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.