Protocol

 
 

Protocol for Temporomandibular Joint Dysfunction


 

The following is a brief summary of our office treatment protocol for those patients who desire treatment.

TMJ CONSULT (Visit 1)

This visit will be about one hour long. The following is what one can anticipate
at that consultation.

  • Meeting the Doctor and discuss the problem.
  • A brief screening muscle palpation will be done.
  • The doctor’s assistant will complete an initial screening sonography recording of the joints.
  • The doctor will present a treatment method and options.
COMPREHENSIVE EXAMINATION (Visit 2)

This visit will take on average 3 1/2 hours, over half that time will be with
the doctor.  The following will give you some idea of what will be accomplished
at this visit.

  • Diagnostic casts and mecessary photographs will be taken.
  • Thorough review an complete history of the problem.
  • Medical/dental history.
  • Thorough review of all previous doctors and health care providers recommendations and treatment outcomes.
  • Head and neck examination – including muscle palpation and postural.
  • Occlusal evaluation.
  • TMJ evaluation – sonography (joint sound recordings) reviewed.
  • Periodontal examination.
  • Taking of all necessary radiographs and partial review of all radiographs (panoramic, transcranials, cephalometric, AP coronal townes).
  • Recording of pre-existing dental conditions.
  • A further discussion and interaction with the doctor of treatment options.
NEUROMUSCULAR ANALYSIS (Visit 3)

This visit takes approximately 4 hours.  It involves the recording of jaw movements at rest, in function, before and after TENS.  Data is gathered from EMG
recordings and coordinated with CMS recordings.  A "myo-bite" registration that records accurately that physiologic resting position that is unique to each patient is recorded and verified with the objective data.  The following is a brief outline of the recordings that will be taken.

  • Computerized Mandibular Scan (CMS) – Scan 2, 3, 13.
  • Electromyographic (EMG) Analysis with low frequency TENS – Scan 6, 9, 10, 11.
  • Sonography Analysis/ Range of Motion Analysis – Scan 15, 16.
  • Computerized Neuromuscular (Myo-Bite) registration to determine neuromuscular jaw rest position – Scan 4, 5.
PHASE I THERAPY (Visit 4)

This visit usually takes on average 3 hours.  This visit comprises the delivery of the neuromuscular orthotic appliance.  The neuromuscular orthotic is custom designed to the exact jaw recordings specification that was accomplished at the previous visit.  The computer diagnostics and TENS are also implemented in the refining of the appliance to the patients physiologic resting and functioning musculature.