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Tore L. Hansson

~ Temporomandibular joint dysfunction or craniomandibular disorders from a clinical and practical point of view, focusing on TMJ condylar asymmetry when present.

Tore L. Hansson

Monthly Archives: March 2014

Tinnitus and TMD

11 Tuesday Mar 2014

Posted by torelhansson in Condylar asymmetry, dentistry, Functional pain, Mandibular position, Reversible treatment, Temporomandibular joint (a)symmetry, Treatment planning, Uncategorized

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Asymmetry, condylar asymmetry recognition, Dentistry, Occlusal device, Occlusal splint, Oral Stability, Temporomandibular joint disorder, Tinnitus, TMJ rehabilitation, Treatment planning

Tinnitus in itself is not an indication for dental intervention. However,if tinnitus is mentioned at an examination of facial pain of either myogeneous or arthrogeneous origin there may be a chance to influence its existence. After reviewing some records of patients some years ago and present experience it is my opinion that it is about one third of the patients suffering tinnitus and TMD who will notice a reduction or even a total elimination of their tinnitus from oral stability initially from a stabilization splint compensating for a temporomandibular joint vertical condylar asymmetry, when present.

As it was just one third who reported a benefit regarding their tinnitus it must be up to the patient to decide if it is worth while to invest in an oral device fighting tinnitus. Objective information regarding a dubious result should precede the decision. It is also  important to tell the patient that very often the relief from tinnitus does not come immediately after the insertion of the device. It is reported by several patients that it could take a couple of months before they noticed a difference in their tinnitus. In conclusion: When a stabilization splint is being delivered  in trying to influence a tinnitus the patient might have to wear the splint several months before a change occurs  and before one actually knows if it was beneficial or not. 

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Mounting casts

04 Tuesday Mar 2014

Posted by torelhansson in Asymmetry Index TMJ, Condylar asymmetry, dentistry, Occlusal adjustment, Occlusion, Prosthodontics, Retruded Position of the Mandible, Temporomandibular joint (a)symmetry, Tension headache, Treatment planning, Uncategorized

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Asymmetry, Asymmetry Index, Centric relation, condylar asymmetry recognition, Dental laboratory work, Dentistry, Mounting casts, Occlusal adjustment, Occlusal device, Occlusal splint, Occlusion, Oral rehabilitation, Oral Stability, TMJ rehabilitation, Treatment planning

The other day I had to check the mounting of the casts of the upper and lower jaws of a patient with a condylar asymmetry of about 6%. The reason for my visit to the dental laboratory was that the right side lower four units bridge had been redone and several times before that adjusted. And yet the patient found it too low i.e. her teeth of her right side did not contact in occlusion unless she  forced her mandible to the right.

During the visit at the laboratory it became once again obvious to me from the discussions with two well experienced dental technicians that very often the indices to be used in mounting the casts cannot be used. The indices are perforated and mostly show slides in the material used indicating that the mandible of the patient has not been stable at the time of index registration.  Therefore the technicians try to analyze different facets of the occlusal surfaces of the casts. They try to fake the movements of the patients mouth that have created them and thereafter, still manually, they fix the casts in the position which seems to  be the starting point for the suspected movement.This position usually is looked upon as the intercuspal position and will be used for the subsequent mounting of the casts.

At a condylar asymmetry it is therefore easy to understand that with the above described mounting of the casts the crowns or bridges of the ” shorter condyle ” side will be too low. Clinically oral stability will be lacking despite the insertion of the prosthodontic work. Very often tooth contacts of the ” higher condyle  ” side will be looked upon as occlusal interferences and removed in an ” adjustment “.This actually results in a decrease of the vertical dimension and a not one hundred percentage satisfied patient.

The problem and frustration can easily be avoided if the vertical condylar asymmetry is transferred into the Maaxloc instrument. A registration at the clinic or at the laboratory is made  and used in mounting the casts with the result that mostly the prosthodontic work can be inserted  without any adjustment at its delivery.

Recent Posts

  • House of Gnathology part II
  • Splint (Oral Orthosis) Adjustment, A Necessity?
  • Too many adjustments on the dental work?
  • Prefabricated occlusal devices,mouth guards or splints
  • Splint adjustments

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Categories

  • Abused protrusion
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Recent Posts

  • House of Gnathology part II
  • Splint (Oral Orthosis) Adjustment, A Necessity?
  • Too many adjustments on the dental work?
  • Prefabricated occlusal devices,mouth guards or splints
  • Splint adjustments

Recent Comments

torelhansson on House of Gnathology part …
Paul C. Riley, DDS on House of Gnathology part …
torelhansson on Asymmetry Index ( AI ) for tem…
R on Asymmetry Index ( AI ) for tem…
marjan on TMJ Condylar Asymmetry

Archives

  • December 2016
  • January 2016
  • December 2015
  • September 2015
  • August 2015
  • July 2015
  • March 2015
  • February 2015
  • December 2014
  • October 2014
  • June 2014
  • May 2014
  • April 2014
  • March 2014
  • February 2014
  • January 2014
  • December 2013

Categories

  • Abused protrusion
  • Arthrogeneous origin of pain
  • Asymmetry Index TMJ
  • Bruxism
  • Condylar asymmetry
  • dentistry
  • Function & dysfunction of the stomatognathic system
  • Functional pain
  • Gnathology
  • Implantology
  • Mandibular position
  • Myogeneous origin of pain
  • Occlusal adjustment
  • Occlusal device
  • Occlusal splints
  • Occlusion
  • Occlusion
  • Orthodontics
  • Orthopantomogram OPG
  • Orthosis
  • Prosthodontics
  • Retruded Position of the Mandible
  • Reversible treatment
  • Temporomandibular joint (a)symmetry
  • Temporomandibular Joint Clicking and Popping
  • Temporomandibular Joint Disk Displacement
  • Temporomandibular joint morphology
  • Temporomandibular Joint Sounds
  • Tension headache
  • TMD
  • TMJ radiology
  • tooth clenching
  • tooth grinding
  • Treatment planning
  • Uncategorized

Meta

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