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TREATED CASES

This patient in his 40's presented with complaints about daily headaches, face pain, noises in both jaw joints, problems sleeping, felt his appearance was not normal, and he was worried about grinding down more of his teeth. The patient had a lot of dental work done over the years to include five crowns on the upper and three on the lower.

The analyses of his mounted diagnostic casts on a dental articulator revealed that he had contacts of back teeth on the side opposite of the side he was moving his jaw, indicating potential causes for muscle problems. The Condylographic exam showed that he had bilateral – right and left side – internal derangements of both jaw joints, termed anterior disc displacements with reduction. This means that when all the patient's teeth were in contact as the bite was closed, the discs were popped out of place ahead of the condyle in the jaw joint. When the patient opened as wide as possible, the discs popped back causing the noise when he moved his jaw.

THE PATIENT

CHIEF COMPLAINT

  • I want to stop bruxing, and wearing out my teeth
  • Facial pain
  • I have a lot of joint noise
  • I want a nice smile
  • I want my "TMJ's" fixed
  • I have difficulty breathing when sleeping

 

Photograph of the patient's upper teeth showing many crowms and worn down teeth.

Photograph of the patient's lower teeth showing crowns, fillings, and worn down teeth.

Condylographic computerized exam showing the problems in both jaw joints as the discs popped in and out of place over the condyle in the jaw joint.

Temporary crowns placed on the upper teeth in a form that when coupled to the temporary crowns placed on the lower teeth the discs in the jaw joints were maintained in their proper place. This eliminated the noise in the jaw joints along with relaxing the muscles moving the jaw which lead to stopping the headaches. The patient was also pleased with his new appearance.

Temporary crowns placed on the lower teeth.

The combination of the temporary crowns on both the upper and lower teeth to accommodate proper jaw and jaw joint relationships along with eliminating the headaches and face pain.

The placement of the final porcelain to gold crowns in the same position as the temporary crowns.

The patient's new appearance.

These are the Condylographic computerized jaw joint movements after the placement of the porcelain crowns showing normal tracings indicatig that that the discs are in their proper places. All the patient's original symptoms are now abated.

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