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ABSTRACT
It is proposed that damage to the masticatory system from intense parafunction can be assessed more accurately by the Weak Link Theory. The theory predicts that the more intense and the more prolonged the forces, the more the tendency of damage to either. 1. the periodontal tissue; 2. the teeth; or 3. the orofacial structures. To test the theory, 22 subjects were selected based on reports of nocturnal bruxism. Each was assessed for masticatory system breakdown on the Russell Periodontal Index, the Helkimo Dysfunction Index, and a Tooth Wear Index. A Bruxcore (Forgione, A. 1974 J Dent Res 53:127) was used to obtain an objective score of bruxism. Five of eleven subjects with mild bruxism scored high on only one index. Significantly more subjects (ten of eleven) with moderate to severe bruxism scored high on one index only.
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Notes on contributors
Noshir R. Mehta
Dr. Noshir R. Mehta is Professor and Chairman of General Dentistry and Director of the Gelb Orofacial Pain Center at Tufts University School of Dental Medicine. He holds a Diplomate from the American Board of Orofacial Pain and is a Fellow of the International College of Dentists and a Fellow of the American College of Dentists. Since receiving his D.M.D. degree and his M.S. in periodontics at Tufts, he has been involved in occlusion research. Dr. Mehta has lectured internationally on TMD/MPD and has published numerous scientific papers.
Albert G. Forgione
Dr. Albert G. Forgione is Chief Clinical Consultant of the Gelb Orofacial Pain Center at Tufts University School of Dental Medicine. He received a Ph.D. in psychology from Boston University. Dr. Forgione then joined Tufts and lectured in Behavioral Medicine. He has authored two books and several papers. He started the TMJ Center at Tufts with Dr. Mehta in 1978.
George Maloney
Dr. George Maloney graduated Magna Cum Laude, Phi Beta Kappa from the University of Massachusetts at Amherst with a B.S. in biology. He received his D.M.D. from the University of Pennsylvania and he completed a General Practice Residency at Worcester City Hospital. In 1990, he completed a program in the study of temporomandibular disorders and orofacial pain at the Gelb Orofacial Pain Center. He is currently an Associate Clinical Professor at the center. His research interests include TMD-related ear pain, tinnitus, and headache. Dr. Maloney is a Diplomate of the American Board of Orofacial Pain.
Richard Greene
Dr. Richard A. Greene received his B.A. from Clark University and his D.M.D. degree and TMJ certification from Tufts University. After completing the Tufts TMJ certificate program in 1990, Dr. Greene stayed on as a faculty member and is now Assistant Clinical Professor at the Gelb Center at Tufts. Dr. Greene has maintained a private general dentistry practice in Cambridge, Massachusetts since 1973. His practice emphasizes treatment of patients with temporomandibular joint and orofacial pain disorders. He has lectured extensively and has published and conducted research in the field of TMD. Dr. Greene is a Diplomate of the American Board of Orofacial Pain.