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Though not stated in either of the texts in my references, it seems that the issue of teeth being mobile rather than very firm is not addressed.

I assume each author is describing these anatomical findings relative to a dentition of tight teeth.

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A variety of therapies has been described in literature for its management.

The present study is a prospective study carried out to evaluate the efficacy of occlusal splint therapy and compare it with pharmacotherapy (using analgesics and muscle relaxants) in the management of Myofascial Pain Dysfunction Syndrome.

Ironically perhaps, it appears that periodontists could enhance their diagnostic regimen and accuracy if we all gained the necessary training and skill is accurately mounting diagnostic casts on articulators and learned to find the apparent initial contact in the centric relation closure arc of our patients with periodontal disease. Okeson JP: Management of temporomandibular joint disorders and occlusion, ed 4, St Louis, 1998, Mosby.

The best interpretation I can offer is the second molar or molars were the initial contacts and they moved to permit maximum intercuspation.

The marks on the cuspids suggest they were the next in contact when excursions occurred, but they were mobile enough to allow the extensive marking in the patient’s power wiggle.

All the patients were evaluated for GPI, VAS, maximum comfortable mouth opening, TMJ clicking and tenderness during rest and movement as well as for the number of tender muscles at the time of diagnosis, after the 1 week of initiation of therapy and every month for three months of follow-up.

Results: There was a progressive decrease in GPI scores, number of tender muscles, TMJ clicking and tenderness with various jaw movements and significant improvement in mouth opening in patients on occlusal splint therapy during the follow-up period as compared to the pharmacotherapy group.

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