Prosthetic Management of TMJ Disorders

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Prosthetic Management of TMJ Disorders Mohammed Alfarsi BDS, MDSc(Pros), PhD www.drmohdalfarsi.com com.+*()ا&%$ر"!. www Mohd@DrMohdAlfarsi.com @DrMohdAlfarsi DrMohdAlfarsi 056 224 2227

Overview

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

Introduction

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

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.

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.

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.

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!!

TMD Signs & Symptoms Examination Patients Complaints Treatment

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

Patients Complaints Clicking Joint

Patients Complaints Clicking Joint

Patients Complaints Clicking Joint

Patients Complaints Clicking Joint

Patients Complaints Clicking Joint Disc displacement with reduction

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

Patients Complaints Locked Joint

Patients Complaints Locked Joint

Patients Complaints Locked Joint

Patients Complaints Locked Joint

Patients Complaints Locked Joint Disc displacement without reduction

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

Patients Complaints Dislocated Jaw

Patients Complaints Dislocated Jaw

Patients Complaints Dislocated Jaw

Patients Complaints Dislocated Jaw

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

Patients Complaints Worn Teeth

Patients Complaints Worn Teeth

Patients Complaints Worn Teeth

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

Patients Complaints Facial Pain Headache

Patients Complaints Facial Pain Headache

Patients Complaints Facial Pain Headache Muscle Tone Muscle Fatigue

Examination

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

Examination Range of Motion

Examination Range of Motion

Examination Range of Motion 35-42 mm 8 mm

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

Examination Pathway of Jaw Opening

Examination Pathway of Jaw Opening

Examination Pathway of Jaw Opening

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

Examination Midline

Examination Midline

Examination Midline

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

Examination TMJ Tenderness

Examination TMJ Tenderness

Examination TMJ Tenderness Lateral Intraauricular

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

Examination Masticatory Muscle Tenderness

Examination Masticatory Muscle Tenderness

Examination Masticatory Muscle Tenderness Masseter Temporalis Lateral pterygoid

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

Examination Joint Sounds

Examination Joint Sounds

Examination Joint Sounds

Treatment Management of TMD

Treatment Management of TMD Physiotherapy Prosthetic Medication Surgical

Treatment Management of TMD Prosthetic

Treatment

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.

Treatment Prosthetic Management of TMD Splints

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

Treatment Prosthetic Management of TMD Splints

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

Treatment

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

The End

The End References www.wiley.com/go/gray