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Employing Specific Immediate Complete Anterior Guidance Development (ICAGD) Occlusal Adjustment Protocols to Achieve Short Disclusion Time
Abstract
Disclusion Time Reduction (DTR) performed with the Immediate Complete Anterior Guidance Development (ICAGD) coronoplasty, is a well-established computer guided occlusal adjustment treatment protocol for treating the occluso-muscle subset of Temporomandibular Disorders (TMD). ICAGD aims to reduce prolonged duration (time in seconds) occlusal surface friction that occurs between opposing posterior teeth during mandibular excursions when patients normally chew, and when they parafunction. Long duration posterior friction initiates prolonged posterior tooth periodontal ligament fiber compressions and pulpal flexures that together neurally activate and trigger excessive muscle contractions within the masticatory muscles, and the muscles associated with swallowing. This unique neuroanatomy initiates and perpetuates chronic muscular TMD symptomatology, which can be readily resolved with the ICAGD coronoplasty utilizing the T-Scan 10 computerized occlusal analysis system synchronized with the BioEMG III electromyograph. This chapter describes in detail the proper DTR/ICAGD case selection criteria, the procedural T-Scan 10/BioEMG III setup and armamentarium, the step-by-step occlusal and muscular data recording sequences, the ICAGD coronoplasty clinical procedures, the bur positioning guidelines, the optimal ICAGD clinical endpoints, and the necessary post ICAGD follow-up patient care.
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