• About

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: February 2015

TMJ Condylar Asymmetry

21 Saturday Feb 2015

Posted by torelhansson in Asymmetry Index TMJ, Bruxism, Condylar asymmetry, dentistry, Function & dysfunction of the stomatognathic system, Mandibular position, Orthodontics, Prosthodontics, Retruded Position of the Mandible, Temporomandibular joint (a)symmetry, Temporomandibular Joint Disk Displacement, Uncategorized

≈ 1 Comment

Tags

Arthrogeneous origin of TMJ pain, Asymmetry, Asymmetry Index, Centric relation, condylar asymmetry recognition, Dentistry, Oral rehabilitation, Oral Stability, Orthodontics, Retruded Position of the Mandible, Temporomandibular joint diagnostics, Temporomandibular joint disorder, TMJ rehabilitation, Treatment planning

when present,is a must to consider, in any dental rehabilitation. I dare to have this opinion after more than three decades of experience in treating ” asymmetrical ” patients shared with several successful colleagues. Although I repeat my opinion   it seems relevant as we on a regular basis are exposed to excellent crowns, bridges,supra constructions on implants and even completed orthodontics and yet a not satisfied patient.The chosen mandibular position for the rehabilitation in the majority of these patients has not been correct.

Results of recent research performed in different countries indicate that the mechanics of the temporomandibular joint is essential in order to maintain a pain free and functioning stomatognathic system (Quintessence International Symposium, Scottsdale,Arizona February 6-7, 2015). Overloading of the joint seems  not only to jeopardize the intraarticular structures of the joint resulting in anything from internal derangement to osteoarthritis but also to be the trigger for masticatory muscle pain.

At a vertical temporomandibular joint condylar asymmetry the loading of the two joints is in danger as the vertical dimensions of the two condyles are not equal. Therefor the vertical dimensions of the two temporomandibular joint condyles need to be analyzed before any treatment is initiated. It is of utmost importance to determine the highest condyle as at an asymmetry  this condyle has to be the guide for the mandibular movement of  rotation(the Retruded Position of the Mandible)in which the rehabilitation is going to be executed.

Additionally,in patients with functional facial pain it sometimes might be difficult to clinically manipulate the mandible into the correct position for rehabilitation. At such occasions the result of the vertical condylar analysis in the panoramic X-ray easily can be transferred into the Maaxloc device by Dentatus, in which the index for the mandibular position of the planned rehabilitation is made.

Advertisement

TMD 2015, Condylar Asymmetry?

10 Tuesday Feb 2015

Posted by torelhansson in Arthrogeneous origin of pain, Asymmetry Index TMJ, Bruxism, Condylar asymmetry, Function & dysfunction of the stomatognathic system, Functional pain, Mandibular position, Retruded Position of the Mandible, Temporomandibular Joint Clicking and Popping, Temporomandibular Joint Disk Displacement, Temporomandibular Joint Sounds, Treatment planning, Uncategorized

≈ 2 Comments

Tags

Arthrogeneous origin of TMJ pain, Asymmetry, Asymmetry Index, Bruxism, condylar asymmetry recognition, Dentistry, Occlusal device, Retruded Position of the Mandible, Temporomandibular joint diagnostics, Temporomandibular joint disorder, Temporomandibular joint pain, TMJ rehabilitation, Treatment planning

Reflecting back on the interesting information given by eighteen well known international speakers at the Quintessence International Symposium on TMD & FACIAL PAIN and HEADACHE, Bridging the Gap Between Current Research and Clinical Practice in Scottsdale Arizona ( February 6-7,2015, Co-Chaired by Drs Daniel M.Laskin and Charles S.Greene ) I once again would like to stress the importance to recognize a temporomandibular joint condylar asymmetry when present. Several speakers stressed the overloaded temporomandibular joint as the cause of TMD and advised to pay less attention  to the masticatory muscles initially at  the examination of TMD pain. Lack of synovial liquid and mini ruptures or even nano ruptures of the joint tissues are to be looked upon as causes for cartilage degeneration with osteoarthritis / osteoarthrosis as the end result.

It is my opinion that in combination with bruxism a temporomandibular joint condylar asymmetry needs to be acknowledged and addressed. The shorter condyle side joint is in its morphology unstable and easily develops internal derangement of its articulating parts.  The well known phenomenon of disk displacement is thereby a fact and the first step in joint break down with the diagnosis Arthritis microtraumatica art.temp.mand. In this perspective occlusion becomes extremely important . The shorter condyle side joint needs to be supported with the correct vertical dimension of occlusion. What is missing in vertical dimension inside that joint needs to be compensated for at the level of the teeth of the ipsilateral side. In my mind this is the only possibility to create a stable occlusion with the maintenance of improved joint function after the initially reversible approach with an orthotic device.

Finally a statement/question that might need some thoughts: How much longer are we as a profession going to talk about occlusion without considering the vertical dimension of the two temporomandibular joints!?

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

  • Register
  • Log in
  • Entries feed
  • Comments feed
  • WordPress.com

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

  • Register
  • Log in
  • Entries feed
  • Comments feed
  • WordPress.com

Create a free website or blog at WordPress.com.

Privacy & Cookies: This site uses cookies. By continuing to use this website, you agree to their use.
To find out more, including how to control cookies, see here: Cookie Policy
  • Follow Following
    • Tore L. Hansson
    • Already have a WordPress.com account? Log in now.
    • Tore L. Hansson
    • Customize
    • Follow Following
    • Sign up
    • Log in
    • Report this content
    • View site in Reader
    • Manage subscriptions
    • Collapse this bar