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TMD: Temporomandibular Joint Primary Problems
There are varying degrees of temporomandibular joint dysfunctions. Each one will present with varying degrees of concerns. Most early stages of TMJ often go unrecognized and untreated by most dentists. Click and popping or gratings are certainly NOT normal but clinical indicators that there is an underlying issue. Note: It is important not to have any dentist decrease your vertical height of your teeth if you are at stages II and later. Read more on Class II Division 2 Type Problems.
- Note: a consensus statement by members of a multidisciplinary organization of clinicians who have extensive experience in the diagnosis and treatment of patients with temporomandibular joint (TMJ) arthropathy and associated musculoskeletal disorders have arrived at these guidelines which represents current accepted theory and practice among the membership.
- Wilkes CH: Surgical treatment of internal derangements of temporomandibular joint. Arch Otolarngol Head Neck Surg 117:64, 1991
Read more: Degenerative Joint Disease: Clinical Considerations
The condyle and disc (TM joint) is just one of the many components that can exhibit these break downs in postural mal alignment conditions. In order to help reverse the forces that contribute condylar bone degeneration, disc displacement problems as well as occlusal and muscular strains it is important to decompress the condyles to allow adequate joint space to re-occur in the glenoid fossa. This will require and evaluation by your dentist to see if you have 1) masticatory dysfunctions, 2) joint derangement problems and or 3) pain. The dentist should prudently recognize the various musculoskeletal occlusal signs and symptoms that are all precursors to TMD and orofacial pain problems. A lower removable orthotic appliance is used by many TMJ patients who have experienced various stages of joint conditions to decompress (unload) the joints and compressed discs.
In severe stages of TMJ decompression is always a good principle and guide to follow even if the disc are perforated. Disc reduction (decompression) is the therapeutic medical model, not further compression.
Note: Teeth are the load bearing component of the masticatory system, not the joints. Occlusal equilibration procedures must be re-evaluated as to whether it is positively contributing to joint compression or helping to move the strained TMJ problems toward a decompressed condition.
TM joints become pathologic when occlusal vertical support is lost.
Read More: TMD Problems that Challenge Dentistry – Four Main Categories
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