Manual of Temporomandibular Disorders (eBook)

Edward F. Wright, DDS, MS, MAGD, is a professor at the University of Texas Health Science Center-San Antonio (UTHSCSA). He completed a one-year general dentistry residency and the University of Minnesota's two-year TMJ and Craniofacial Pain Fellowship. He taught TMD diagnosis and treatment to more than 100 U.S. Air Force residents in general dentistry, orthodontics, periodontics, and prosthodontics. Upon retiring from the Armed Forces, he completed a two-year research fellowship in TMD diagnosis and treatment at the South Texas Veterans Health Care System and taught TMD diagnosis and treatment to their general dentistry residents. He is now UTHSCSA's Course Director for their predoctoral dental students' TMD Course and Dental Anatomy and Occlusion Course, and teaches TMD to the school's general dentistry, orthodontics, periodontics, and prosthodontics residents. Dr. Wright is the primary author of more than 30 journal articles.

Preface xv

Introduction 1

Part I Initial Evaluation 5

Chapter 1 Patient Interview 11

Chapter 2 Review of the "Initial Patient
Questionnaire" 31

Chapter 3 Clinical Examination 39

Chapter 4 Imaging 71

Chapter 5 TMD Diagnostic Categories 81

Chapter 6 Contributing Factors 97

Part II Common Acute TMD Conditions and Treatments
103

Chapter 7 TMD Secondary to Trauma 105

Chapter 8 TMD Secondary to Dental Treatment 109

Chapter 9 Lateral Pterygoid Spasm 125

Chapter 10 Intermittent and Continuous Forms of TMJ Disc
Displacement without Reduction with Limited Opening 131

Chapter 11 TMJ Subluxation and Luxation 145

Part III Occlusal Appliance Therapy 149

Chapter 12 Stabilization Appliance 153

Chapter 13 Anterior Positioning Appliance 213

Part IV Multidisciplinary Treatment Approach 223

Chapter 14 Self-Management Th erapy 229

Chapter 15 Physical Medicine 247

Chapter 16 Cognitive-Behavioral Intervention 261

Chapter 17 Pharmacological Management 275

Chapter 18 Other Dental Procedures 295

Chapter 19 Integrating Multidisciplinary Therapies 313

Part V Case Scenarios 331

Case 1: Pulpal Pathosis Mimicking TMD Symptoms 333

Case 2: Tooth Pain: No TMD Pain 335

Case 3: Chronic Sinusitis 336

Case 4: Chronic Forehead Pain Referred from the Neck 337

Case 5: Myalgia Secondary to Nocturnal Parafunctional Habits
339

Case 6: Tooth Attrition: No Pain 340

Case 7: Myalgia Secondary to Daytime Parafunctional Habits
341

Case 8: Medial Pterygoid Spasm 342

Case 9: Tension, Depression, and Poor Sleep as Contributing
Factors 343

Case 10: Fibromyalgia as a Contributing Factor 344

Case 11: TMJ Disc Displacements and When to Treat Th em: No Pain
345

Case 12: TMJ Arthralgia 346

Case 13: TMJ Disc Displacement with Reduction with Intermittent
Locking 347

Case 14: TMJ Disc Displacement without Reduction with Limited
Opening: Unlocked 349

Case 15: TMJ Disc Displacement without Reduction with Limited
Opening: Not Unlocked 350

Case 16: Osteitis Causing Inability to Open Wide 353

Case 17: Lateral Pterygoid Spasm 354

Case 18: Acute Exacerbation of TMD 357

Case 19: Multiple Forms of Head and Neck Pain after Crown
Insertion 359

Case 20: Appliance Th at Positioned Condyles into Th eir
"Proper Position" 360

References 362

Part VI Fundamentals of Clinical Studies 365

Appendices 385

Glossary 419

Index 423