Оглавление
Robin J. M. Gray. Temporomandibular Disorders
Table of Contents
List of Tables
List of Illustrations
Guide
Pages
Dedication
Temporomandibular Disorders
Preface to the Second Edition
Acknowledgements
About the Companion Website
1 About the Book. About temporomandibular disorders: what is a ‘TMD’?
About the book
Chapter 2: Clinical aspects of anatomy, function, pathology, and classification
Chapter 3: Articulatory system examination
Chapter 4: I've got ‘TMJ’
Chapter 5: I've got a clicking joint
Chapter 6: I've got a locking joint
Chapter 7: I've got a grating joint
Chapter 8: You've changed my bite
Chapter 9: I've got pain in my face
Chapter 10: I've got a dislocated jaw
Chapter 11: My teeth are worn
Chapter 12: I've got a headache
Chapter 13: I've got whiplash
Chapter 14: What's of use to me in practice?
Chapter 15: You and the lawyer
Chapter 16: The referral letter
Chapter 17: How to make a splint
Chapter 18: Bruxism: Current knowledge of aetiology and management
Chapter 19: Splint therapy for the management of TMD patients: An evidence‐based approach
Chapter 20: Patient information
Appendix I: Flowcharts
Appendix II: Glossary of terms
Appendix III: Short answer questions
2 Clinical Aspects of Anatomy, Function, Pathology, and Classification. The joint anatomy, histology, structure, capsule, synovial membrane, and fluid, ligaments
Histology
The joint capsule
Synovial membrane
Ligaments. The temporomandibular ligament
The stylomandibular ligament
The sphenomandibular ligament
The intra‐articular disc (meniscus)
The bones of the temporomandibular joint. The mandibular condyle
The temporal bone
Innervation of the TMJ
Vascular supply to the TMJ
Mandibular (jaw/masticatory) muscles
Masseter muscle
Function
Parafunction
Examination
The temporalis muscle
Function
Parafunction
Examination
The lateral pterygoid muscle
Function
Parafunction
Examination
Medial pterygoid muscle
Function
Parafunction
Examination
Cervical muscles
Function
Parafunction
Examination
Sternocleidomastoid muscle
Classification and Pathology
Rare conditions
Condylar hyperplasia
Neoplasms
Uncommon conditions
Common conditions
Disc displacement
Myofascial pain
Diagnoses of TMDs
GROUP I: Muscle disorders
GROUP II: DDs
GROUP III: Other common joint disorders
Further Reading
3 Articulatory System Examination
1 Examination of the temporomandibular joints. Range of movement
Pathway of jaw opening
Maxillary and mandibular midlines
TMJ tenderness 2 and 3
Lateral palpation
Intra‐auricular palpation
Examination by manipulation of the mandible
Mandibular (masticatory) muscle tenderness 2. Masseter muscle
Temporalis muscle
Lateral pterygoid muscle
Joint sounds 4. Clicking
Crepitus
Signs of bruxism
Occlusal examination 1
Centric occlusion and centric jaw relation
Anterior guidance
Posterior interferences
Freedom in centric occlusion
Record‐keeping
Further Reading
4 I've Got ‘TMJ’! History
Medical history
Examination 1
Range of movement
Joint sounds
Signs of bruxism
Temporomandibular joint tenderness 2 3
Mandibular muscle tenderness 2
Occlusion 1
Intraoral examination
Special tests
Differential diagnosis
Final diagnosis for Mrs Davies
Management. Explanation and reassurance
Physiotherapy
Soft laser
Acupuncture
Drug therapy
Splint therapy 7
Further Reading
Evidence‐based Dentistry
5 I've Got a Clicking Joint. History
Examination 1
Radiographs
Other special tests
Why do TMJs click? 4
When do TMJs click? 4
Why does the mouth deviate when opening?
What preliminary investigations may you use?
Radiographs
MRI, arthography
What is the most likely diagnosis for Mrs Smith?
Is disc displacement painful?
How should disc displacement with reduction be managed? Does it always need treatment? 5
Treatment. Explanation and reassurance
Physiotherapy
Drug therapy
Anterior repositioning splint 7
The patient journey. History and examination 1
Special tests
Diagnosis
Treatment
Advice and reassurance
Splint treatment 7
Result
Further Reading
Evidence‐based Dentistry
6 I've Got a Locking Joint. History
Examination 1
Radiographs/Imaging
Diagnosis
Treatment
TMJ locking 6
How important is measuring the range of movement? 6
Conclusion
Further Reading
Evidence‐based Dentistry
7 I've Got a Grating Joint
Examination 1
Radiographic examination
Diagnosis
Treatment
Explanation and reassurance
Physiotherapy
Medication
Reduction of contributory predisposing factors
Final treatment plan
What is crepitation? 4
Is osteoarthrosis always associated with pain and crepitus? 4
Radiographic changes
Treatment of pathological sequelae
Invasive treatment. Arthrocentesis
Intra‐articular injection of a steroid
Hyaluronate
Further Reading
Evidence‐based Dentistry
8 You've Changed My Bite. History
Examination 1
Special tests
Treatment
Discussion
How can this conformative approach be adopted practically?
Conclusion
Further Reading
Evidence‐based Dentistry
9 I've Got Pain in My Face. History
Examination 1
Radiographic examination
Differential diagnosis
Neuralgic pain
Treatment
Questions to ask patients regarding pain in general. Site
Character
Severity
Duration and frequency
Onset and time
11
Further Reading
10 I've Got a Dislocated Jaw
Examination 1
Radiographs
Other special tests
Likely diagnoses
Management
Further Reading
Evidence‐based Dentistry
11 My Teeth Are Worn. History
Examination 1
Radiographic examination (Bitewings)
Diagnosis
Treatment
Important considerations in tooth surface loss. Abrasion
Attrition
Parafunction
Management of attrition
Clinical photographs
Dated reference casts (study models)
Silicone index
Determine the cause
Prevent and treat the sensitivity
Treatment options
Categories of tooth surface loss. Category 1
Category 2
Category 3
9
10
Further reading
12 I've Got a Headache
Examination
Radiographs
Articulatory system exam 1
Which muscles are tender?
Why do joints click? 4
Likely diagnosis
Headache
Management
Patient journey
Further Reading
13 I've Got Whiplash
Examination 1
Radiographic examination
Record‐keeping
Are TMD and whiplash related?
Trauma
Physiological
Psychological
Cultural
Likely diagnosis
Management
Drug therapy
Physiotherapy
Further Reading
Evidence‐based Dentistry
14 What's of Use to Me in Practice?
Counselling and reassurance
Drug therapy
Physiotherapy
Splint therapy 7
Mouth prop
Occlusal adjustments
Does orthodontic treatment cause TMD? 12
Restorative treatment, the dentist, and TMD
The use of a facebow and semi‐adjustable articulators
Radiographs
Further referral 13
Further Reading
Evidence‐based Dentistry
15 You and the Lawyer
Case scenario 1: note and record‐keeping
Case scenario 2: a medical report request
Do you get enough information? Have you got the necessary experience?
What will you receive?
You will receive a quantity of notes
Doctor's records
Dentist's records
Walk‐in centre records
Royal Infirmary records
Dental hospital records
Your report
Case scenario 3: a disgruntled patient
Particulars of claim
Particulars of negligence
Particulars of injury
Further Reading
16 The Referral Letter
Details
History
Medical and social history
Request
Further Reading
17 How to Make a Splint 7. How do you make a stabilisation splint?
Facebow registration
Armamentarium (Figure 17.2)
Reference plane locator
Locating and marking a reference point on the patient's face
Taking the facebow registration (assembling the earbow on the patient)
Centric relation record
Fitting a stabilisation splint
How do you make an anterior repositioning splint? 7
Bite registration
Fitting the ARPS
Further reading
18 Bruxism: Current Knowledge of Aetiology and Management. Aetiology of bruxism
Definition of bruxism
Bruxism and TMD
Why bruxism (parafunction) is potentially damaging?
How much evidence about the efficacy of botulinum toxins on bruxism?
How can bruxism be managed? 8
Further reading
Evidence‐based dentistry
19 Splint Therapy for the Management of TMD Patients: An Evidence‐Based Discussion
Stabilisation splint (SS) 7
Are occlusal splints effective for treating sleep bruxism?
Anterior repositioning splint (ARPS) 7
Do occlusal contacts change following splint therapy?
Mandibular advancement/snoring appliances
Further Reading
Evidence‐based Dentistry
20 Patient Information
Stabilisation splint 7
Anterior repositioning splint 7
Use and care of occlusal bite splint 7
General advice for patients with a TMD
Exercise programme for patients with TMD
Vertical movement
Lateral movement
Protrusive movement
Appendix I Flowcharts
Appendix II Glossary of Terms
Further Reading
Appendix III Short Answer Questions
Index
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