Prosthodontics & Occlusion · single question
A patient presents with an occlusal guard but reports multiple adjustments have not resolved their complaint of 'something wrong with my bite.' What is the MOST appropriate next step?
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Correct answer: C. Refer for TMJ imaging studies (MRI/CT)
When an occlusal guard with multiple adjustments fails to resolve a patient's bite complaint, further diagnostic imaging is warranted. TMJ imaging (MRI for soft tissue/disc assessment, CT/CBCT for bony changes) helps rule out: disc displacement, condylar erosion, tumors, or other structural pathology that cannot be managed with an occlusal appliance. Continuing to adjust without diagnosis perpetuates an unresolved problem.
- A. ❌ More occlusal adjustments without a diagnosis continue the same failed approach.
- B. ❌ Muscle relaxants may provide temporary relief but do not diagnose or address structural pathology.
- C. ✅ CORRECT – When conservative appliance therapy fails, imaging (MRI/CBCT) is the appropriate next diagnostic step to identify structural TMJ pathology.
- D. ❌ Fabricating a new guard without addressing the underlying cause will likely produce the same outcome.
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