Revision-Temporomandibular Disorders (TMD) and Orthodontic Treatment P2 Flashcards
MAJOR THEORIES COVERING THE MECHANISM OF ACTION OF SPLINTS
- occlusal disengagement
- vertical dimension
- maxillomandibular realignment
- TMJ repositioning
- cognitive awareness
Orthofunction vs Pathofunction
Contributory factors
Signs of dysfunction may be the result of
- Signs of dysfunction may be the result of HOW the individual uses the occlusion and not a result of its structural features .
- Thus the term non-physiologic occlusion does not imply cause and effect .
The myogenic factor in the etiology of headache and facial pain.
The myogenic factor in the etiology of headache and facial pain.
- Increased number and more frequent headaches in individuals with few occlusal contacts or unstable occlusion .
- Stress is a perpetuating factor .
Structural Position
- Optimum Condyle / Disk Position
- Optimum Integrated Muscle Activity
- Maximal Occlusal Stability
TMD MANAGEMENT BEFORE ORTHODONTIC TREATMENT
All patients candidates for orthodontic therapy , independently of the type of malocclusion, must get the same attention during screening .
TMD MANAGEMENT BEFORE ORTHODONTIC TREATMENT
SCREENING EXAMINATION
- No evidence of TMD – Proceed with orthodontic treatment
- Evidence of TMD – Differential diagnosis
- Recommend orthodontic treatment – Observe TMD
- Stabilize TMD before any orthodontic treatment
TMD MANAGEMENT BEFORE ORTHODONTIC TREATMENT
Medical History
Special attention must be given to:
- inflammatory bone & muscle disorders
- face and head trauma
- chronic facial pain
TMD MANAGEMENT BEFORE ORTHODONTIC TREATMENT
Clinical Examination
- Pain
- Limitations
- Noises
- Deviations
MAGNETIC RESONANCE IMAGING (MRI)
At present, the only available and logical gold standard to identify the presence or absence of TMD is the evaluation of a patient’s chief complaint , history , clinical examination , and, when indicated, X-rays/MRI .
TMD misdiagnosis
A lot of persons who are considered as TMD patients have other problems. They are misdiagnosed because they mimic TMD.
Dentists should deal only with
sos
- TMJ internal derangements of the disc and related structures
- ” Disorders of the chewing muscles and myogenic type of pain
- Maybe also with some tension type headaches
Dentists should not deal with
sos
- Neuropathic pain
- Micraine
- Cluster headache
DISC DISPLACEMENT WITH REDUCTION
Management
extra