Final; Occlusion and TMD Flashcards
This is a common subgroup of orofacial pain and disorders
TMD
What are the two types of TMD
myogenous (muscle related)
arthrogenous (joint related)
What is the basis of accurate TMD diagnosis
a good history taking
What are the six cardinal criteria to be considered when diagnosis TMD
pain limitation of function limitation of movement physical changes altered jaw relationships temporomandibular sounds that have been increasing in intensity and frequency
What is the etiology of TMD
normal funtion + an event = physiological tolerance = TMD symptoms
What are three factors that can cause TMD
predisposing factors; increase risk
initiating factors; cause TMD
prepetuating factors; enhance progression of TMD
What are some examples of predisposing factors of TMD
systemic (generalized joint issues), occlusal, loss of posterior teeth
What are some examples of initiating factors of TMD
trauma, parafunctional habits
What are some examples of perpetuating factors of TMD
behavioral, social or emotional stress
What are the five factors associated with TMD
occlusal condition trauma emotional stress deep pain input (referred pain) parafunctional activities
Problems in bringing the teeth together into MI are reflected in what
the muscles
Once the teeth are in occlusion, problems in loading the masticatory structures are reflected in what
the joints
What two things relate occlusion to TMD
introduction of an acute condition
presence of orthopedic instability
This occurs when the stable MI position of teeth is in harmony with the musculoskeletally stable position of the condyles in their fossae
orthopedic stability; mirror definition of CR
What are the two components of parafunctional habits
diurnal parafunctional activity (awake and conscious)
nocturnal parafunctional activity
Is this diurnal or nocturnal parafunctional activity; bruxism
noctural
Is this diurnal or nocturnal parafunctional activity; clenching and grinding, cheek/tongue biting, finger/thumb sucking
durnal
If occlusal interferences created muscle symptoms, then dentistry should care of TMD, but if occlusal interferences are not related to symptoms, then what
the dentist must refrain from providing dental therapies
This type of treatment to stabilize occlusion may be appropriate for TMD patients with occlusal instability and recurrent symptoms
prosthetic rehabilitation
Prosthetic treatment in TMD patients should only be carried out when
after reversible therapy has resulted in the relief of pain and the normalization of function
What are the two types of treatment modalities of TMD
conservative (reversible and non-invasive)
non-conservaative (irreversible); like surgery
This is intended to directly eliminate or alter the cause or disorder and its consequences
definitive treatment
This is directed toward altering the patients symptoms and reducing pain and dysfunction; usually have no effect on the cause of the disorder
supportive therapy
What are two examples of supportive therapy
pharmacologic therapy
physical therapy
This is a removable device, usually made of hard acrylic that fits over the occlusal and incisal surfaces of the teeth of one arch; creates positive occlusal contact with the teeth in opposing arch
occlusal appliance (splint)
What are some examples of occlusal appliances
bite guard
night guard
interocclusal appliance
orthopedic device
What are three uses for occlusal appliances
- temporarily provides a more orthopedically stable joint position
- to introduce an optimum functional occlusion that reorganizes the neuromuscular reflex activity
- to protect teeth and supportive structures from abnormal forces that may cause breakdown or occlusal wear
Research evidence indicated that occlusal appliance therapy is successful in reducing what percentage of TMD symptoms
70-90%
occlusal appliances reduce parafunctional muscle activity, hence reducing what
myogenous pain
Occlusal appliances also reduce forces placed on the TMJs and other structures within the masticatory system, therefore causing these structures to become what, and the associated symptoms decrease
unloaded
What are the five common features to all occlusal appliances
temporary alteration of occlusal condition alteration of condylar position increase in vertical dimension cognitive awareness placebo effect
What are the six types of occlusal appliances
stabilization appliance anterior positioning appliance anterior bite plane posterior bite plane pivoting appliance soft (resilient) appliance
For which arch is are the occlusal appliances typically fabricated for
the maxillary arch; providing optimum functional occlusion for the patient
When the occlusal appliance is in place, what becomes of the condyles
they are in their most musculoskeletally stable position at the time when the teeth are contacting evenly and simultaneously
The primary treatment goal of occlusal appliances is to eliminate what
orthopedic instability
