TMD and Orthodontics A Clinical Guide for the Orthodontist 1st edition by Sanjivan Kandasamy, Charles Greene, Donald Rinchuse, John Stockstill ISBN 3319197821 9783319197821

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ISBN 10: 3319197821
ISBN 13: 9783319197821
Author: Sanjivan Kandasamy, Charles Greene, Donald Rinchuse, John Stockstill

This evidence-based book, featuring contributions from world-renowned experts, discusses in detail the functional anatomy of the temporomandibular joint as well as the aetiology, diagnosis, treatment and medicolegal implications of patients with temporomandibular disorders (TMD).Despite advances in our understanding of the aetiology of TMD and in developing current treatment rationales, a number of issues remain controversial. These include the extent to which the temporomandibular joint should be a central focus of orthodontic diagnosis and treatment, as well as the role that occlusion and malocclusion play in precipitating TMD symptoms. Indeed, few subjects in dentistry and the specialty of orthodontics are open to as many interpretations or misinterpretations as TMD. This textbook provides clinical orthodontists with essential information and guidance that will assist them in understanding and effectively managing this complex multilayered problem. Throughout, clear clinical guidelines are presented on the basis of current scientific and clinical evidence. TMD and Orthodontics will be a highly valuable chairside resource for orthodontists everywhere.

TMD and Orthodontics A Clinical Guide for the Orthodontist 1st Table of contents:

1: Static and Functional Anatomy of the Human Masticatory System

1.1 Occlusal Concepts and Terminology

1.1.1 Review of Occlusion Concepts and Definitions

1.1.2 Terms and Concepts

1.1.3 Mandibular Movement Terminology

1.1.4 Dental Definitions and Concepts

1.1.5 Occlusion Concepts and Definitions

1.2 Masticatory System Anatomy: Concepts and Terminology

1.2.1 Masticatory System

1.2.2 Muscles of Mastication

1.2.2.1 Masseter Muscle

1.2.2.2 Temporalis Muscle

1.2.2.3 Medial Pterygoid Muscle

1.2.2.4 Lateral Pterygoid Muscle

1.2.2.5 Digastric Muscle

1.2.3 Functional Characteristics of the Masticatory Muscles

1.2.4 Anatomy of the Temporomandibular Joints

1.2.4.1 Structural and Functional Characteristics of the Temporomandibular Joint

1.2.5 Biomechanical Principles in TMJ Loading

References

Occlusal Concepts and Terminology

Masticatory System Anatomy – Concepts and Terminology

2: Temporomandibular Disorders: Etiology and Classification

2.1 Introduction

2.2 Etiologic Considerations of Temporomandibular Disorders

2.2.1 The Occlusal Condition

2.2.1.1 An Acute Change in the Occlusal Condition

2.2.1.2 Orthopedic Instability Coupled with Loading

2.2.2 Trauma

2.2.3 Emotional Stress

2.2.4 Deep Pain Input

2.2.5 Parafunctional Activities

2.3 Classification of Temporomandibular Disorders

2.3.1 Masticatory Muscle Disorders

2.3.1.1 Local Muscle Soreness

2.3.1.2 Myofascial Pain

2.3.2 Temporomandibular Joint Disorders

2.3.2.1 Internal Derangements

Etiology of Internal Derangements

2.3.2.2 Osteoarthritis

2.4 Summary of the Continuum of TMJ Intracapsular Conditions

Conclusion

References

3: Screening Orthodontic Patients for Temporomandibular Disorders

3.1 Introduction

3.2 Assessment of Patients Presenting with or Who Develop TMD Symptoms

3.3 Previous and Current TMD Screening Forms or Recommended Protocols

3.4 What to Do If Positive Findings Are Obtained During a Screening Exam?

3.5 What to Do If the Orthodontist Is Consulted Specifically for TMD Issues?

3.6 What to Do If TMD Symptoms Arise During Orthodontic Treatment?

3.7 What to Do If a Patient Develops TMD After Orthodontic Treatment?

References

4: Psychological Considerations

4.1 Introduction and Overview

4.2 TMD as a Biopsychosocial Disorder

4.3 Why Behavior Matters in the Differential Diagnosis of TMD?

4.3.1 Parafunctional Behaviors

4.3.2 Psychological Traits

4.4 Recommendations for Clinical Best Practice

4.4.1 A Behavioral Perspective on Usual TMD Treatment

4.5 Summary

References

5: Sleep Bruxism: What Orthodontists Need to Know?

5.1 Definition of Sleep Bruxism

5.2 Classification of Sleep Bruxism

5.3 Epidemiology

5.4 Risk Factors

5.5 Comorbidities

5.6 Pathophysiology

5.6.1 Sleep Architecture

5.6.2 Catecholamines and Neurochemistry

5.6.3 Stress and Psychosocial influences

5.6.4 Genetic and Familial Predisposition

5.6.5 Local Factors Including Dental Occlusion

5.6.6 Salivary Flow, Airway Patency, and Jaw Motor Activity During Sleep

5.7 Clinical Features of Sleep Bruxism

5.7.1 Tooth Grinding Reports

5.7.2 Tooth Wear

5.7.3 Jaw Muscle Symptoms

5.7.4 Muscle Hypertrophy

5.7.5 Awake Clenching

5.7.6 Headaches

5.7.7 Sleep Disordered Breathing (SDB)

5.7.8 Gastroesophageal Reflux

5.8 Diagnostic Considerations

5.8.1 Clinical Assessment

5.8.2 Ambulatory Monitoring

5.8.3 Sleep Laboratory Recording

5.9 Management of Sleep Bruxism

5.10 The Effects of Sleep Bruxism on Orthodontic Procedures

References

6: Orthodontics and TMD

6.1 Introduction

6.2 Orthodontics and TMD: An Evolution of Controversy

6.3 What Are TMDs? (See Chap. 2)

6.4 Occlusion, Malocclusion, and TMD

6.5 Centric Relation Dilemma

6.6 Functional Occlusion and Orthodontics

6.7 Articulators for Orthodontic Diagnosis

6.8 TMJ Sounds, Internal Derangements, and Orthodontics

6.9 Internal Derangements, Recapturing Discs, and Orthodontics

6.10 TMJ Imaging for Orthodontics

6.11 TMD Informed Consent in Orthodontics

Conclusion

References

7: Idiopathic/Progressive Condylar Resorption: An Orthodontic Perspective

7.1 Introduction

7.2 Sex and Age

7.3 Mechanical Loads

7.4 Orthognathic Surgery as a Risk Factor

7.5 Pathology of the Condyle Undergoing Resorption

7.6 The Role of the TMJ Disc in Development of ICR/PCR

7.7 Survey of Orthodontists About ICR/PCR

7.8 Diagnosis of the ICR/PCR Patient

7.8.1 History

7.8.2 Orthopantogram and Lateral Cephalometric Radiographs

7.8.3 Cone Beam Computed Tomography (CBCT)

7.8.4 Radioisotope Diagnosis

7.8.5 Magnetic Resonance Imaging (MRI)

7.8.6 Occlusal Splints: Diagnostic Aspects

7.9 Timing and Surgical Options for Correction of ICR/PCR

7.10 Rationale for the Use of TMJ TJR in the Surgical Management of End-Stage ICR/PCR

7.11 Case

7.12 Management of the ICR/PCR Patient and Medico-legal Implications

References

8: Management of TMD Signs and Symptoms in the Orthodontic Practice

8.1 General Considerations

8.2 Patient Self-Directed Care and Education

8.3 Home Care Instructions

8.4 Psychological Approaches to Treatment

8.5 Oral Appliances (Splints)

References

9: Surgical Management of Temporomandibular Joint Problems

9.1 Surgical Management of Internal Derangements

9.2 Orthognathic Surgery and the TMJ

9.2.1 Orthognathic Surgery as a Cause of TMJ Problems

9.2.2 Orthognathic Surgery as a Cure for TMJ Problems

Conclusions

References

10: TMD and Its Medicolegal Considerations in Contemporary Orthodontic Practice

10.1 The Standard of Care

10.2 Defining the Duty of Care

10.2.1 Ascertaining the Patient’s Chief Complaint

10.3 The Comprehensive Clinical Examination

10.3.1 The Patient’s Medical, Dental, and Social History

10.3.2 The Examination

10.3.3 Radiographic and Photographic Examination

10.4 Diagnostic Considerations

10.5 Informed Consent

10.6 To Whom Does One Refer?

10.7 Records Management

Conclusion

References

Index

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