TMD / TMJ Equipment
The tools of TMD /TMJ Therapy
Why do you need Biometric Tools for treating TMD / TMJ?
Just as there is a need for biometric measurement in all other health care professions, dentists too need to be measuring, monitoring, and marking the course of treatment with their TMD /TMJ patients.
Real time measurement of muscle activity, jaw movement, TMJ function and occlusal contacts helps the dental practitioner better understand the TMD /TMJ patient. And better control the course of treatment they provide.
You don’t know until you measure
A fact of dental occlusion is that it is very sensitive to change. You can feel a change in your occlusal contacts that measures 20 microns, or 20/1000 ths of a millimetre.
If the patient’s occlusion is not balanced, both in biting and in function, the muscles of mastication will be affected. Bite imbalance will require accommodation by your jaw muscles. This accommodation often leads to dysfunction. And after 2 or 3 months, this dysfunction becomes your ‘normal’ bite. The bite is normal only in that it has been the bite you have had to live with for the last few weeks.
‘Normal’ does not mean ‘healthy’.A bite imbalance has far reaching affects on posture, on structural strain in the body, in muscular strain and fatigue, and on neural strain and pain.
Yet without Biometric tools, you will never truly know what your patient’s occlusal problems are or how those problems manifest themselves.
Biometric Equipment for TMD / TMJ
We dentists are very familiar with Articulating Paper. The paper or mylar that marks the contacts between the upper and lower dental arches when they come together. But did you know that articulating paper is a very inaccurate way of measuring the force of tooth contact? That the articulating paper cannot tell you of the percentage of force generated by each mark? Or the timing of each mark? And that studies show that the more experienced the dentist in treating occlusal disharmonies, the worse the dentist is at predicting the import of markings from articulating paper?
The Tscan a unique tool for the dental profession as it is the only device that measures the location, force, balance and timing of the patient’s true occlusion. And it does it with consistency and relevance. Tscan takes the guess work out of occlusal adjustments in both the clench bite and the functional movements of the teeth in chewing or grinding.
This is important because of the sensitive and complex neuromuscular link between the proprioceptive fibres in the periodontal ligaments that sense tooth contact and tell the brain what jaw muscles to activate to prevent tooth fractures.
The Tscan tells us visually what evolution has created naturally. Specifically the when, how and where teeth are touching. This makes Tscan a valuable and useful tool in treating the dental malocclusion associated with TMD /TMJ.
Knowing the occlusal data is only part of the problem. It is also important to know how the jaw and the muscles of the head and neck are responding to the occlusal scheme the patient has and when a better occlusal scheme is providing true muscle relaxation and true mandibular balance. Without a physiologic balance to the head, neck and jaw, you will not provide balance to the whole body system.
1) EMG Data
The reading of muscles is key in the understanding of how occlusion is being accommodated in the patient. Occlusal imbalance can be micro (the teeth) or macro (the jaw position). Real time EMG reading of the muscles of the head and neck let you know why symptoms exist and help you determine what needs to happen to eliminate those stresses that cause the symptoms.
2) Jaw Tracking
We cannot visually track the movement of the mandible as it closes into the present occlusion. The movements are to quick and minute to be understood visually. But with a jaw tracking system, we can see how the mandible moves, twists, and shifts to bring the lower teeth safety up into the upper teeth. And we can see if we are improving that movement or not. Jaw tracking is a key to successfully treating TMD / TMJ cases both quickly and effectively.
The teeth occluding determines the function and position of the TMJ’s. But it is important that we know how healthy or unhealthy the TMJ actually is and how the TMJ’s function in movement.
And MRI cannot diagnose clicks or pops. An MRI cannot diagnose the grating sounds the patient experiences or when they happen in jaw movements. Sonography helps the dentist ‘see’ the action of the joint structures and better understand the health of the TMU’s.
The two main Kinesiograph companies that support the dentist in their TMJ therapy are Myotronics and Bio-Research. I use both in my office in my TMD / TMJ treatments.