## 4 Discussion  
From the data obtained, it can be concluded that  
* The elastodontic device (EQ UNIVERSAL, Eptamed srl Via Ravennate, 979, 47522 Cesena (FC) ITALY) is capable of causing, in patients with temporomandibular disorders, a reduction in muscle tone at rest (scan 9) of the examined muscles (maseter, anterior temporal, digastric and sternocleidomastoid muscles) compared to a standard bite sold in pharmacies that, instead, causes an increase in muscle tension. * The reduction of electromyographic activity with Eptamed is greater in the closed-eye condition than in the open-eye condition when scan 9 is recorded. * No statistically significant difference was assessed during the kinesographic examination at the maximum opening of the mouth in the comparison between the two groups at T0 and T1. * No improvement in the electrical activity of the muscles was observed after 6 months of the use of the standard bite. Following the results obtained from the above-mentioned study, the Eptamed device can be considered as a device to be administered to patients with TMD and orofacial pain before they start orthodontic therapy, as it is able to relax the stomatognathic muscles. These results are in line with the findings of [PERSON] et al. in which, comparing the electromyographic and kinesigraphic examination of two elastodontic devices, it was seen that both ensured muscle relaxation, reducing the risk of TMD(s) development in treated subjects [22]. A few articles in the literature over the years called orthodontic treatment into question as a possible cause of TMD. [PERSON] et al. examined 166 children after orthodontic treatment, and 52% of them manifested signs and symptoms of TMDs [23]. [PERSON] et al. had shown that the development of dysfunction occurred equally in both orthodontically treated and untreated subjects, this means that orthodontic treatment does not always lead to the achievement of a muscular balance [24]. Also, [PERSON] stated that clinical symptoms of joint derangement were noted as occlusions were changed, and he suggested that the various orthodontic forces provided during therapy may predispose patients to temporomandibular joint problems [25]. But, the most emblematic case is a 1987 [PERSON] vs. Malloy Michigan court case [26] in which an orthodontist was ordered to recover damages against a patient who had undergone mismanaged orthodontic treatment that caused her joint problems. [PERSON] and [PERSON] [27] state that orthodontic treatment of patients with TMD is considered radical and maximizes the risk of iatrogenic complications; that is, there is a significant risk of failure. In this regard, guidelines based on the latest scientific evidence were drawn up, and an orthodontist must consider them in clinical practice [28]. In a nutshell, it is required of dentits to conduct a thorough examination and/or screening of TMD (presence of clicks, joint pain or mandibular deviations [29]) during orthodontic consultation and before starting orthodontic treatment both in patients who already have temporomandibular disorders and in healthy patients. However, it is necessary to stop any treatment if symptoms worsen (in patients diagnosed with TMD) or arise (in patients without TMD before treatment). In this way, the orthodontist can avoid both the worsening and the occurrence of TMD due to poorly managed orthodontic treatment. In this circumstance, electromyographic and kinesigraphic examination are essential tools that help the clinician assess whether a neuromuscular balance can be achieved following orthodontic treatment that does not compromise the health of the temporomandibular joint. According to [PERSON] et al., the electromyographic examination is considered an easily reproducible examination, so much so that the instrumentation used and a well-controlled sEMG protocol allow it to be used for longitudinal studies [30].