TMD dr whitney
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Which imaging tool is relatively non invasive and give a view of internal joint structure with a video camera?
which imaging tool has a higher exposure rate than a pantomogram but gives the most detailed bony structure view, but doesn't provide info about the disc?
Which tool is usually imaged in mouth open and closed positions to provide disc information, and has no radiation exposure but gives limited bone information compared to CT?
T/F Orthopantomogram is one of the diagnostic tools for imaging TMJ problems.
F, not diagnostic, but good for screening, ruling out major pathology, has superimposition of other bone structures
People at risk for TMD include:
history of trauma
more than ___ missing _____ teeth (posterior or anterior)
Over jet greater than ___ mm
CR/CO shift greater than ___ mm
___________ crossbite (posterior or anterior?)
____ (high,low) plane angle Class __ occlusion w/ open bite
- 5 missing posterior teeth
- overjet> 4mm
- CR/CO shift greater than 4mm
- posterior crossbite
- High plane angle Class 2
Patients with what condition complain of headaches, muscle pain and fatigue, and think their bite is "off" but usually is not?
MFPDS (myofascial pain)
What imaging tool should be ordered for a patient with myofascial pain?
Pantomogram to rule out other causes such as cancer, impacted teeth, etc
You have a patient that complains of pain in the TMJ, and upon exam they have clicking, pain to palpation of the TMJ, and upon opening they deviate to one side. What is the diagnosis
Anterior Disc Displacement with reduction
about 1/__ people in the population have ADD w/ reduction, and normally non surgical treatment is recommended. however, if it is very painful, ___________ may be indicated
If you have ADD without reduction on your right side, then you will have problems moving to the ___ side in excursive movements.
Left (or opposite the affective side gives problems)
Although surgery can be indicated, which treatment is most often effective for patients with ADD w/out reduction?
1/_ asymptomatic people have some DJD (osteoarthritis) in the TMJ as they age.
Three clinical findings of DJD are
P___ to __
decreased motion all directions
- 1/6, crepitus
- pain to palpation
an occlusal change to an anterior open bite can be a symptom of ________
what is the imaging ordered for a DJD patient?
TMJ displacement occures when the condyle moves from the ____ over the _____.
what is the acute and long term tx for dislcation
acute tx: repositioning of condyles
- LT: autologous blood injections
In a TMJ arthroscopy procedure, which joint space is inflated, inspected, irrigated and sweeped?
- Superior joint space
- Steroid or narcotic (morphine) are sometimes also injected during this procedure.
Post op care for TMJ arthroscopy includes
No chew diet for ___
NSAIDs for ____
range of motion exercises
splint therapy if indicated
regular follow up
- 1-2 weeks no chew
- NSAIDs 1-2 months
Arthrocentesis has the same indications as for ______
Complications are the same as _______
- same indications as for surgery
- complications same as for arthroscopy (procedure is basically the same but without the camera)
What is a risk of injecting steroids into the superior joint space during arthrocentesis?
joint degeneration, infection
For a patient with common joint dislocation, an option instead of removing the eminence surgically would be what?
autologous blood injections.
what are the two goals of autologous blood injections?
- decrease range of motion
- decrease dislocation episodes
The 4 goals of minimally invasive TMJ surgery
Remove _____ impingement
Provide for s______ m_____
- smooth movement
What are the 3 minimally invasive procedures discussed for TMD
- autologous blood injections
A costochrondral rib graft with aggressive Pys Therapy is the treatment for a child with ______
ankylosis of the condyle
same as for adult but also for adult may do total joint reconstruction and gap arthroplasty
complications of TMJ arthroplasty include injury to which two nerves?
- other comlications
- infection, hypomobility, degenerative joint changes
T/F severe arthritis is an indication for total joint replacement of the TMJ
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