title: Thirty-year follow-up of a TMD case treated based on the neuromuscular concept.
abstract: OBJECTIVE
  Occlusal therapy is employed to alleviate the symptoms of a temporomandibular disorder (TMD) at times. However, the long-term effect of occlusal therapy in the masticatory system is not well understood. This case study aims to present a 30-year follow-up of a TMD case.
  
  
  METHODS
  The patient developed TMD with intermittent closed lock of the left temporomandibular joint (TMJ). Chief complaints included trismus, pain, and noise of the left TMJ during function. The patient's occlusal disharmony was assessed with use of electronic instruments and corrected based on the neuromuscular concept. A minimum-invasive and reversible approach using adhesive occlusal restorations was used.
  
  
  RESULTS
  The jaw movement and masticatory muscle activity assessed at the 7- and 23-year follow-ups revealed that the established occlusion was well adapted, and re-established the patient's functional occlusion system. The patient has been free from TMD symptoms with the corrected occlusion for 30 years.
  
  
  CONCLUSIONS
  Occlusal reconstruction based on the neuromuscular concept can be stably integrated into the patient's functional occlusion system.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Yamashita
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Kondo
authors.forename: Junro
authors.initials: J
authors.lastname: Yamashita
mesh_terms: D004576:Electromyography / Q000379:methods; D005157:Facial Pain / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007574:Jaw Relation Record / Q000379:methods; D004204:Joint Dislocations / Q000503:physiopathology / Q000628:therapy; D008335:Mandibular Condyle / Q000503:physiopathology; D008406:Masseter Muscle / Q000502:physiology; D009119:Muscle Contraction / Q000502:physiology; D020247:Myofunctional Therapy / Q000295:instrumentation / Q000379:methods*; D009469:Neuromuscular Junction / Q000502:physiology; D019558:Occlusal Adjustment; D017090:Occlusal Splints; D016059:Range of Motion, Articular / Q000502:physiology; D013703:Temporal Muscle / Q000502:physiology; D013705:Temporomandibular Joint Disorders / Q000503:physiopathology / Q000628:therapy*; D004561:Transcutaneous Electric Nerve Stimulation / Q000379:methods; D014313:Trismus / Q000628:therapy; D055815:Young Adult
keywords: Dental adhesives; Dental occlusion,; Electrocardiography transcutaneous electric nerve stimulation,; Temporomandibular joint disorders,