[Clinical aspects of cranio-mandibular disorders. III. Principles of elective therapy]

The therapeutic approaches on 406 patients of both sexes, agent between 9 and 78 (mean age 30.47) and suffering from cranio-mandibular disorders, have been analyzed, in order to evaluate the more frequent measures of treatment and to improve the management of pain and dysfunction of the stomatognathic system. Having confirmed the multifactorial aetiology, an individual treatment plan was worked out. Of the initial therapies, active gymnastics (63.58%), bland aspecific drugs (21.02%), assisted relaxation practices (7.17%) were of particular importance. As occlusion measures, stabilisation splint (44.61%) had precise instruction for use; in case of mandibular dislocation, a repositioning splint was constructed in articulator, in order to achieve a new therapeutic position (30.51%); sometimes, only a vertical dimension increase of previous prosthesis was made (14.35%). The specific symptom profiles of the diagnostic subgroups in which the sample was subdivided induced to adopt considerably different procedures, due to the basic pathology. The final therapy considered above all prosthetic (35.64%) and orthodontic (25.12%) rehabilitations, whether structural changes were necessary; moreover occlusal adjustment (5.64%); only few cases (2.05%) required a surgical consultation. A deliberate choice of conservative approach was evident in a remarkable number of patients (26.15%), treated in an absolutely reversible way.