Parameters of an optimal physiological state of the masticatory system: the results of a survey of practitioners...

While bioelectronic instruments have been available for nearly 30 years to assist dentists in day-to-day evaluations of patients' masticatory systems, little guidance has been published to support physiological norms or ideals. An electronic questionnaire was developed and administered to an international group of dentists familiar with the use of bioelectronic instrumentation. Respondents were asked to provide feedback on the norms or ideal parameters of jaw movement, masticatory muscle function with electromyography, and joint sounds through electrosonography that they use in guiding evaluation and treatment of patients with temporomandibular disorders, neuromuscular occlusion, and orthodontics. Surveys were collated to determine areas of consensus. Out of 150 surveys, 55 responses were received from dentists representing nine different countries. Sixty percent of the respondents reported treating more than 150 cases in the past five years using bioelectronic testing. While experience ranged from 2-30 years with different types of devices, average experience was longer with mandibular/jaw tracking (mean 15.3 years) and electromyography (mean 14.1 years) than with electrosonography (mean 7.0 years). Parameters proposed as norms or ideals for electromyographic rest and clench values, and mandibular tracking (velocity, freeway space, and trajectory to closure) were very consistent. Although a smaller number of respondents reported utilization of electrosonography, their criteria for data significance and tissue-type genesis of joint sounds were consistent. While the intra-patient variability may limit the diagnostic use of bioelectronic instruments, the current study demonstrates that through decades of experience, dentists have independently arrived at very consistent definitions of an ideal physiology that can be used to guide treatment.