Manual of Temporomandibular Disorders

by Edward F. Wright (Assistant Professor, University of Texas Health Science Center, San Antonio)

• ISBN13: 9780813807522
• ISBN10: 0813807522
• Format: Paperback
• Copyright: 2005-02-01
• Publisher: Wiley-Blackwell

Summary

Manual of Temporomandibular Disorders, Second Edition is a four-color, softcover handbook of information on temporomandibular disorders, an array of medical and dental conditions that affect the temporomandibular joint (TMJ), masticatory muscles, and contiguous structures. The book will provide evidence-based, clinically practical information that allows dentists to diagnose TMD accurately, rule out disorders that mimic TMD (that is, make a differential diagnosis), and provide effective therapy for most patients. This title offers comprehensive coverage in a compact package. The book's tone is conversational, with a focus on solving TMD problems at chairside. The author's crisp, engaging writing style allows the clinician to find precise answers quickly, without wading through a morass of detail.

Author Biography

Edward F. Wright, DDS, MS, MAGD, is an assistant professor at the University of Texas Health Science Center–San Antonio (UTHSCSA). He completed a 1-year general dentistry residency and the University of Minnesota’s 2-year TMJ and Craniofacial Pain Fellowship. He taught TMD diagnosis and treatment to more than 100 U.S. Air Force general dentistry, orthodontic, periodontal, and prosthodontic residents. Upon retiring from the Armed Forces and completing a 2-year research fellowship in TMD diagnosis and treatment at the South Texas Veterans Health Care System, he taught TMD diagnosis and treatment to their general dentistry residents. He is now UTHSCSA’s Course Director for their undergraduate dentistry students’ TMD Course and Dental Anatomy and Occlusion Course, and Module Director for their splint therapy rotation. Dr. Wright is the primary author of 23 journal articles and 6 abstracts.

Table of Contents

Preface	xi
Introduction	xiii
Part I. Initial Evaluation	1	(76)
Patient Interview	5	(14)
Review of the ``Initial Patient Questionnaire''	19	(8)
Clinical Examination	27	(27)
Range of Motion	28	(2)
TMJ Noise	30	(2)
Palpation	32	(15)
Intraoral Examination	47	(3)
Additional Evaluations	50	(4)
Imaging	54	(6)
Plain Radiographs	54	(1)
Panoramic Radiograph	55	(1)
Tomography (Corrected Tomography)	56	(1)
Arthrography	56	(1)
Computed Tomography	56	(1)
Magnetic Resonance Imaging	56	(1)
Imaging Recommendations	56	(4)
TMD Diagnostic Categories	60	(12)
TMJ Articular Disorders	61	(6)
Disc Displacement Disorders	61	(3)
Dislocation (Also Known as Subluxation)	64	(1)
Inflammatory Disorders	65	(1)
Osteoarthritis	65	(1)
Ankylosis	66	(1)
Fracture	66	(1)
Congenital or Developmental Disorders	67	(1)
Masticatory Muscle Disorders	67	(5)
Myofascial Pain	67	(1)
Myositis	68	(1)
Myospasm	68	(1)
Myofibrotic Contracture	69	(1)
Local Myalgia	70	(1)
Neoplasia	70	(2)
Contributing Factors	72	(5)
Part II. Common Acute Tmd Conditions and Treatments	77	(38)
TMD Secondary to Trauma	79	(4)
TMD Secondary to Dental Treatment	83	(11)
Medial Pterygoid Muscle Pain	85	(2)
Inability to Close into Maximum Intercuspation	87	(1)
Occlusal Interference Sequelae	88	(2)
Preventing Aggravation from Dental Treatment	90	(1)
Obstructive Sleep Apnea Appliances	91	(3)
Lateral Pterygoid Myospasm	94	(5)
Acute TMJ Disc Displacement without Reduction	99	(12)
TMJ Dislocation	111	(4)
Part III. Occlusal Appliance Therapy	115	(66)
Stabilization Appliance	119	(53)
Mandibular Positions and Bite Registration	121	(3)
Physical Variables	124	(8)
Full or Partial Coverage	124	(1)
Maxillary or Mandibular	125	(2)
Hard or Soft	127	(4)
Thick or Thin	131	(1)
Appliance or Wire Retention	131	(1)
Appliance Adjustments	132	(19)
Internal Adjustments	133	(2)
Internal Reline	135	(3)
External Adjustments	138	(7)
External Reline	145	(3)
Appliance Repair	148	(3)
Appliance Examples	151	(14)
Pressure-cured Mandibular Acrylic Stabilization Appliance	152	(3)
Maxillary Acrylic Stabilization Appliance	155	(3)
Hard Thermoplastic Stabilization Appliance	158	(3)
Soft Thermoplastic Stabilization Appliance	161	(3)
Dual Laminate Thermoplastic Stabilization Appliance	164	(1)
Appliance Management	165	(7)
Anterior Positioning Appliance	172	(9)
Mandibular Position and Bite Registration	174	(1)
Design and Adjustments	175	(1)
Appliance Management	176	(5)
Part IV. Multidisciplinary Treatment Approach	181	(80)
Self-management Therapy	185	(14)
Self-management Instructions	186	(3)
Closure Muscle-stretching Exercise	189	(1)
Lateral Pterygoid Muscle-stretching Exercise	190	(2)
Posture Exercises	192	(1)
Muscle Massage	193	(1)
Trigger-point Compression	193	(1)
Breaking Daytime Habits	194	(5)
Physical Medicine	199	(9)
Muscle Massage	200	(1)
Trigger-point Compression	200	(1)
Trigger-point Injection	200	(1)
Physical Therapy	201	(2)
Acupuncture	203	(1)
Chiropractics	204	(1)
Magnetic Therapy	205	(3)
Cognitive-Behavioral Intervention	208	(11)
Breaking Daytime Habits	212	(2)
Relaxation	214	(1)
Hypnotherapy	214	(1)
Biofeedback	215	(1)
Stress Management	216	(3)
Pharmacological Management	219	(12)
Analgesics	220	(1)
Anti-inflammatory Medications	221	(2)
Nonsteroidal Anti-inflammatory Drugs	221	(2)
Steroidal Anti-inflammatory Drugs	223	(1)
Muscle Relaxants	223	(2)
Tricyclic Antidepressants	225	(1)
Nutritional Supplements	226	(1)
Topical Analgesic Cream	227	(4)
Other Dental Procedures	231	(15)
Occlusal Equilibration	233	(2)
Orthodontic--Orthognathic Therapy	235	(2)
Prosthodontic Therapy	237	(1)
TMJ Surgery and Implants	238	(8)
Integrating Multidisciplinary Therapies	246	(15)
Treatment Summaries and Clinical Implications	246	(6)
Occlusal Appliances	247	(1)
Self-management Therapy	247	(1)
Closure Muscle-stretching Exercise	247	(1)
Posture Exercises	247	(1)
Massage and Trigger-point Compression	247	(1)
Trigger-point Injections	248	(1)
Physical Therapy	248	(1)
Acupuncture	248	(1)
Chiropractics	248	(1)
Magnetic Therapy	249	(1)
Breaking Daytime Parafunctional, Muscle-tightening, or Fatiguing Habits	249	(1)
Relaxation	249	(1)
Hypnotherapy	250	(1)
Biofeedback with Relaxation	250	(1)
Stress Management	250	(1)
Pharmacological Management	250	(1)
Occlusal Therapy	251	(1)
TMJ Surgery	251	(1)
Integrating Conservative Therapies	252	(2)
TMD Refractory to Initial Therapy	254	(1)
Long-term Management	255	(6)
Part V. Case Scenarios	261	(26)
Case 1 Pulpal Pathosis Mimicking TMD Symptoms	263	(1)
Case 2 Chronic Sinusitis	264	(1)
Case 3 Chronic Forehead Pain Referred from the Neck	265	(2)
Case 4 Myofascial Pain Secondary to Nocturnal Parafunctional Habits	267	(1)
Case 5 Tooth Attrition---No Pain	268	(1)
Case 6 Myofascial Pain Secondary to Daytime Parafunctional Habits	269	(1)
Case 7 Tense, Depressed, and Poor Sleep as Contributing Factors	270	(1)
Case 8 Fibromyalgia as a Contributing Factor	271	(1)
Case 9 TMJ Disc Displacements and When to Treat It---No Pain	272	(1)
Case 10 TMJ Inflammation	273	(1)
Case 11 Intermittent Acute TMJ Disc Displacement without Reduction	274	(1)
Case 12 Acute TMJ Disc Displacement without Reduction---Unlocked	275	(1)
Case 13 Acute TMJ Disc Displacement without Reduction---Not Unlocked	276	(2)
Case 14 Osteitis Causing Inability to Open Wide	278	(2)
Case 15 Lateral Pterygoid Myospasm	280	(2)
Case 16 Acute Exacerbation of TMD	282	(1)
Case 17 Multiple Forms of Head and Neck Pain after Crown Insertion	283	(2)
Case 18 Appliance that Positioned Condyles into Their ``Proper Position''	285	(2)
Appendices	287	(28)
1. Initial Patient Questionnaire	289	(4)
2. TMJ Disc Displacements	293	(1)
3. TMD Self-management Therapies	294	(2)
4. Occlusal Appliance Care Instructions	296	(2)
5. Jaw Muscle-stretching Exercise	298	(2)
6. Posture Improvement Exercises	300	(3)
7. Laboratory Occlusal Appliance Instructions	303	(2)
8. Example of Dental Record Entries	305	(2)
9. Examples of Physical Therapy Consultations	307	(2)
10. Examples of Psychology Consultations	309	(2)
11. Working with Insurance Companies	311	(2)
12. Sources for Additional TMD Information	313	(2)
Glossary	315	(4)
Index	319