers, appliances, orthotics, or mandibular repositioning. Additionally, this chapter will highlight the newest disclusion time reduction therapy (DTR) studies that support the clinical implementation of this highly effective measured occlusal treatment for occluso-muscle disorder.