Prosthetic Management of TMJ Disorders

Transcription

1 Prosthetic Management of TMJ Disorders Mohammed Alfarsi BDS, MDSc(Pros), PhD com.+*()ا&%$ر"!. DrMohdAlfarsi

2 Overview

3 Overview Prosthetic Management of TMJ Disorders Theory : Examination Discussion : Treatment

4 Introduction

5 Introduction What is TMD? - Tempromandibular disorders cover wide range of conditions.

6 Introduction What is TMD? - Tempromandibular disorders cover wide range of conditions. - They can affect any part of the articulatory system, which consists of the TMJ, the muscle of mastications and the occlusion.

7 Introduction What is TMD? - Tempromandibular disorders cover wide range of conditions. - They can affect any part of the articulatory system, which consists of the TMJ, the muscle of mastications and the occlusion. - Any problem that affect one of those parts is likely to affect the others.

8 Introduction What is TMD? - Tempromandibular disorders cover wide range of conditions. - They can affect any part of the articulatory system, which consists of the TMJ, the muscle of mastications and the occlusion. - Any problem that affect one of those parts is likely to affect the others. - Sign and symptoms may include preauricular or facial pain, restriction or alteration of the range of mandibular movement, muscle pain that is worse with function, localized jaw joint pain, jaw joint sounds such as clicking or crepitation, unexplained tooth sensitivity, tooth or restoration fracture, and chronic daily headache.

9 Introduction What is TMD? - Tempromandibular disorders cover wide range of conditions. - They can affect any part of the articulatory system, which consists of the TMJ, the muscle of mastications and the occlusion. - Any problem that affect one of those parts is likely to affect the others. - Sign and symptoms may include preauricular or facial pain, restriction or alteration of the range of mandibular movement, muscle pain that is worse with function, localized jaw joint pain, jaw joint sounds such as clicking or crepitation, unexplained tooth sensitivity, tooth or restoration fracture, and chronic daily headache. - Can affect up to 70% of population. Around 20% develops symptoms, the rest can be subclinical. Only 5% seeks treatment!!

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11 TMD Signs & Symptoms Examination Patients Complaints Treatment

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13 Patients Complaints Facial Pain Headache Locked Joint Clicking Joint Dislocated Jaw Worn Teeth

14 Patients Complaints Clicking Joint

15 Patients Complaints Clicking Joint

16 Patients Complaints Clicking Joint

17 Patients Complaints Clicking Joint

18 Patients Complaints Clicking Joint Disc displacement with reduction

19 Patients Complaints Facial Pain Headache Locked Joint Clicking Joint Dislocated Jaw Worn Teeth

20 Patients Complaints Locked Joint

21 Patients Complaints Locked Joint

22 Patients Complaints Locked Joint

23 Patients Complaints Locked Joint

24 Patients Complaints Locked Joint Disc displacement without reduction

25 Patients Complaints Facial Pain Headache Locked Joint Clicking Joint Dislocated Jaw Worn Teeth

26 Patients Complaints Dislocated Jaw

27 Patients Complaints Dislocated Jaw

28 Patients Complaints Dislocated Jaw

29 Patients Complaints Dislocated Jaw

30 Patients Complaints Facial Pain Headache Locked Joint Clicking Joint Dislocated Jaw Worn Teeth

31 Patients Complaints Worn Teeth

32 Patients Complaints Worn Teeth

33 Patients Complaints Worn Teeth

34 Patients Complaints Facial Pain Headache Locked Joint Clicking Joint Dislocated Jaw Worn Teeth

35 Patients Complaints Facial Pain Headache

36 Patients Complaints Facial Pain Headache

37 Patients Complaints Facial Pain Headache Muscle Tone Muscle Fatigue

38

39 Examination

40 Examination Range of Motion Pathway of Jaw Opening Midline TMJ Tenderness Masticatory Muscle Tenderness Joint Sounds

41 Examination Range of Motion

42 Examination Range of Motion

43 Examination Range of Motion mm 8 mm

44 Examination Range of Motion Pathway of Jaw Opening Midline TMJ Tenderness Masticatory Muscle Tenderness Joint Sounds

45 Examination Pathway of Jaw Opening

46 Examination Pathway of Jaw Opening

47 Examination Pathway of Jaw Opening

48 Examination Range of Motion Pathway of Jaw Opening Midline TMJ Tenderness Masticatory Muscle Tenderness Joint Sounds

49 Examination Midline

50 Examination Midline

51 Examination Midline

52 Examination Range of Motion Pathway of Jaw Opening Midline TMJ Tenderness Masticatory Muscle Tenderness Joint Sounds

53 Examination TMJ Tenderness

54 Examination TMJ Tenderness

55 Examination TMJ Tenderness Lateral Intraauricular

56 Examination Range of Motion Pathway of Jaw Opening Midline TMJ Tenderness Masticatory Muscle Tenderness Joint Sounds

57 Examination Masticatory Muscle Tenderness

58 Examination Masticatory Muscle Tenderness

59 Examination Masticatory Muscle Tenderness Masseter Temporalis Lateral pterygoid

60 Examination Range of Motion Pathway of Jaw Opening Midline TMJ Tenderness Masticatory Muscle Tenderness Joint Sounds

61 Examination Joint Sounds

62 Examination Joint Sounds

63 Examination Joint Sounds

64 Treatment Management of TMD

65 Treatment Management of TMD Physiotherapy Prosthetic Medication Surgical

66 Treatment Management of TMD Prosthetic

67 Treatment

68 Treatment Prosthetic Management of TMD Splints It will provide the patient with an improved occlusion and break any parafunctional habits when he/she wears it, which will lead to relaxation of the muscles and the TMJ.

69 Treatment Prosthetic Management of TMD Splints

70 Treatment Prosthetic Management of TMD Splints Anterior Repositioning Splint - The anterior repositioning splint (ARPS) is a full-coverage splint constructed on the lower arch, which guides the mandible downwards and forwards into a protrusive position to correct the disc condyle incoordination - The aim of the splint is to place the mandible into a new protrusive position for a therapeutic period of time, usually 3 continuous months. Maintaining

71 Treatment Prosthetic Management of TMD Splints

72 Treatment Prosthetic Management of TMD Splints Fabrication - CLINIC: Primary impression for both arches, Bite and Facebow record - LAB: constructs FULL ARCH COVERAGE HARD ACRYLIC splint - CLINIC: Fit it (reline if needed) then adjust the occlusion

73 Treatment

74 Treatment Patients Complaints Facial Pain Headache Locked Joint Clicking Joint Dislocated Jaw Worn Teeth

75 The End

76 The End References