Descripción
Fully updated with the latest information in the field, this comprehensive book provides a practical guide to diagnosing and managing temporomandibular disorders in the dental practice. Written in an accessible, user-friendly style, it offers a simplified approach to the basic concepts and management decision points for the most commonly observed temporomandibular conditions, integrating the latest advances and advice throughout. Quick Consult, Focal Point, and Technical Tip boxes provide quick access to relevant information, and study results are summarized in graphs for ease of comprehension.
Manual of Temporomandibular Disorders, Fourth Edition examines an array of medical and dental conditions that affect the temporomandibular joint (TMJ), masticatory muscles, and contiguous structures. It presents evidence-based, clinically practical information to help dentists diagnose TMD accurately, rule out disorders that mimic TMD, and provide effective therapy for most patients.
Special features include:
- Frequently Asked Questions
- Quick Consults, Technical Tips, and Focal Points
- Information on disorders that mimic TMD and factors that warrant referral
- Extensive color photographs and line drawings
- A companion website providing helpful examples and patient handouts
Manual of Temporomandibular Disorders, Fourth Edition is a must-have how-to manual for general dentists, dental students, and residents involved in this area of practice.
Preface
About the Companion Website
Introduction
Part I Initial Evaluation
Chapter 1 Patient Interview
Summary
References
Chapter 2 Review of the “Initial Patient Questionnaire”
Chapter 3 Clinical Examination
Range of Motion
TMJ Noise
TMD Palpations
Intraoral Examination
Occlusal Changes
TMD Pain Caused by a Tooth
Tooth Pain without Local Pathology
Additional Evaluations
References
Chapter 4 Imaging
Plain Radiographs
Panoramic Radiograph
Axially Corrected Sagittal Tomography
Computed Tomography (CT)
Cone Beam Computed Tomography (CBCT)
Magnetic Resonance Imaging (MRI)
Arthrography
Ultrasound
Imaging Strategies
Imaging Recommendations
References
Chapter 5 TMD Diagnostic Categories
TMJ Disorders
Joint Pain
Joint Disorders
Joint Diseases
Fractures
Congenital/Developmental Disorders
Masticatory Muscle Disorders
Muscle Pain Limited to the Orofacial Region
Contracture
Hypertrophy
Neoplasm
Movement Disorders
Masticatory Muscle Pain Attributed to Systemic/Central Disorders
Headache Disorders
Headache Attributed to TMD
Associated Structures
Coronoid Hyperplasia
References
Chapter 6 Contributing Factors
References
Part II Common Acute TMD Conditions and Treatments
Chapter 7 TMD Secondary to Trauma
References
Chapter 8 TMD Secondary to Dental Treatment
Preventing Aggravation from Dental Treatment
Medial Pterygoid Muscle Pain
Inability to Close into Maximum Intercuspation
Occlusal Interference Sequelae
Obstructive Sleep Apnea Appliances
References
Chapter 9 Lateral Pterygoid Spasm
References
Chapter 10 Intermittent and Continuous Forms of TMJ Disc Displacement without Reduction with Limited Opening
Intermittent Disorder (Disc Displacement with Reduction with Intermittent Locking)
Continuous Disorder (Disc Displacement without Reduction with Limited Opening, Also Known as Closed Lock)
References
Chapter 11 TMJ Subluxation and Luxation
References
Part III Occlusal Appliance Therapy
Chapter 12 Stabilization Appliance
Mandibular Positions and Interocclusal Record
Physical Variables
Full or Partial Coverage
Maxillary or Mandibular
Hard, Intermediate, or Soft Material
Thick or Thin
Appliance or Clasp Retention
Summary of Physical Variables
Appliance Adjustments
Internal Adjustments
Internal Reline
External Adjustments
External Reline
Appliance Repair
Appliance Examples
Pressure-Cured Mandibular Acrylic Stabilization Appliance
Maxillary Acrylic Stabilization Appliance
Hard Thermomolded Stabilization Appliance
Impak Stabilization Appliance
Dual Laminate Thermomolded Stabilization Appliance
Soft Thermomolded Stabilization Appliance
Appliance Management
References
Chapter 13 Anterior Positioning Appliance
Mandibular Position and Interocclusal Record
Design and Adjustments
Appliance Management
References
Part IV Multidisciplinary Management Approach
Chapter 14 Self-Management Therapy
Self-Management Instructions
Closure Muscle-Stretching Exercise
Lateral Pterygoid Muscle-Stretching Exercise
Posture Exercises
Controlling Awake Behaviors
References
Chapter 15 Physical Medicine
Muscle Massage
Yoga
Trigger-Point Compression
Trigger-Point Injection
Botulinum ToxinPhysical Therapy
Acupuncture
Chiropractics
References
Chapter 16 Cognitive-Behavioral Intervention
Controlling Awake Behaviors Relaxation
Hypnotherapy (Hypnosis)
Biofeedback Assisted Relaxation
Stress Management
References
Chapter 17 Pharmacological Management
Analgesics
Anti-Inflammatory Medications
Nonsteroidal Anti-Inflammatory Drugs (Ingested Form)
Steroidal Anti-Inflammatory Drugs
Muscle Relaxants
Anticonvulsants
Tricyclic Antidepressants
Topical Medications
Over-the-Counter Topical Medications
Prescription Topical Medications
Nutritional Supplements
References
Chapter 18 Other Dental Procedures
Occlusal Equilibration
Orthodontic–Orthognathic Therapy
Prosthodontic Therapy
TMJ Surgery and Implants
References
Chapter 19 Integrating Multidisciplinary Therapies
Management Summaries and Clinical Implications
Self-Management Therapy
Massage and Trigger-Point Compression
Lateral Pterygoid Muscle-Stretching Exercise
Closure Muscle-Stretching Exercise
Posture Exercises
Occlusal Appliances
Physical Therapy
Yoga
Trigger-Point Injections
Acupuncture
Chiropractics
Magnetic Therapy
Controlling Awake Parafunctional, Muscle-Tightening, or Fatiguing Behaviors
Relaxation
Hypnotherapy (Hypnosis)
Biofeedback-Assisted Relaxation
Stress Management
Pharmacological Management
Occlusal Therapy
TMJ Surgery
Integrating Conservative Therapies
TMD Refractory to Initial Therapy
Long-Term Management
References
Part V Case Scenarios
Case 1: Symptomatic Irreversible Pulpitis Mimicking TMD Symptoms
Case 2: Tooth Pain: No TMD Pain
Case 3: Chronic Sinusitis
Case 4: Chronic Forehead Pain Referred from the Neck
Case 5: Myalgia Secondary to Sleep Parafunctional Behaviors
Case 6: Tooth Attrition: No Pain
Case 7: Myalgia Secondary to Awake Parafunctional Behaviors
Case 8: Medial Pterygoid Spasm
Case 9: Personal Stressors and Sleep Disturbances as Contributing Factors
Case 10: Fibromyalgia as a Contributing Factor
Case 11: TMJ Disc-Condyle Complex Disorders and When to Provide Therapy: No Pain
Case 12: TMJ Arthralgia
Case 13: TMJ Disc Displacement with Reduction with Intermittent Locking
Case 14: TMJ Disc Displacement without Reduction with Limited Opening: Unlocked
Case 15: TMJ Disc Displacement without Reduction with Limited Opening: Not Unlocked
Case 16: Osteitis Causing Inability to Open Wide
Case 17: Lateral Pterygoid Spasm
Case 18: Acute Exacerbation of TMD
Case 19: Multiple Forms of Head and Neck Pain after Crown Insertion
Case 20: Appliance That Positioned Condyles into Their “Proper Position”
References
Part VI Fundamentals of Clinical Studies
Prominent Clinical Study Designs
Case Report
Case Series Study
Cross-sectional Study
Case-control Study
Cohort Study
Nonrandomized Clinical Trial
Randomized Controlled Trial (RCT)
Parallel-Group Randomized Clinical Trials
Cross-Over Randomized Clinical Trials
Other Types of Publications Literature Reviews
Systematic Reviews
Meta-analyses
Clinical Practice Guidelines
Considerations in Assessing Clinical Trials
Conclusions
References
Appendices on Website
Appendix 1 Referral Criteria for Hygienists
Appendix 2 Initial Patient Questionnaire
Appendix 3 TMJ Disc–Condyle Complex Disorders
Appendix 4 TMD Self-Management Therapies
Appendix 5 Occlusal Appliance Care Instructions
Appendix 6 Closure Muscle-Stretching Exercise
Appendix 7 Posture Improvement Exercises
Instructions
Exercises
Appendix 8 Laboratory Stabilization Appliance Instructions
Maxillary or Mandibular Impak Stabilization Appliance
Maxillary or Mandibular 0.15-in. Soft Thermoplastic Appliance or Dual Laminate Thermoplastic Stabilization Appliance
Maxillary or Mandibular 2-mm Hard Thermoplastic Appliance or Acrylic Stabilization Appliance
Appendix 9 Example of Dental Record Entries
Initial Exam
Insertion Appointment
Follow-Up
Follow-Up
Appendix 10 Examples of Physical Therapy Referral
Appendix 11 Examples of Psychology Referral
Appendix 12 Sources for Additional TMD Information
Patient Brochures and Book
Patient Advocacy Group
TMD Practice Management Businesses
Practitioners with TMD Expertise and Fellowship Programs
Professional TMD Organizations
TMD Textbooks
TMD Journals
Glossary
Index
Edward F. Wright, DDS, MS, is a Professor in the Department of Comprehensive Dentistry at the University of Texas Health Science Center-San Antonio (UTHSCSA) in San Antonio, Texas, USA.
Gary D. Klasser, DMD, is a Professor in the Department of Diagnostic Sciences at Louisiana State University, School of Dentistry, as well as the Director of the LSU Orofacial Pain Continuum in New Orleans, Louisiana, USA.