TMD Theories and Philosophy

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Muscular Theory

  • Perspective on muscle balance
  • Examines pain patterns from trigger points
  • Muscle changes do not necessarily involve increased EMG activity – hypomobility,
  • Tight muscles lead to altered TMJ mechanics – altered degenerative changes in joints
  • Malocclusion can result in tight muscles

Psychological Theory

  • Most of the symptoms are due to stress, tension or emotional upset
  • Leads to increased muscular activity
  • Nocturnal bruxism
  • Psychological testing – stress related behavior, anxiety and poor coping skills
  • Eventually bruxism and clenching lead to changes in the dentition and muscles
  • Leading to TMJ disorders, muscular imbalance and eventual malocclusion.

Malocclusion Theory

  • Use of splints to prevent premature contact
  • Relief can be obtained by revising occlusion – Two schools of focus:
  1. Occlusal disharmony causes the muscular dysfunction
  2. TMJ mechanics
  • Cause of premature contact is due to trigger points in the muscles – Relieve muscles before splinting
  • Prolonged dental work, stress or trauma – malocclusion can perpetuate trigger point activity
  • Proprioception/muscle disturbance can cause malocclusion and altered TMJ mechanics

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