Was ist eine Funktionsstörung des Kiefergelenks?
As the research continues to highlight the dangers of sleep disordered breathing and its relevance to dentistry, significant global bodies are joining in the unified appeal for worldwide action, practitioners are having to educate themselves and intervene for the benefit of their patient's health and well being.
For over 30 years, MRC has created simple and effective solutions to address the global demand for a more biological approach rather than mechanical interventions.
Come and join us in the movement to learn more about the global solution for a global problem!
Intra- und extrakapsulär
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Was verursacht TMJ-Störung?
Many dentists think it is just grinding the teeth and advise patients to wear a splint in order to stop teeth grinding, although this is not always a significant factor in TMJ disorder.
Any trauma to the joint is going to cause a TMJ dysfunction. Accidents, falls and whiplash injuries are some of the most common contributors to TMJ disorder. It’s so widespread it can't be just traumatic injury to the joint. It’s understandable that if the jaw sustains a blow, damage can occur, but what about a lifetime of incorrect swallowing patterns and an open mouth posture?
With a correct, normal swallow there is no distilisation of the condyle, but an incorrect swallow and mouth open posture will distilise the condyle twice a minute. This is a substantial source of the trauma to the joint, and a common cause of TMJ disorder.
Patients who display excessive muscle activity (even children) will most likely have the precursor for TMJ disorder. Anything that distilises or pushes the mandible back is going to cause TMJ disorder, and one of the most common causes of this is poor myofunctional habits.
We see these patients also have poor posture. Dr Mariano Rocabado was the first one to discover the association between class II, forward head posture and cranio-cervical issues. These patients (even the younger ones) have poor posture and this can be improved by correcting their swallowing patterns. So you’ll see these patients, children particularly, who have TMJ disorder are very fidgety and they cannot swallow with their head sitting correctly on the spine. A patient exhibiting a normal swallow should display very little back-and-forth rocking movement of the head on the spine. The reverse swallow is quite a severe action and this is why the muscles are in dysfunction all the time - they’re overworking.
Diagnose von Kiefergelenksstörungen
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Die Behandlungsmöglichkeiten
So what are the treatment options? If there aren’t any intra-capsular issues then three-to-six months using the TMJ Appliance™ will resolve a lot of the issues. Generally patients should be reviewed after one and two months to monitor progress. If 50 percent of the patient's symptoms have been relieved, then treatment is working.
So why does it work? It unloads the joint, aligns the jaws, brings the mandible forward, corrects midline shifts, corrects tongue position and stops any poor myofunctional habits. The key point to realise here is that we are focusing on myofunctional issues. The TMJ Appliance™ also prevents tooth grinding, it’s soft, flexible and easy to use.
The TMDAppliance™ (‘D’ for daytime use) was developed as a single-arch, mouldable and removable daytime splint that is also suitable if a patient has some missing teeth, or if they display an intra-capsular issue.
The Bruxogard™ was designed for patients who have problems with teeth grinding (bruxing).
The TMJ-MBV™ (Mouth Breather Version) was designed for patients who snore and have trouble with mouth breathing during sleep. The TMJ-MBV™ has a higher-profile than the TMJ Appliance™, with large breathing holes.
If the patient has used the TMJ Appliance™ for several months and they haven’t had adequate relief from their symptoms, there are a few options available. One option is to custom-make a splint and the other is to do composite build ups. MRC have developed a procedure for composite build ups know as Myolay™. Building up the four lower molars with composite by two to three millimetres can provide good joint decompression and also help to re-align the occlusion.
The clinical diagnosis of TMJ disorder is all about keeping things simple. Combining quality patient education with simple yet effective diagnostic techniques and appliances makes this type of treatment easy to offer in your practice.
Our Myobrace® Patient Education CD-ROM features information, videos, animations and definitions to help doctors explain TMJ disorder to patients.
For more information on TMJ disorder and MRC's TMJ appliances please visit the appliances section of this website or contact your nearest MRC regional office.