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OC Clinical Research › Research Findings › GNM Convergence Pilot Study

What this is

The GNM Convergence Pilot Study is an Occlusion Connections (OC) community effort to compile, in one place, what many of us have observed in our own practices for years: that GNM orthotic treatment moves a patient’s K7 measurements toward physiologic norms, and that those measurable changes track with the Patient Subjective Summary scores before and after GNM orthotic treatment.

OC dentists are beginning to compile their cases, treated according to the OC GNM teachings and orthotic adjustment protocols. This page presents the initial findings from the first 23 cases.

Why now

The clinical use of computerized mandibular tracking, electromyography, and joint vibration analysis in TMD diagnosis and treatment has been challenged in the published literature, most prominently by Manfredini and colleagues, who have questioned whether these instrumented measurements reliably distinguish disease states or detect treatment-related change. Cooper and Adib responded with methodological critiques of those studies in 2014, but the broader skeptical position has continued to be cited in TMD literature.

Much of what the neuromuscular and GNM community knows sits inside individual practices — in private files, charts, and decades of careful clinical judgment that has never been assembled anywhere outside our own offices. The intent of this pilot is to begin getting those observations into a durable, shared form before that knowledge is lost.

What we are examining

We use the term “convergence” to describe what we see clinically: when treatment is working, the separate K7 channels tend to move together toward a physiologic norm rather than drifting independently. The pilot is built to document whether that pattern holds up when the data is actually counted. It is framed as a question to examine honestly, not a conclusion to confirm.

EXAMINE  ·  MEASURE  ·  INTERPRET  ·  TREAT  ·  VERIFY

Every case followed the same five steps. The tables below put the Measure and Verify results side by side.

What each case captures

For every case, four K7 channels are recorded before treatment and after, each paired with the patient’s own symptom scores:

Channel What it reads
Scan 2 / Scan 7 Sagittal trajectory and AV ratio (before = Scan 2 in the habitual bite; after = Scan 7 with the GNM orthotic in)
Scan 9 Resting EMG, eight channels
Scan 11 Functional clench EMG — natural clench and cotton-roll clench
Scan 15 ESG joint sounds
Patient Subjective Summary Each symptom self-scored 0–5 (5 = severe), totalled

The initial findings

Chart of 23 cases: each patient's total symptom score before and after GNM orthotic treatment, beside the four K7 channels and closing velocity
Each row is one patient. Left: the patient’s total symptom score, before and after. Right: each K7 channel, before → after, and whether it moved toward, or was at, the physiologic norm.

What the first 23 cases show

Measure Before → after
Patient symptom scores Lower in all 23 cases; median reduction 90%. One case changed very little (−2%).
Resting EMG (Scan 9) Moved toward the OC normative values in 19 of 23
Natural clench (Scan 11) Moved toward the 250 µV norm in 18 of 23
Recruitment gap (Scan 11) Narrowed in 13 of 23
Joint sounds (Scan 15) Normal joint sounds (quiet, or low-amplitude soft-tissue sounds below 300 Hz) in 6 of 23 before treatment, and 15 of 23 after. 17 cases had pathologic high-frequency (>300 Hz) sounds before; 10 of them no longer did after (5 quiet, 5 soft tissue only). One case with quiet joints before (compressed condyles that rotated but did not translate) showed >300 Hz sounds after both condyles were decompressed; here the new sound reflects the disc beginning to move, not a worse joint.
AV ratio (Scan 2 / 7) Group average 0.56 → 0.63 (see below); individual cases vary
Terminal velocity (22 cases) 10 of the 11 that began below 250 mm/s reached 250+; the other 11 were 250+ before and after

Cases where a channel did not move are shown the same as cases where it did. They are part of what the pilot is meant to examine.

The opening path and the 0.618 harmonic reference

The AV ratio expresses the opening path as anterior-posterior movement over vertical movement. In the GNM framework, 0.618 — the golden proportion — is the harmonic reference, corresponding to a path about 58° from the occlusal plane. Each patient’s physiologic AV ratio is read in the context of their own skeletal architecture, so 0.618 is a reference, not a pass/fail line.

Every patient's wide-and-fast opening path before and after treatment, drawn as on the K7 sagittal trace, with the 0.618 reference path
Every patient’s opening path, drawn as on the K7 sagittal trace.
The average opening path before (0.56) and with the GNM orthotic (0.63) against the 0.618 reference path
With the GNM orthotic, the group’s average path moves from 0.56 to 0.63, toward the 0.618 reference path.
Twenty-three small K7-style windows, one per patient, showing the opening path before and after treatment
Each patient individually: 11 moved closer to 0.618 and 12 moved further, consistent with a patient-specific target. A path that moves past 0.618 suggests the joints are not yet fully optimized, even when range of motion improves; the joint sounds (Scan 15) show whether the condyle–disc relationship has normalized.

What this is — and what it is not

The compiled data are offered as clinical documentation, not as a controlled study. They neither prove that GNM orthotic therapy is uniquely effective nor that the K7 is a perfect diagnostic instrument.

This work doesn’t claim to meet methodological standards no one else meets, or even to meet the standards critics demand. It claims something simpler and more empirical: we measure things others don’t measure. We document what we measure. We compile that documentation across OC practices. We make it publicly accessible. We name our limitations honestly. We invite the field to engage with the data on its merits.

Limitations we name plainly:

What comes next

The first step is simply to compile the cases honestly and see what they tell us. This page will be updated as more OC dentists contribute cases. How the study works and how to contribute a case: the study protocol. OC dentists who would like to take part can contact Dr. Clayton Chan at: clayton@drclaytonchan.com.

De-identified case data are available to qualified researchers on request.

Continue Learning

◆ The Evidence Base

◆ The Four K7 Channels

◆ The Optimized Myo-Trajectory and the 0.618 Reference

OC Clinical Research — The GNM Research Group, since 2008

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