Manual of Temporomandibular Disorders

Manual of Temporomandibular Disorders, Third Edition is a handbook of information on temporomandibular disorders and an array of medical and dental conditions that affect the temporomandibular joint (TMJ), masticatory muscles, and contiguous structures. The book provides evidence–based, clinically practical information that allows dentists to diagnose TMD accurately, rule out disorders that mimic TMD (that is, make a differential diagnosis), and provide effective therapy for most patients. This book offers comprehensive coverage in a compact package. In a conversational tone, Dr. Wright focuses on solving TMD problems at chairside. The author’s crisp, engaging writing style allows the clinician to find precise answers quickly, without wading through a morass of detail. Changes to this third edition include: integration of sleep apnea with TMD (including graphs from studies about TMD aggravation and occlusal changes from oral sleep apnea appliances); expansion of the Topical Medications section including new topical medications (including efficacy graphs); expansion of the Nutritional Supplements section (including efficacy graphs); techniques for preventing TMD aggravation from dental treatment; more tables summarizing material; updated patient handouts; revised terminology to correspond with the newly recommended terminology; and completely updated references.

Preface Introduction Part I. Initial Evaluation  Chapter 1.  Patient Interview  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  Chapter 4.  Imaging  Plain Radiographs  Panoramic Radiograph  Axially Corrected Sagittal Tomography  Computed Tomography  Cone Beam Computed Tomography  Magnetic Resonance Imaging  Arthrography  High–Resolution Ultrasound  Imaging Strategies  Imaging Recommendations  Chapter 5.  TMD Diagnostic Categories  TMJ Disorders  Masticatory Muscle Disorders  Headache Disorders  Associated Structures   Chapter 6.  Contributing Factors  Part II. Common Acute TMD Conditions and Treatments  Chapter 7.  TMD Secondary to Trauma  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  Chapter 9.  Lateral Pterygoid Spasm  Chapter 10. Intermittent and Continuous forms of TMJ Disc Displacement without Reduction with Limited Opening  Chapter 11. TMJ  Subluxation and Luxation   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 Thermoplastic Stabilization Appliance  Impak Stabilization Appliance  Dual Laminate Thermoplastic Stabilization Appliance  Soft Thermoplastic Stabilization Appliance  Appliance Management  Chapter 13. Anterior Positioning Appliance  Mandibular Position and Interocclusal Record  Design and Adjustments  Appliance Management  Part IV. Multidisciplinary Treatment Approach  Chapter 14. Self–Management Therapy  Self–Management Instructions  Closure Muscle–Stretching Exercise  Lateral Pterygoid Muscle–Stretching Exercise  Posture Exercises  Breaking Daytime Habits  Chapter 15. Physical Medicine  Muscle Massage  Yoga  Trigger–Point Compression  Trigger–Point Injection  Physical Therapy  Acupuncture  Chiropractics  Magnetic Therapy  Chapter 16. Cognitive–Behavioral Intervention  Breaking Daytime Habits  Relaxation  Hypnotherapy Biofeedback Assisted Relaxation   Stress Management  Chapter 17. Pharmacological Management  Analgesics  Anti–inflammatory Medications  Nonsteroidal Anti–inflammatory Drugs (Ingested Form)   Steroidal Anti–inflammatory Drugs  Muscle Relaxants  Tricyclic Antidepressants  Topical Medications  Nutritional Supplements  Chapter 18. Other Dental Procedures  Occlusal Equilibration  Orthodontic–Orthognathic Therapy  Prosthodontic Therapy  TMJ Surgery and TMJ Implants  Chapter 19. Integrating Multidisciplinary Therapies  Treatment 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  Breaking Daytime Parafunctional, Muscle–Tightening, or Fatiguing Habits Relaxation  Hypnotherapy  Biofeedback Assisted Relaxation  Stress Management  Pharmacological Management  Occlusal Therapy  TMJ Surgery  Integrating Conservative Therapies  TMD Refractory to Initial Therapy  Long–Term Management  Part V. Case Scenarios  Case 1:  Pulpal Pathosis 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 Nocturnal Parafunctional Habits  Case 6:  Tooth Attrition—No Pain Case 7:  Myalgia Secondary to Daytime Parafunctional Habits  Case 8:  Medial Pterygoid Spasm  Case 9:  Tension, Depression, and Poor Sleep as Contributing Factors  Case 10:      Fibromyalgia as a Contributing Factor  Case 11:      TMJ Disc Displacements and When to Treat Them—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,”  Part VI. Fundamentals of Clinical Studies  Designs of and Advice for Performing Clinical Studies  Literature Review  Study Population  Institutional Review Board (IRB) Approval  Developing Study’s Parameters Strengthening your Study  Writing and Submitting Manuscript  Practice–Based Research  Prominent Clinical Study Designs  Case Report  Case Series Study  Cross–Sectional Study  Case–Control Study  Cohort Study  Nonrandomized Clinical Trial Randomized Controlled Trial  Parallel–Group Randomized Clinical Trials  Cross–Over Randomized Clinical Trials  Other Types of Publications You May Want to Consider  Literature Reviews  Systematic Reviews  Meta–analyses  Considerations in Assessing Clinical Trials  Conclusions  Appendices  1.  Referral Criteria for Hygienists  2.  Initial Patient Questionnaire  3.  TMJ  Disc–Condyle Complex Disorders   4.  TMD Self–Management Therapies   5.  Occlusal Appliance Care Instructions   6.  Closure Muscle–Stretching Exercise   7.  Posture Improvement Exercises   8.  Laboratory Stabilization Appliance Instructions  9.  Example of Dental Record Entries  10.  Examples of Physical Therapy Referral  11.  Examples of Psychology Referral  12.  Working with Insurance Companies  13.  Sources for Additional TMD Information  Glossary  Index Files on Accompanying CD Appendices  1. Referral Criteria for Hygienists.doc  2. Initial Patient Questionnaire.doc  3. TMJ Disc–Condyle Complex Disorders.doc  4. TMD Self–Management Therapies.doc  5. Occlusal Appliance Care Instructions.doc  6. Closure Muscle–Stretching Exercise.doc  7. Posture Improvement Exercises.doc  8. Laboratory Stabilization Appliance Instructions.doc  9. Example of Dental Record Entries.doc 10. Examples of Physical Therapy Referral.doc 11. Examples of Psychology Referral.doc 12. Working with Insurance Companies.doc 13. Sources for Additional TMD Information.doc Appendices in Spanish Initial Patient Questionnaire in Spanish.doc TMD Self–Management Therapies in Spanish.doc Occlusal Appliance Care Instructions in Spanish.doc Closure Muscle–Stretching Exercise in Spanish.doc TMD Course Material Part I.ppt Part II.ppt Part III.ppt Part IV.ppt Part V.ppt TMD Course Manual.doc  

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.