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This study was focussed on the effects of changes in interocclusal clearance on the activity of oral muscles. Two types of occlusal splints were incorporated in 20 subjects without TMJ-syndrome. Their muscle reactions were recorded electromyographically in the masseter muscle. The results show 5 groups of muscle reaction correlated with the mean postural face height. The changed height of the postural position has a significant influence on the control pattern of the masticatory system.

The concept of perioperative diagnosis and treatment of patients with chronic TMJ disease has been confirmed by a follow-up examination of ten female patients after surgical treatment. Eight of the ten patients were pain-free after observation periods of 3 to 20 months. Following an initial bite-guard splint therapy, instrumental functional analysis, MR tomography and arthrographic visualization of dynamic movement profiles are indispensable. The results have also shown that, depending on the intraoperative finding, a postoperative splint therapy should be performed for six months.

50 patients were treated with analogous acoustic EMG biofeedback in 5 sessions of 20 minutes each. 75% of the patients experienced improvement both of the clinical signs and their subjective symptoms. It is emphasized that 1. biofeedback training with acoustic analogous EGM biofeedback may support successful treatment of mandibular dysfunctions and 2. stress reduction and pretreatment with bite planes may increase the probability of successful treatment.

A total of 1440 patients with the diagnosis "mandibular joint complaints" were referred to the Out-Patient Clinic for Dental Prosthetics between 1974 and the first half of 1979. A clinical functional analysis (Krogh-Poulsen) was used to examine 1114 of these patients. The number of women patients (73%) was impressively high. The myoarthropathies appeared most frequently between the twentieth and the fortieth year of life. Complaints had been present for at least one year prior to referral in 44% of the patients. Tenderness of the pterygoideus muscle at clinical examination was observed most frequently. Treatment with a biteplate brought relief from complaints in 82% of the patients.

The influence exerted by objectifiable factors on the therapeutic result of temporo-mandibular joint disorders was analyzed in follow-ups carried out in 73 patients. As the most frequent cause of still existing complaints occlusal interferences, especially balance contact, were found. The majority of these balance contacts had developed after termination of our therapy, as a result of occlusal surfaces having an unfavorable shape with regard to masticatory function or as a result of spaces in the dentition that had not been treated prosthetically. It was possible to demonstrate that lasting therapeutic success is mainly due to the consistent securing of an interference-free centric and eccentric occlusion. Function controls should also be carried out as a routine measure in people with healthy temporo-mandibular joints, in order to guarantee improved prophylaxis of disorders in the stomatognathic system.

In the present study the influences of type and duration of complaints, findings, therapeutic method, duration of therapy and patient cooperation on the prognosis of temporo-mandibular joint disorders were analyzed. The elimination of occlusal interferences may be regarded as causal therapy in the large majority of temporo-mandibular joint disorders. In these cases a very good and long-term rate of success may be achieved by the method of selectively grinding-in the teeth according to A. Lauritzen.

Thirty-three patients with the tentative diagnosis of a myofacial pain syndrome were treated symptomatically and causally after standardized diagnostic exmaination. Eleven months after the termination of therapy, twelve patients were without symptoms, seventeen showed improvements and the clinical picture of four patients had not changed at all. When supporting the therapeutic success by prosthetic measures the choice of the articulator system (Dentatus, Condylator) was irrelevant.

Both stabilizing splints and relaxing appliances have been recommended for the treatment of myofacial pain. It was the goal of the present study to compare the therapeutic effect of these two types of appliances. 26 patients with myofacial pain, whose symptoms were not overshadowed by arthropathy and in whom previous physiotherapy had failed to bring about sufficient pain relief, were divided into two prospectively randomized groups. They received either a stabilizing splint or a relaxing appliance. The therapeutic effect was assessed with the aid of the patients' subjective reports and the Helkimo indices. In spite of the small number of patients the statistical evaluation of the results showed stabilizing splints to be significantly (p less than 0.03) superior to relaxing appliances in the treatment of myofacial pain.

It was the objective of this study to evaluate the effects of the changes assessed by clinical functional analyses before and after treatment on the subjective symptoms of 234 patients with TMJ disorders and facial pain. The results showed that the numbers of tender muscles and the changes in interincisal opening are more closely correlated with the subjective discomfort of the patients than the extent of interocclusal clearance or deviation during jaw opening.

A three dimensional adjustable supporting system is described which is useful in achieving a trouble-free mandibular position in asymmetrical myoarthropathies. The reproducible adjustment of the supporting point makes it possible to compare different favourable positions of the condyle with least expenditure of technique and time. The description is supplemented by a case report.