Locating Painful Teeth with T-Scan^®

Occlusal Trauma: Case Report

After almost one year post insertion of ceramic crowns on tooth #s 14 and 15 (Figure above), tooth #14 remained painful to chew on since the day of its delivery. Over the year, the practitioner attempted a number of times to adjust this crown but couldn't isolate the contact that was the problem. Inspection of the figure above shows five contacts present on tooth #14 represented by five paper markings; the actual problem contact could not be determined from the paper marks.

Pre-Treatment: T-Scan Findings

Figure 2a - 5.786 sec; MB #14 is orange (moderately forceful)	Figure 2b - 5.886 sec; MB #14 spikes up from orange to pink (very forceful) .122 seconds later

A T-Scan recording was made of the patient clenching and grinding (figures 2a and b) revealed that spiking occurred on the MB contact of tooth #14.

Post-Treatment: Findings after Occlusal Adjustment with T-Scan

Figure 3a - 3.248 sec; MB #14 lessened in forces (green).	Figure 3b - Forces rise only to yellow after .114 sec. The problem contact forces are lessened and the pain is relieved.

Note that tooth #s 2 and 15 are very forceful, before and during, the recorded grinding motion.  But those teeth are not sore or painful to the patient.  As pointed out earlier, often the tooth that is sore is less force than other teeth nearby.

Post adjustment, the new T-Scan III recording illustrates that there is no more spiking up of the MB contact area to the highest forces (Figures 3a and b).

Conclusion

The T-Scan III System can aid the clinician in the isolation of painful teeth that are occlusally activated. By employing a "Clenching and Bruxing" recording that elicits the pain, and locating the spiking of forces within the force movie playback, it becomes simple to identify which contact is the problem contact. After corrective adjustments are accomplished, follow up Clenching and Bruxing recordings will reveal a removal of the spiking of force and noticeable pain relief for the patient.