Hear from Expert Bio-Dental Engineer John C. Radke

How Temporomandibular Disorders (TMDs) Are Disrupting the Dental Industry

By Brittany Haynes on Sep 23, 2019
The Handbook of Research on Computerized Occlusal Analysis Technology Applications in Dental Medicine, an anticipated title released in July 2019 and edited by Dr. Robert B. Kerstein from Tufts University School of Dental Medicine & Private Dental Practice Limited to Prosthodontics, USA, presents the impact of computerized occlusal analysis technology on both dental occlusal science and daily clinical practice. With this publication’s high influence on the use of advancements such as T-Scan technology, Mr. John Radke, author of the chapter “Adding Technology to Diagnostic Methods,” shares his research on the topic in the IGI Global interview below.

What has inspired you to pursue research activities in your area of expertise?

I worked with and was mentored by one of the true pioneers in the research of temporomandibular disorders (TMDs) back in the 1970s, Dr. Bernard Jankelson, a prosthodontist and great innovator who practiced privately in Seattle, Washington. After he died, I dedicated my career to continuing to follow-up on his research into the causes of and the solutions for TMDs. A second mentor that I encountered in 1985, Prof. Arthur Lewin, a prosthodontist at the University of the Witwatersrand in Johannesburg, South Africa, encouraged me to continue to pursue research into the quantification of masticatory function. This ultimately required the simultaneous precise measurement of jaw motion and masticatory muscle activity. A third mentor, Prof. Takao Maruyama, Chairman of Prosthodontics at the University of Osaka, in Osaka, Japan, established a breakthrough event in 1992 by establishing the first quantitatively effective method to evaluate masticatory motions, the Average Chewing Pattern (ACP).1 My lab continued to pursue this same research approach and by 2000 we added simultaneous electromyographic (EMG) activity to create Average Chewing Cycle (ACC) patterns of several masticatory muscles. The advantage of averaging in both cases is that randomness within the patterns is canceled and the underlying pattern emerges. By recording a large group of very normal subjects we have also been able to reveal the ideal masticatory movement and muscle patterns.

Why are your respective areas of research important to the field at large?

Temporomandibular Disorders are quite common within the population, but consist of at least 38 distinct conditions, many sharing the same symptoms such as headaches, earaches, noisy temporomandibular joints (TMJ), etc. Consequently, TMDs are not easy to diagnose accurately and dentists, who have been given the official responsibility to treat TMDs, are not taught how to do so in dental school. Those providers today who treat TMDs have had to seek that knowledge on their own after graduation. The prevalence of TMDs falls somewhere between 5% to 12% of the population, which means somewhere between 16 and 40 million patients. The difficulty treating TMDs results from the difficulty in determining which of the 38 distinct conditions exists and sometimes the answer is more than one. Thus, the key to the successful treatment is often predicated upon a very accurate diagnosis. Our lab is currently pursuing ideas to create new technologies that will enhance the accuracy of the diagnosis of TMDs.

In your opinion, what are some of the benefits of your research to its community of users?

Our lab has produced a technology that is capable of evaluating vibrations that are recorded from the temporomandibular joints referred to as Joint Vibration Analysis (JVA). Often the dentist user can predict from just the analysis of the vibrations the conditions within the TMJ. In other cases, the analysis indicates to the dentist that an MRI or CBCT is likely to reveal more information about the condition of the joint. Another technology, electrognathography, quickly and inexpensively records the masticatory motions from the incisor teeth by tracking a small magnet placed in the labial vestibule. This is used to calculate the ACP. A compatible electromyograph simultaneously records the muscle activity to create the ACC patterns. Combined, these technologies represent the best method to quickly evaluate the ability of a patient to masticate.

While dentistry is perceived as a kind of cosmetic business by many, a patient’s poor quality of masticatory function or the inability to masticate food properly has wide-reaching consequences. For example, the presence of Irritable Bowel Syndrome (IBS) has been linked to TMDs, which should not surprise anyone because thorough mastication is a required condition for proper digestion. Many patients with symptoms associated with ear pathologies such as tinnitus, earache, etc. do not exhibit any detectable ear pathology because the symptoms are secondary to TMDs. There is also a direct link between sleep apnea and TMDs. It has been manifestly demonstrated that the masticatory system is fully connected with the rest of the body.

How do you feel your publication sets the pace for these innovations?

The most obvious deficit in the area of TMDs is the lack of an educational effort by the dental schools. Graduates do not have any concept of either its diagnosis or treatment. In fact, the universities have tended to pass off TMDs as being mainly psychosomatic and not worthy of physical treatment. The emotional factors have been assumed to be primary by them, whereas one recent study has demonstrated that they are secondary to physical factors.2 We are envisioning that the Handbook of Research on Clinical Applications of Computerized Occlusal Analysis in Dental Medicine will be adopted within the curriculum of some dental schools and that their new graduates will eventually be capable of the diagnosis and treatment of TMDs. As more and more dentists become capable of fully understanding TMDs, we expect the treatment success rate to increase dramatically.

What has your experience been like publishing with IGI Global?

Publishing with IGI Global has been a very positive experience. We have been guided through the very complicated process swiftly and securely by simply following their concise instructions. The response to the first edition was much greater than expected, I think mainly due to the excellent marketing system of IGI Global. The ability to get the book delivered to the world is not less important than the writing of it. As authors, we are very grateful to IGI Global for all of their efforts on our behalf.

1. Kuwahara, T., Miyauchi, S. & Maruyama, T. (1992). Clinical classification of the patterns of mandibular movements during mastication in subjects with TMJ disorders.Int J Prosthodont,, 5(2), 122-9.

2. Thumati P, Sutter B, Kerstein RB, Yiannios N & Radke J. (2018). Changes in Beck Depression Inventory - II Scores of TMD Subjects after Occlusal Treatment. Adv Dent Tech, 1(1), 1 - 13.

IGI Global would like to thank Mr. Radke for sharing his research on computerized occlusal analysis technology. Additionally, for more information about this research, publication, and technology, view the Handbook's comprehensive digital brochure.

About Bio-Dental Engineer John Radke: John C. Radke received his BM degree from Cornish College in Seattle, WA and his MBA degree from the Keller Graduate School of Management, Chicago, IL. He is currently Chairman of the Board of BioResearch Associates, Inc., located in Milwaukee, Wisconsin. Since 1972 he has actively developed electronic and computer software-based diagnostic products for dentistry. These include devices for electronic jaw tracking, temporomandibular joint vibration analysis, electromyography, and TENS. Mr. Radke has lectured nationally and internationally in more than 30 countries. He has published numerous articles on the scientific methods (Fourier series, wavelet transforms, artificial neural networks and genetic algorithms) used for analyzing physiologic measurements such as; 1) vibrations recorded from the temporomandibular joints, 2) electromyographic data from active muscles of mastication and 3) functional and parafunctional jaw movements. He has served as a consultant and reviewer for scientific publications. Mr. Radke is a long-standing member of the International Association for Dental Research and the American Association for the Advancement of Science. He’s an honorary member of the Italian Academy of Electromyography and Kinesiography and Medica Odontologia Craneo-mandibular A. C. of Mexico. Since 1969, he has received numerous patents for his innovative instrument designs.

Mr. Radke's chapter, “Adding Technology to Diagnostic Methods,” and its source title, the Handbook of Research of Computerized Occlusal Analysis Applications in Dental Medicine (3 Volumes), are available throughIGI Global’s Online Bookstoree and world-renownedInfoSci®-Bookss, a database of 5,300+ reference books with over 100,000 full-text chapters focusing on emerging research.

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