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Temporomandibular Disorders: A Problem-Based Approach

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Temporomandibular Disorders: A Problem-Based Approach

Robin Gray, Ziad Al-Ani

ISBN: 978-1-444-34009-9 February 2011 Wiley-Blackwell 224 Pages

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Description

A quick, systematic and logical approach to diagnosing and treating temporomandibular disorders (TMD), this latest book in the Dental Update series is an essential clinical companion for dental students and practising dentists. Starting with an overview of the basic principles of TMD, such as the anatomy of the temporomandibular joint and its physiology and pathology in relation to clinical treatment, the book goes on to present the realities of managing patients, using a case-based approach to help readers understand and engage with the information. Each later chapter presents a different problem in the form of a case study, and each study features a systematic approach to aid learning.

Temporomandibular Disorders: A Problem-Based Approach promotes learning as a dynamic process of active involvement. It encourages valuation by self-assessment with questions at the end of the book, and a unique link to an online interactive quiz where readers can test their knowledge of TMD. The final chapters include practical guides of how to make splints and samples of patient information sheets that can be used as templates. The book is illustrated in full colour, with helpful clinical images and diagrams.

KEY FEATURES

  • Uses a case-based approach to promote effective management of TMD
  • Covers basic scientific background as well as clinical scenarios
  • Addresses not only ‘why’ but also ‘how’ with a highly practical focus
  • Includes a unique link to an online interactive quiz (visit www.wiley.com/go/gray)
  • Contains many full colour clinical images and diagrams

Related Resources

Preface ix

Acknowledgements x

1 About the Book 1

About temporomandibular disorders: what is a ‘TMD’? 1

2 Clinical Aspects of Anatomy, Function, Pathology and Classification 6

The joint anatomy, histology, structure, capsule, synovial membrane and fluid, ligaments 6

The intra-articular disc (meniscus) 10

The bones of the temporomandibular joint 13

Mandibular (jaw/masticatory) muscles 14

Classification and Pathology 24

Further reading 28

3 Articulatory System Examination 29

Examination of the temporomandibular joints 29

Mandibular (masticatory) muscle tenderness 35

Signs of bruxism 39

Further reading 46

4 I’ve Got ‘TMJ’! 47

History 47

Examination 48

Special tests 50

Differential diagnosis 50

Management 51

Further reading 56

5 I’ve Got a Clicking Joint 57

History 57

Examination 58

Other special tests 60

Treatment 66

The patient journey 71

Further reading 72

6 I’ve Got a Locking Joint 74

History 74

Examination 75

Diagnosis 76

Treatment 77

TMJ locking 78

Further reading 80

7 I’ve Got a Grating Joint 81

Examination 81

Diagnosis 82

Treatment 82

Final treatment plan 85

Further reading 88

8 You’ve Changed My Bite 89

History 89

Examination 92

Treatment 92

Discussion 93

Further reading 97

9 I’ve Got Pain in My Face 98

History 98

Examination 99

Differential diagnosis 100

Treatment 103

Questions to ask patients regarding pain in general 104

Further reading 105

10 I’ve Got a Dislocated Jaw 106

Examination 107

Likely diagnoses 107

Management 108

Further reading 110

11 My Teeth Are Worn 111

History 111

Examination 112

Diagnosis 114

Treatment 114

Important considerations in tooth surface loss 116

Further reading 123

12 I’ve Got a Headache 125

Examination 126

Radiographs 126

Articulatory system exam 126

Likely diagnosis 128

Management 129

Patient journey 131

Further reading 131

13 I’ve Got Whiplash 132

Examination 133

Record keeping 134

Are TMD and whiplash related? 134

Likely diagnosis 136

Management 136

Further reading 137

14 What’s of Use to Me in Practice? 138

Counselling and reassurance 138

Drug therapy 139

Physiotherapy 139

Splint therapy 139

Mouth prop 141

Occlusal adjustments 143

Radiographs 145

Further referral 145

Further reading 146

15 You and the Lawyer 148

Case scenario 1: note and record keeping 149

Case scenario 2: a medical report request 151

Case scenario 3: a disgruntled patient 154

Further reading 157

16 The Referral Letter 158

Details 158

History 158

Request 159

Further reading 160

17 How to Make a Splint 161

How do you make a stabilisation splint? 161

Fitting a stabilisation splint 172

How do you make an anterior repositioning splint? 177

Further reading 182

18 Patient Information 183

Stabilisation splint 183

Anterior repositioning splint 183

General advice for patients with a TMD 185

Exercise programme for patients with TMD 185

19 Glossary of Terms 187

Further reading 206

20 Short Answer Questions 207

Index 209