Oral Medicine TMD

Question 1

Describe how central sensitisation plays a role in TMD

Answer 1

Central sensitisation contributes to continuation of TMD, but not to initial onset of symptoms

Question 2

5

What are the aetiological factors for TMD

Answer 2

Anxiety and Depression
Macro-trauma - Previous trauma to TMJ region
Micro-trauma - clenching and bruxism
Degenerative changes (osteo arthritis)
Neoplastic changes

Question 3

Why is TMD a heterogenous disorder?

Answer 3

the aetiology of the disorder differs between patients. I.e there is no specific factor that contributes to TMD in all cases

Question 4

Why is ear pain associated with TMD?

Answer 4

Brain defers to largest structure - Ear is close to TMJ and is a bigger structure.

Question 5

What is the normal opening range?

Answer 5

36-52mm

Question 6

What is the normal lateral deviation range?

Answer 6

8-12mm

Question 7

What is a michigan splint?

Answer 7

Occlusal splint with anterior ramp so that canine guidance occurs on lateral excursion resulting in an increased vertical dimension

Question 8

What is the goal of an occlusal splint?

Answer 8

• reduce wear on teeth
• prevent over-eruption
• increase vertical dimension to stretch MoM so their power is decreased and ability to clench is lessened
• prevent disc derangement

Question 9

What are the limitations of an occlusal splint?

Answer 9

1. ptn may still clench - splint is foreign body
2. occlusal changes (over eruption) can occur if not full coverage

Question 10

How thick is an occlusal splint typically?

Answer 10

3mm