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Immediate Complete Anterior Guidance Development (ICAGD) Applied to Post-orthodontic Patients with Temporomandibular Disorders: A Single Interventional Study of 50 Cases

Objective: The objective was to test the efficacy of immediate complete anterior guidance development (ICAGD) treatment applied to a select group of postorthodontic temporo-mandibular disorder (TMD) patients with specified myalgic symptoms. Materials and Methods: The symptoms of a carefully selected group of fifty postorthodontic myalgic TMD patients without serious temporomandibular joint disturbances were documented with a 0–10 Visual Analogue Scale, pre and post ICAGD treatment. Bilateral masseter and temporalis muscle activity and relative bite force were measured multiple times before and after treatment. The Mann–Whitney U-test was used to analyze the anamnestic data, and Student's paired t-test was used to analyze all the measured data. Results: Disclusion times were significantly reduced (P = 0.000) as were the posttreatment subjective symptoms (P = 0.0003). The relative force levels clenching in maximum intercuspal position became more equally distributed between the left and right sides after treatment (P < 0.0002), although the total electromyography (EMG) activity during the clenching did not change (P > 0.4940). The left and right lateral excursive EMG activity was significantly reduced after treatment (P < 0.05). Conclusions: The application of ICAGD reduced: (a) the lateral excursive disclusion times, (b) the myalgic reported symptoms, (c) the left–right imbalance of forces during clenching, and (d) the amount of muscular effort during lateral excursions for this group of postorthodontic myalgic TMD patients.