TMJ Disorders and Orofacial.pdf - E-Lib FK UWKS

Introduction
The dental functional diagnostic procedure determines the functional condition of the structures
of the masticatory system. For patients with functional disturbances it serves to arrive at a specific
diagnosis. For medical and legal reasons, it is necessary for all patients who are facing dental
restorative or orthodontic treatment, even for those who are assumed to have no malfunction.
Often no connection can be established between the clinical findings discovered through conventional
methods (testing of active movements and muscle palpation) and the symptoms reported
by the patient. For that reason, specific manual examination methods for the masticatory system
have gained prevalence during the past 15 years. These focus on the so-called loading vector and
recognize the capacity of biological systems for adaptation and compensation. A cause-targeted
treatment is then indicated only when the caregiver knows which structures are damaged (loading
vector) and the cause of the damage (the harmful influences).
Prosthetics
Tooth preservation
Surgery
Orthodontics
Periodontics
Posture and locomotion
Dental diseases
and trauma
Idiopathic factors
Systemic diseases
Psychosomatic diseases
Psychosocial factors
Changes In the
occlusion
\ 7
Altered
neuromuscular
programming
i
t
Changes In
Intrinsic and
extrinsic factors
Changes in
tooth position
Abrasion
Periodontal lesions
Dyskinesias
Changes in muscle tonus
Disturbances of
coordination
Lesions in the joint
surfaces
Capsulitis
Capsule constriction
Muscle shortening
Myofascial pain
Changes in body
posture
1 Possible causes and consequences
of an altered occlusion
Idiopathic or iatrogenic alterations
of the static or dynamic occlusion
can influence the neuromuscular
programming, and thereby affect
other structures of the masticatory
system. The same sequence of
events can also be precipitated by
intrinsic factors or other extrinsic
factors. Usually during a clinical examination
the changes listed in the
right-hand column receive the
most attention. But to plan a causetargeted
therapy it is necessary to
determine what the specific causes
of the altered neuromuscular programming
are. A differentiated investigation
protocol could set aside
the old superficial philosophical discussion
of the causes of functional
disturbances within the masticatory
system ("occlusion versus psyche")
in favor of an individualized
patient analysis.