Publications

Scholarly Journals--Accepted

  • NEUROMUSCULAR AVOIDANCE IN THE STOMATOGNATHIC SYSTEM: A PILOT STUDYTITLE CHANGED: AVOIDANCE BEHAVIOR TO MINESCULE IATROGENICALLY APPLIED OCCLUSAL INTERFERENCES: A PILOT STUDY1. Submitted to General Dentistry, March 2017- REJECTED2 Submitted to CDA Journal, June, 20173 Accepted for publication in CDA journal, April, 2018 Abstract:   The relationship between teeth and the stomatognathic system is highly affected by clinical dentistry.  However, lack of interest and thereby research showing the relationship between subtle occlusal interferences and the protective response of the stomatognathic system, has influenced our profession’s awareness of the problem.  This has resulted in a void in truly understanding the dento-occlusal interface and its significance.  The physiology of the masticatory system continuously seeks homeostasis between the teeth, periodontium, masticatory muscles, TM Joints, the craniofacial skeleton and the neuromuscular system.  Hence, one unfavorable occlusal interference, even as thin as 10-60 micrometers, could cause unfavorable jaw positioning and attendant physiological changes.  It is speculated that the neuromuscular system of the head and neck will shift the position of the mandible relative to the maxilla to avoid any occlusal interference seeking the best possible maximum interocclusal position.  Homeostasis of the masticatory system is greatly affected over time by the fit of this ‘acquired’ occlusion.  Once this phenomenon is identified, very favorable occlusal therapies can follow.   Iatrogenic interferences at near the 50 micrometer level were added to an occlusal stop of tooth #30 (usually the mesial buccal cusp tip) and to a non-occluding cusp of the contralateral first molar (usually the mesial lingual cusp tip) which served as  control. The results obtained from this proof of concept study demonstrated mandibular avoidance behaviors when these interferences are created.  (04/2018)
  • "The effect of specially designed and managed occlusal devices on patient symptoms and pain: A cohort study." .  Published General Dentistry, March/April, 2015 Academy of General Dentistry. ABSTRACT  There is limited data regarding the benefit of using an occlusal device to help patients diminish a variety of symptoms involving temporomandibular disorders (TMD), head, neck and shoulder pain. The purpose of this paper is to evaluate the effect of a carefully adjusted occlusal device on twelve different patient symptoms to determine if trends are present justifying a randomized trial of the treatment methodology. Splints were designed and managed to stable, reproducible mandibular positions in a cohort of 157 dental patients with histories of TMD, head, neck and shoulder pain. The patients were provided a self-reporting Numeric Rating Scale (NRS) each visit ranging from zero to ten with ten being the highest intensity level for the following 12 symptoms: Temporomandibular Joint (TMJ) pop, TMJ click, TMJ lock, jaw pain, headache, neck pain, shoulder pain, earache, ear ring (Tinnitus), clenching, grinding, and opening pain. Data was gathered for this study from the first, sixth, twelfth, and eighteenth visits. Significant improvement (p < .001) in eleven of the twelve symptoms occurred. The number of patients within the tinnitus group limited the predictability with that symptom. Conclusions. Significant reductions in the symptoms of temporomandibular and/or head, neck and shoulder pain were recorded when a hard surface occlusal device (splint) was used in accordance with the clinical protocol. Clinical implications of the splint described in this article and the clinical techniques associated with its design and management provided symptom and pain reduction in the  (03/2015)

Scholarly Journals--Published

  • The effect of specially designed and managed occlusal devices on patient symptoms of tinnitus: A cohort study1. Submitted to General Dentistry, Feb, 2017-REJECTED2. Currently under re-write3. Published in CRANIO Nov, 2018 ABSTRACT The effect of a specially designed and managed occlusal device on tinnitus: a cohort study. Bioesthetic Maxillary Anterior Guided Orthoses (BMAGO’s) were designed and managed to stable, reproducible mandibular positions.  The authors define this as Seated Stable Condylar Position (SSCP).  The patients in this study all had histories of TMD, head, neck and shoulder pain. They wore the Orthosis 24/7, eating, talking and sleeping with it; they were seen every 2 weeks for adjustment.  It essentially became their surrogate occlusion.  They were provided a self-reporting Numeric Rating Scale (NRS) at the beginning of each visit ranging from zero to ten with ten being the highest intensity discomfort or pain level for 12 TMD symptoms, including symptoms of tinnitus.  In the data gathering for this study, visits 1 through 6, as well as visits 12 and 18 was intentional in order to specifically study the effects of the BMAGO on tinnitus. Conclusions: Significant reductions in the symptoms of tinnitus were recorded when a BMAGO (splint) was used in accordance with the clinical protocol.  Clinical results, after proper techniques associated with its design and management were provided, produced symptom and pain reduction in the dental system and adjacent tissues. These implications may now be extended, with predictability, to symptomatic reduction of tinnitus as well.  (11/2017)

Non-Scholarly Journals

  • Open Bite Centric Registration This is a  video that is awaiting completion of surveys before submission to Med Ed Portal for publication.  It demonstrtes the technique of haw to perform an Open CR registrtion using a Panadent Tray. (06/2015)
  • Video demonstration of Panadent Earbow- to be completed Dec,2009 (05/2008 - 12/2009)
  • Video Demonstration of Panadent Axiopath III- hinge axis location.  To be completed Dec,2009 (02/2007 - 11/2009)

Scholarly Journals--Submitted

  • "The effect of specially designed and managed occlusal devices on patient symptoms and pain: A cohort study." submitted to The Journal of Prosthetic Dentistry July, 2013.  It was rejected Sept, 2013 and is now being reworked and submited to Academy of General Dentistry. (03/2015)