37 Year Old Female Conquered TMJ with No Surgery: Optimized Orthotic

37 Year Old Female Conquered TMJ with No Surgery: Optimized Orthotic

Leanna presented to my office with severe masticatory muscle pains.  She also was wearing a lower splint which was not comfortable even after attempting to wear various upper and lower neuromuscular appliances, splints, deprogrammers and bionators. She has seen 35 previous health professionals with not improvement or resolution to her pains.

1. Physiotherapy 4
2. Atlas Orthopedics
3. Massage 3 
4. Colonoscopy Doctor 2
5. Orthodonist 4
6. General Dentist 7
7. Medical Doctor 2
8. Maxiofacial Surgeon 2
9. Peridontist 2
10. Opthamologist 
11. Chiropractor 
12.  TMJ Specialist 2
13. Acupunturist 3
14. Radiologist
15. Psychologist 2
16. Family Medicine
17. MD Rehab. Specialist

When jaw locked Leanna saw numerous specialist (15 doctors). They all recommended orthognathic surgery and or 4 bicuspid removal.

Zygomatic Facial Pain - Occlusion Connections, Clayton A. Chan DDS 1

Orthotics - Occlusion Connections, Clayton A. Chan DDS 2

Orthotics, splints and Bionators - Occlusion Connections, Clayton A. Chan DDS 3

Jaw Restrictions - Occlusion Connections, Clayton A. Chan DDS 4

Posterior open bite - Occlusion Connections, Clayton A. Chan DDS 5

Cervical Neck MVA - Occlusion Connections, Clayton A. Chan DDS 6

Cone Beam Imaging TMJ - Occlusion Connections, Clayton A. Chan DDS 7

MRI TMJ - Occlusion Connections, Clayton A. Chan DDS 8

MRI TMJ - Occlusion Connections, Clayton A. Chan DDS 9

Electrosonograph (ESG): Temporomandibular Joint Sound Analysis

Reveals high frequency low signature patterns mainly on the right temporomandibular joint on late opening and early closing cycles (repeated).  This is indicative of temporomandibular joint degeneration disease (filtered 0-330) using fast fouriet transfer (FFT) analysis.

ESG Before Treatment

Panoramic TMJ - Occlusion Connections, Clayton A. Chan DDS 10

TMJ Medications - Occlusion Connections, Clayton A. Chan DDS 11

Resting Electromyography (EMG) Before Orthodontic/Orthopedic Treatment

The following show the resting EMGs before treatment. Note hyper active cervical group EMGs (LCG/RCG) before myomonitor TENS and persistent high cervical group (LCG/RCG) EMGS after TENS – this is before any treatment. This data has significant implications that were missed and overlooked even by some NM clinicians. Also note low EMGS in temporalis anterior and masseter groups before and after TENSing.

Resting EMGS before Treatment

K7 Jaw Tracking and EMGs - Occlusion Connections, Clayton A. Chan DDS 13

Micro Occlusion - Occlusion Connections, Clayton A. Chan DDS 13

Micro Occlusion - Occlusion Connections, Clayton A. Chan DDS 14

Range of Motion - Occlusion Connections, Clayton A. Chan DDS 15

Posture - Occlusion Connections, Clayton A. Chan DDS 18

Tomograms before and after GNM Orthotic - Occlusion Connections, Clayton A. Chan DDS 19

Kerr's Occlusal Wax - Occlusion Connections, Clayton A. Chan DDS 17

Cervical Dysfunction EMGs and GNM Orthotic - Occlusion Connections, Clayton A. Chan DDS 20

Cervical Dysfunction EMGs and GNM Orthotic - Occlusion Connections, Clayton A. Chan DDS 21

Cervical Dysfunction EMGs and GNM Orthotic - Occlusion Connections, Clayton A. Chan DDS 22

Cervical Dysfunction EMGs and GNM Orthotic - Occlusion Connections, Clayton A. Chan DDS 23

GNM Orthotic 2 - Occlusion Connections, Clayton A. Chan DDS 24

Cervical Dysfunction EMGs and GNM Orthotic - Occlusion Connections, Clayton A. Chan DDS 25

EMGs before and after Orthodontic Orthopedic Treatment

Resting EMGS before and After Ortho

GNM Orthodontics- Occlusion Connections, Clayton A. Chan DDS 25

GNM Orthodontics- Occlusion Connections, Clayton A. Chan DDS 26

ICAT imaging after ortho/orthopedic verticalization – centric occlusion, free of pain and masticatory dysfunction.

L Chan Before and After Ortho - Clayton A. Chan, DDS

ICAT imaging after ortho/orthopedic verticalization – maximum opening with not pain, no restrictions.

L Chan Before and After Ortho 2 Max open - Clayton A. Chan, DDS

GNM Orthodontics- Occlusion Connections, Clayton A. Chan DDS 27

GNM Orthodontics- Occlusion Connections, Clayton A. Chan DDS 28

GNM Orthodontics- Occlusion Connections, Clayton A. Chan DDS 29

Optimal Bite K7 - Occlusion Connections, Clayton A. Chan DDS 30

Functional Clench EMGs Before and After Orthopedic Treatment

Left Window: Before treatment – Functional closure (clenching teeth together) in habitual occlusion before treatment indicates functional impairment and dysfunction (2 repeated natural clenches compared to clenching on wet cotton rolls used as a control).  Patient has masticatory dysfunction and occlusion is not supporting patients jaw function.

Right Window: After orthodontic orthopedic treatment – Functional clench now on orthopedically corrected natural dentition (2 natural clenches vs. 2 cotton rolls over natural corrected teeth used as controls).  Note significantly improve muscles recruitment indicative of physiologic health. Muscles and orthopedically corrected occlusion is now supporting healthy physiologic function.

Functional EMGS before and after treatment

K7 EMGs - Occlusion Connections, Clayton A. Chan DDS 31

K7 Jaw Tracking and ROM - Occlusion Connections, Clayton A. Chan DDS 32

Jaw Tracking before and after TMJ orthodontics - Occlusion Connections, Clayton A. Chan DDS 33

Jaw Tracking and EMGs - Occlusion Connections, Clayton A. Chan DDS 34

To date (10 years after treatment) Leanna continues to live a life of comfort free of TMD pain and discomfort.

  • Initial evaluation and diagnostic work up: February 8, 2005
  • End of Phase 1 Orthotic treatment completed: April 10, 2008
  • Phase 2 Treatment Orthopedic treatment completed: October 24, 2011