practice brochure for dentists by chenshu


									STABILIZATION APPLIANCES - fitting on the                  ESTABLISHING A NEW OCCLUSION may be                      ..
maxillary arch and worn during sleep, are the simple       needed if the symptoms return every day after the
path to long term relief in most cases. Anti-retrusive     night appliance is removed. The process involves
inclines surrounding the bite table let the jaw            deprogramming the jaw muscles with a flat plate
muscles exercise and brace without driving the             appliance, testing the new occlusion for at least a
condyles into the bruised retrodiskal tissues. Steep       couple of months with tight fitting unobtrusive
slopes are for pure joint problems, flat slopes are for    unilateral removable bite restoring appliances which
pure muscle problems, and various combinations are         don’t impair speech and can be worn all day
used for everything in between. We make temporary          including eating, and then transferring the new
stabilization appliances chairside for people who          occlusion to the teeth with composite resin build-ups.
don’t know if their symptoms are related to their          Finally, only after several more months of stable
TMJs or people with recent symptoms due to a               relief, the well established and fully worn-in new
triggering episode such as a long dental procedure.        occlusion is made permanent with crowns or onlays,
                                                           usually performed by the patient’s general dentist
PIVOT APPLIANCES provide quick relief for                  with Dr. Summer providing any support required.
acute TMJ conditions by distracting the affected
condyle. If the pivot is correctly placed, the patient     ORTHOPEDIC DISK RECAPTURE may be
can bite forcefully on the appliance without pain.         needed for patients who find that nothing provides
                                                           relief as long as a TMJ disk keeps popping in and out
ANTERIOR FLAT PLATE APPLIANCES                             of place. Permanently repairing the anatomy requires
significantly reduce the amplitude of the forces used      permanently changing the occlusion, which can
in nocturnal bruxism. If the joints are no longer          necessitate significant dental work; so this treatment
inflamed, these appliances often eliminate headache.       is only used when other treatments have failed and
                                                           the prognosis for recapture is excellent or when most
TELESCOPIC APPLIANCES provide joint                        of the upper or lower posterior teeth need restoration
protection even when the mouth is part way open.           anyway. To help identify anatomical features which
Our telescopic appliances have been redesigned for         affect prognosis, I performed and published a disk
adults, with a lower profile for comfort and lateral       recapturing study with the leading TMJ radiologist
freedom of movement for joint health. Usually they         using before and after MRI on 119 joints undergoing
are not set to reposition the mandible - just to prevent   disk recapture. Reprints available by request.
it from retruding excessively during sleep. With all
the teeth embedded in acrylic, unwanted tooth              FUNCTIONAL ORTHODONTICS may be
movement is prevented.                                     needed to move teeth which obstruct a healthy bite or
                                                           to improve the pattern of facial growth. Studies have
STABILIZING THE OCCLUSION may be                           shown that TMJ disorders or loss of jaw muscle
needed to give the mandible a consistent home base         strength can adversely affect a patient’s pattern of
to which the TMJs can acquire the same goodness of         facial growth. Studies have also shown that facial
fit seen in all healthy joints. A bite can be              growth continues slowly but steadily throughout life,,
destabilized by disk displacement or degenerative          so its direction and harmony influence long term
remodeling which shorten the affected condyle or           prognosis. Functional orthodontic appliances can
TMJ swelling which effectively lengthens the               improve facial growth by protecting damaged TMJs
affected condyle. Restabilizing the bite may involve       and providing an exercise template which stimulates
reducing high spots, building up low spots, moving         healthy jaw muscle development. Palatal expansion
teeth, or any combination of these three. The choice       can be used to enlarge the nasal airway or to increase
depends on face height and the state of the dentition.     the maxillary space available for erupting teeth.

       New Advances
      in Treatment for
       TMJ Disorders
          and Sleep

                    The TMJ Clinic
    833 SW   11th   Ave. # 810, Portland OR 97205

PHONE:                503-241-7353

Sis, this is the only part of the brochure that I
can’t finish and make look nice. I know you
can do it easily. Thanks in advance. Love Bro
M O R E E F F E C T I V E T R E AT M E N T O F S L E E P A P N E A                                         O RT H O P E D I C S F O R
Current oral appliances can effectively protrude the mandible and thereby enlarge the pharyngeal           LO N G T E R M R E L I E F
airway while exerting some forward traction on the base of the tongue at the hypopharynx, but they
still can’t prevent the body of the tongue from dropping back and plugging the oropharynx and
                                                                                                           OF TMJ DISORDERS
velopharynx. To solve that problem, our new combination appliance employs a novel tongue holding           The vast majority of TMJ disorder patients
                                                                                                           have a displaced disk and chronically
device (THD) with a tongue rear depressor added to a titratable telescopic jaw protrusion appliance.
                                                                                                           bruised retrodiskal tissues in at least one
The mandible is held in protrusion by telescopic (Herbst) components which have been redesigned for        TMJ. The muscles get involved, because
sleep apnea appliances. They are lower in profile for more comfort and they can be individually            they are responding organs. Inflammation
adjusted in .007” increments over a ½” range without tools for titration of mandibular position.           in any joint produces reflex bracing in the
                                                                                                           muscles which cross that joint. Thus an
The tongue is fixed to the protruded mandible by a gentle clamp comprised of specialized upper and         inflamed TMJ produces reflex jaw muscle
lower tongue gripping surfaces biased together by an orthodontic elastic. Each tongue gripping             bracing, just as an inflamed ankle or knee
surface contains several thousand plastic points all slanted forward at a 45 degree angle, so the tongue   causes reflex leg muscle bracing - limping.
can easily slide into the space between the tongue gripping surfaces but cannot be pulled out without
opening wide enough to activate the tongue release mechanism. A recent pilot study for the FDA             While most treatments are directed at
showed that the THD can keep the tongue protruded all night without causing pain or inflammation.          increasing adaptive capacity or relieving
                                                                                                           the effects of chronic jaw muscle bracing,
Even protruding the tongue and mandible doesn’t always prevent the rear portion of the tongue from         we aim at the root of the problem by using
contacting the soft palate and obstructing the airway at the velopharynx, so the upper tongue gripping     orthopedic mechanics to protect the TMJs,
surface also contains a smooth tail-like extension which holds down the rear of the tongue, much like      eliminate the inflammation, and thereby
a resilient form of the posterior tongue retainer employed in the Full Breath Solution (FBS) appliance.    stop the reflex jaw muscle bracing.
                                                                                                           Because even untreated TMJ disorders
With the whole pharyngeal airway protected from airway blockage, patients can finally get an oral          naturally resolve in time due to fibrosis of
appliance which is more likely than not to eliminate their sleep apnea problem - without CPAP.             the retrodiskal tissues, we keep the
                                                                                                           treatment proportional to the symptoms.

                                                                                                           The good news is that most people need
                                                                                                           only simple orthopedic treatment to hasten
                                                                                                           the natural adaptation process and thereby
                                                                                                           permanently eliminate their symptoms.

                                                                                                           Some of our orthopedic tools include:
                                                                                                            Stabilization Appliances
                                                                                                            Anterior Flat Plate Appliances
                                                                                                            Pivot Appliances
                                                                                                            Telescopic Appliances
                                                                                                            Stabilizing the Existing Occlusion
                                                                                                            Establishing a New Occlusion
                                                                                                            Orthopedic Disk Recapturing
                                                                                                            Functional Orthodontics

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