Temporomandibular Disorders (TMD) and Orthodontic Treatment P2

Question 1

MAJOR THEORIES COVERING THE MECHANISM OF ACTION OF SPLINTS

Answer 1

1. occlusal disengagement
2. vertical dimension
3. maxillomandibular realignment
4. TMJ repositioning
5. cognitive awareness

Question 2

Orthofunction vs Pathofunction

Answer 2

Question 3

Contributory factors

Answer 3

Question 4

Signs of dysfunction

Answer 4

• 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.

Question 5

What is the etiology of headache and facial pain?

Answer 5

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.

Question 6

Structural Position

Answer 6

1. Optimum Condyle / Disk Position
2. Optimum Integrated Muscle Activity
3. Maximal Occlusal Stability

Question 7

TMD MANAGEMENT BEFORE ORTHODONTIC TREATMENT

Answer 7

All patients candidates for orthodontic therapy, independently of the type of malocclusion, must get the same attention during screening.

Question 8

TMD MANAGEMENT BEFORE ORTHODONTIC TREATMENT

SCREENING EXAMINATION

Answer 8

1. No evidence of TMD – Proceed with orthodontic treatment
2. Evidence of TMD – Differential diagnosis
3. Recommend orthodontic treatment – Observe TMD
4. Stabilize TMD before any orthodontic treatment

Question 9

TMD MANAGEMENT BEFORE ORTHODONTIC TREATMENT

Medical History
pecial attention must be given to:

Answer 9

1. inflammatory bone & muscle disorders
2. face and head trauma
3. chronic facial pain

Question 10

TMD MANAGEMENT BEFORE ORTHODONTIC TREATMENT

Clinical Examination

Answer 10

1. Pain
2. Limitations
3. Noises
4. Deviations

Question 11

MAGNETIC RESONANCE IMAGING (MRI)

Answer 11

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.

Question 12

TMD misdiagnosis

Answer 12

A lot of persons who are considered as TMD patients have other problems. They are misdiagnosed because they mimic TMD.

Question 13

Dentists should deal only with

sos

Answer 13

1. TMJ internal derangements of the disc and related structures
2. ” Disorders of the chewing muscles and myogenic type of pain
3. Maybe also with some tension type headaches

Question 14

Dentists should not deal with

sos

Answer 14

1. Neuropathic pain
2. Micraine
3. Cluster headache

Question 15

DISC DISPLACEMENT WITH REDUCTION

Management

Answer 15

Question 16

DISC DISPLACEMENT WITHOUT REDUCTION

Management

Answer 16

Question 17

TMD MANAGEMENT DURING ORTHODONTIC TREATMENT

If severe signs and symptoms of TMD occur during orthodontic therapy:

Answer 17

1. differential diagnosis
2. postponement of treatment
3. corrective tooth movements
4. discontinuation of treatment

Question 18

TMD MANAGEMENT AFTER ORTHODONTIC TREATMENT

If severe signs and symptoms of TMD occur:

Answer 18

1. differential diagnosis
2. multidisciplinary management