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

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Introduction The Role of Dentistry in Craniofacial Pain Polarizing discussions during the past 10 years have made the role of the dentist in diagnosing and treating pain in the head and neck region increasingly obscure rather than more clear. In the academic debate concerning the etiology—predominantly psychological factors versus predominantly occlusal factors-the practitioner facing the problem of treating a patient has been largely ignored. The argument of multicausal genesis was previously taken as an excuse to regard the multiple causes as an inseparable bundle rather than to dispel at least a certain amount of confusion by specifically testing the individual factors. 9 Differential diagnosis of head and neck pains A pain classification scheme modified from those of Bell (1990) and Okeson (1995). The colors of the backgrounds of the different diagnoses indicate which disorders are outside the realm of dental treatment and which require the inclusion of other disciplines for diagnostic assistance or for ruling out certain conditions. In addition, colors indicate which diagnoses can be arrived at through which steps in the dental examination. As clearly shown by the overview, dentistry covers a significant part of the differential diagnosis of head and neck pain. This does not mean, however, that dentistry should be the leading discipline in treating every case of head and neck pain. There are, for example, areas in which the dentist cannot intervene with primary cause-related treatment, or even with interdisciplinary secondary support. The primary goal of a tissue-specific diagnostic process for identification of loading vectors is to differentiate between conditions that can and cannot be treated by a dentist. Except in the latter instance, the decision must then be made whether dentistry is to provide the sole treatment of the diagnosed conditions or is to be part of an interdisciplinary approach. Neuropathic pain Physical pain Continuous pain Episodic pain Deep pain It is our opinion that every patient with head and neck pain should be seen by a dentist in order to clarify the following questions: • Do the symptoms arise from a structure in the masticatory system (presence of a loading vector)? • Is the loading vector related to the occlusion? • Can the occlusion-related portion of the total loading vec tor be reduced with reasonable effort and expense? • Would symptomatic treatment in the dental office be rea sonable? Superficial pain Manual functional analysis Dental primary diagnosis Other disciplines Sympathetic pain * Deafferentation pain Neuritic pain Paroxysmal neuralgia Viscera! pain Mucogingival pain Cutaneous pain Traumatic neuralgia Atypical tooth pain Postherapeutic neuralgia Herpes zoster Peripheral neuritis Neurovascular pain Vascular pain Glandular, ocular, and auricular pain Pulpaf pain Visceral mucosal pain Periodontal pain Connectivetissue pain Ostealgia m6 periosteal pain jyjpaln —
Migraine with aura Migraine without aura Cluster headache Paroxysmal unilateral headache Neurovascular variants Arteritis pain Carotidynia joint surface pain Retrodiscal palm Capsule pain Ligament pain Arthritic pmn Myofascial pain Myositis Muscle spasm Muscle shortening
Page 1 and 2: Color Atlas of Dental Medicine Edit
Page 3: To my sons Philipp and Sebastian, a
Page 6 and 7: VIII lar joint can come from condyl
Page 8 and 9: Foreword Dr Bumann and Dr Lotzmann
Page 10 and 11: XII Preface Medicine and dentistry
Page 13 and 14: Table of Contents vii Forewords xii
Page 15: Table of Contents xvii 231 Check-Bi
Page 18 and 19: Introduction The Masticatory System
Page 20 and 21: Introduction Functional Diagnostic
Page 24 and 25: Primary Dental Evaluation The denta
Page 26 and 27: darily by discomfort in the joints
Page 28 and 29: Anatomy of the Masticatory System A
Page 30 and 31: Embryology of the Temporomandibular
Page 32 and 33: ounding bone. The fibrocartilaginou
Page 34 and 35: However, the maturation process of
Page 36 and 37: while the transforming growth facto
Page 38 and 39: 20 Anatomy of the Masticatory Syste
Page 72 and 73:
54 Manual Functional Analysis The M
Page 74 and 75:
With identification of a specific l
Page 76 and 77:
The reverse side of the examination
Page 78 and 79:
Whenever a pain symptom is reported
Page 80 and 81:
Manual Fixation of the Head In addi
Page 82 and 83:
Active Movements and Passive Jaw Op
Page 84 and 85:
Active Movements and Passive Jaw Op
Page 86 and 87:
Differential Diagnosis of Restricte
Page 88 and 89:
No crepitus no pain Adaptation of t
Page 90 and 91:
In contrast with other definitions
Page 92 and 93:
Crepitus during the protrusive move
Page 94 and 95:
The three possible conditions of th
Page 96 and 97:
Examination of the Joint Capsule an
Page 98 and 99:
Joint-play Techniques 79 189 Hand g
Page 100 and 101:
joint-play Techniques 81 197 Hand g
Page 102 and 103:
Inferior Traction 83 205 Direction
Page 104 and 105:
Regardless of these scientific find
Page 106 and 107:
Examination of the Muscles of Masti
Page 108 and 109:
Palpation of the Muscles of Mastica
Page 110 and 111:
Page 112 and 113:
Page 114 and 115:
Referred Myofascial Pain 95 24A Myo
Page 116 and 117:
Length of the Suprahyoid Structures
Page 118 and 119:
In summary: Clicking sounds in the
Page 120 and 121:
Investigation of Clicking Sounds 10
Page 122 and 123:
Active Movements and Dynamic Compre
Page 124 and 125:
Manual Translations 105 275 Examina
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Dynamic Compression during Retrusiv
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Group 2: Clicking Sounds due to Par
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Group 1 Lateral/medial portion of j
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No clicking sound during medial tra
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Partial or total disk displacement
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La ! Group 3 Cartilage hypertrophy
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Group 4 Disk displacement with term
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Clinical parameters for selection a
Page 142 and 143:
These five techniques provide infor
Page 144 and 145:
Neuromuscular Deprogramming Before
Page 146 and 147:
cle tone. The centric condylar posi
Page 148 and 149:
from this centric occlusion the pat
Page 150 and 151:
can already be excluded. Because po
Page 152 and 153:
teeth to produce the present loadin
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Influence of Orthopedic Disorders o
Page 156 and 157:
Panoramic Radiograph The panoramic
Page 158 and 159:
Muscle tone can only be evaluated b
Page 160 and 161:
Imaging Procedures Imaging procedur
Page 162 and 163:
The panoramic radiograph of the tem
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Panoramic Radiographs of the Tempor
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Distortion Phenomena Distortions in
Page 168 and 169:
Axial Cranial Radiograph Tomography
Page 170 and 171:
Lateral Transcranial Radiograph The
Page 172 and 173:
Computed Tomography of the Temporom
Page 174 and 175:
_______________________ Three Dimen
Page 176 and 177:
Three-Dimensional Models of Polyure
Page 178 and 179:
T1-andT2-Weighting The magnetizing
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Practical Application of MRI Sectio
Page 182 and 183:
Reproduction of Anatomical Detail i
Page 184 and 185:
Classification of the Stages of Bon
Page 186 and 187:
Disk Position in the Frontal Plane
Page 188 and 189:
Morphology of the Pars Posterior Th
Page 190 and 191:
Progressive Adaptation in T1- and T
Page 192 and 193:
Disk Hypermobility Disk hypermobili
Page 194 and 195:
Total Disk Displacement The inciden
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Disk Displacement without Repositio
Page 198 and 199:
Partial Disk Displacement with Part
Page 200 and 201:
Total Disk Displacement with Partia
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Posterior Disk Displacement As a ru
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Regressive Adaptation of Bony Joint
Page 206 and 207:
The capacity for progressive adapta
Page 208 and 209:
Avascular Necrosis Versus Osteoarth
Page 210 and 211:
Metric (Quantitative) MRI Analysis
Page 212 and 213:
Metric MRI Analysis 193 516 MRI of
Page 214 and 215:
Three-Dimensional Imaging with MRI
Page 216 and 217:
provide no significant new diagnost
Page 218 and 219:
Indications for Imaging Procedures
Page 220 and 221:
Mounting of Casts and Occlusal Anal
Page 222 and 223:
Making of Impressions and Stone Cas
Page 224 and 225:
Fabrication of Segmented Casts Segm
Page 226 and 227:
Techniques for Recording the Centri
Page 228 and 229:
tion of the intermaxillary position
Page 230 and 231:
Centric Registration for Intact Den
Page 232 and 233:
posterior teeth, then fine adjustme
Page 234 and 235:
Jaw Relation Determination for Eden
Page 236 and 237:
Attaching the Anatomical Transfer B
Page 238 and 239:
Attaching the Anatomical Transfer B
Page 240 and 241:
Mounting the Maxillary Cast using t
Page 242 and 243:
Mounting the Maxillary Cast followi
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Mounting the Maxillary Cast followi
Page 246 and 247:
Mounting the Mandibular Cast 227 61
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Axiosplit System 229 625 Fastening
Page 250 and 251:
Check-Bite for Setting the Articula
Page 252 and 253:
Occlusal Analysis on the Casts An o
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Occlusal Analysis on the Casts 235
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Occlusal Analysis Using Sectioned C
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Diagnostic Occlusal Reshaping of th
Page 260 and 261:
Diagnostic Occlusal Reshaping of th
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Diagnostic Waxup In addition to dia
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Diagnostic Waxup 245 680 Completed
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One definite disadvantage is that i
Page 268 and 269:
compare movement paths that were dr
Page 270 and 271:
lateral movements serves to determi
Page 272 and 273:
Axiography 253 703 Insertion of the
Page 274 and 275:
Axiography 255 711 Attachment of th
Page 276 and 277:
HIM-: Axiography 257 719 Tracing th
Page 278 and 279:
Axiography 259 727 Recording the me
Page 280 and 281:
Evaluating the Axiograms and Progra
Page 282 and 283:
Effect of an Incorrectly Located Hi
Page 284 and 285:
actual paths of movement within the
Page 286 and 287:
Electronic Paraocclusal Axiograpy 2
Page 288 and 289:
Diagnoses and Classifications The m
Page 290 and 291:
Classification of Secondary Joint D
Page 292 and 293:
Hyperplasia of the Coronoid Process
Page 294 and 295:
Acute Arthritis Acute arthritis can
Page 296 and 297:
Juvenile Chronic Arthritis The term
Page 298 and 299:
Styloid or Eagle Syndrome Elongatio
Page 300 and 301:
Disk Displacement with Condylar Nec
Page 302 and 303:
Tumors in the Temporomandibular Joi
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Osteoarthritis Bony ankylosis ICD.9
Page 306 and 307:
Joint Disorders—Bilaminar Zone an
Page 308 and 309:
Total disk displacement withoyt rep
Page 310 and 311:
Joint Disorders 291 Perforation of
Page 312 and 313:
Sclerosing of lateral ligament Caps
Page 314 and 315:
Joint Disorders—Ligaments Inserti
Page 316 and 317:
Muscle Disorders Muscle Disorders 2
Page 318 and 319:
Muscle Disorders 299 Muscle spasm F
Page 320 and 321:
Principles of Treatment In this boo
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Nonspecific Treatment Nonspecific t
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Manipulative therapy is the essenti
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arch if the inclination of the ante
Page 328 and 329:
Relationship between joint Surface
Page 330 and 331:
Stabilization Splint The main purpo
Page 332 and 333:
Repositioning Splint A repositionin
Page 334 and 335:
-a*| Splint Therapy 315 834 Reduced
Page 336 and 337:
changed by means of restorations fo
Page 338 and 339:
If it has been necessary to perform
Page 340 and 341:
Example 321 854 Occlusal splint the
Page 342 and 343:
Illustration Credits Many of the pi
Page 344 and 345:
Blumenfeld, I., Laufer, D., Livne,
Page 346 and 347:
Hatcher, D. C, Faulkner, M. C, Hay,
Page 348 and 349:
Moffet, B.: Histologic Aspects of T
Page 350 and 351:
Voy, E.-D., Fuchs, M.: Anatomische
Page 352 and 353:
Dworkin, S. F., LeResche, L, von Ko
Page 354 and 355:
Lobbezoo-Scholte, A. M., De Leeuw,
Page 356 and 357:
Shafagh, I., Yoder, J. L, Thayer, K
Page 358 and 359:
Bumann, A., Schroder, C, Melchert,
Page 360 and 361:
Harms S. E., Flamig D. P., Fisher C
Page 362 and 363:
LiedbergJ., Panmekiate, S., Peterss
Page 364 and 365:
Sahm, C, Witt, E.: Long-term result
Page 366 and 367:
References 347 Mounting of Casts an
Page 368 and 369:
Ferrario, V. F., Sforza, C, Gianni,
Page 370 and 371:
Parkhouse, R. C: Medical complicati
Page 372 and 373:
Karolyi, M.: Beobachtungen uber Pyo
Page 374 and 375:
Index abrasion facets 234 adaptatio
Page 376 and 377:
with disk displacement 281 dentin 8
Page 378 and 379:
N nasion relator 251 neck pain 44 d
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