Table of Contents

Preface Introduction Part I. Initial Evaluation Chapter 1. Patient Interview Chapter 2. Review of the "Initial Patient Questionnaire" Chapter 3. Clinical Examination Range of Motion TMJ Noise TMD Palpations Intraoral Examination Occlusal Changes TMD Pain Caused by a Tooth Tooth Pain without Local Pathology Additional Evaluations Chapter 4. Imaging Plain Radiographs Panoramic Radiograph Axially Corrected Sagittal Tomography Computed Tomography Cone Beam Computed Tomography Magnetic Resonance Imaging Arthrography High-Resolution Ultrasound Imaging Strategies Imaging Recommendations Chapter 5. TMD Diagnostic Categories TMJ Articular Disorders Disc Displacement Disorders Dislocation (Also Known as Subluxation) Inflammatory Disorders Osteoarthritis Ankylosis Fracture Congenital or Developmental Disorders Masticatory Muscle Disorders Myofascial Pain Myositis Myospasm Myofibrotic Contracture Centrally Mediated Myalgia Local Myalgia Neoplasia Chapter 6. Contributing Factors Part II. Common Acute TMD Conditions and Treatments Chapter 7. TMD Secondary to Trauma Chapter 8. TMD Secondary to Dental Treatment Preventing Aggravation from Dental Treatment Medial Pterygoid Muscle Pain Inability to Close into Maximum Intercuspation Occlusal Interference Sequelae Obstructive Sleep Apnea Appliances Chapter 9. Lateral Pterygoid Myospasm Chapter 10. Acute TMJ Disc Displacement without Reduction Chapter 11. TMJ Dislocation Part III. Occlusal Appliance Therapy Chapter 12. Stabilization Appliance Mandibular Positions and Interocclusal Record Physical Variables Full or Partial Coverage Maxillary or Mandibular Hard, Intermediate, or Soft Material Thick or Thin Appliance or Wire Retention Summary of Physical Variables Appliance Adjustments Internal Adjustments Internal Reline External Adjustments External Reline Appliance Repair Appliance Examples Pressure-Cured Mandibular Acrylic Stabilization Appliance Maxillary Acrylic Stabilization Appliance Hard Thermoplastic Stabilization Appliance Impak Stabilization Appliance Dual Laminate Thermoplastic Stabilization Appliance Soft Thermoplastic Stabilization Appliance Appliance Management Chapter 13. Anterior Positioning Appliance Mandibular Position and Interocclusal Record Design and Adjustments Appliance Management Part IV. Multidisciplinary Treatment Approach Chapter 14. Self-Management Therapy Self-Management Instructions Closure Muscle-Stretching Exercise Lateral Pterygoid Muscle-Stretching Exercise Posture Exercises Breaking Daytime Habits Chapter 15. Physical Medicine Muscle Massage Yoga Trigger-Point Compression Trigger-Point Injection Physical Therapy Acupuncture Chiropractics Magnetic Therapy Chapter 16. Cognitive-Behavioral Intervention Breaking Daytime Habits Relaxation Hypnotherapy Biofeedback Stress Management Chapter 17. Pharmacological Management Analgesics Anti-inflammatory Medications Nonsteroidal Anti-inflammatory Drugs (Ingested Form) Steroidal Anti-inflammatory Drugs Muscle Relaxants Tricyclic Antidepressants Topical Medications Nutritional Supplements Chapter 18. Other Dental Procedures Occlusal Equilibration Orthodontic-Orthognathic Therapy Prosthodontic Therapy TMJ Surgery and TMJ Implants Chapter 19. Integrating Multidisciplinary Therapies Treatment Summaries and Clinical Implications Occlusal Appliances Self-Management Therapy Lateral Pterygoid Muscle-Stretching Exercise Closure Muscle-Stretching Exercise Posture Exercises Massage and Trigger-Point Compression Yoga Trigger-Point Injections Physical Therapy Acupuncture Chiropractics Magnetic Therapy Breaking Daytime Parafunctional, Muscle-Tightening, or Fatiguing Habits Relaxation Hypnotherapy Biofeedback with Relaxation Stress Management Pharmacological Management Occlusal Therapy TMJ Surgery Integrating Conservative Therapies TMD Refractory to Initial Therapy Long-Term Management Part V. Case Scenarios Case 1: Pulpal Pathosis Mimicking TMD Symptoms Case 2: Chronic Sinusitis Case 3: Chronic Forehead Pain Referred from the Neck Case 4: Myofascial Pain Secondary to Nocturnal Parafunctional Habits Case 5: Tooth Attrition-No Pain Case 6: Myofascial Pain Secondary to Daytime Parafunctional Habits Case 7: Medial Pterygoid Myospasm Case 8: Tense, Depressed, and Poor Sleep as Contributing Factors Case 9: Fibromyalgia as a Contributing Factor Case 10: TMJ Disc Displacements and When to Treat It-No Pain Case 11: TMJ Inflammation Case 12: Intermittent Acute TMJ Disc Displacement without Reduction Case 13: Acute TMJ Disc Displacement without Reduction-Unlocked Case 14: Acute TMJ Disc Displacement without Reduction-Not Unlocked Case 15: Osteitis Causing Inability to Open Wide Case 16: Lateral Pterygoid Myospasm Case 17: Acute Exacerbation of TMD Case 18: Multiple Forms of Head and Neck Pain after Crown Insertion Case 19: Appliance that Positioned Condyles into Their "Proper Position," Part VI. Fundamentals of Clinical Studies Designs of and Advice for Performing Clinical Studies Literature Review Study Population Institutional Review Board (IRB) Approval Developing Study's Parameters Strengthening Study Writing and Submitting Manuscript Practice-Based Research Prominent Clinical Study Designs Case Report Case Series Study Cross-Sectional Study Case-Control Study Cohort Study Nonrandomized Clinical Trial Randomized Controlled Trial Parallel-Group Randomized Clinical Trials Cross-Over Randomized Clinical Trials Other Types of Publications You May Want to Consider Literature Reviews Meta-analyses Systematic Reviews Considerations in Assessing Clinical Trials Conclusions Appendices 1. Referral Criteria for Hygienists 2. Initial Patient Questionnaire 3. TMJ Disc Displacements 4. TMD Self-Management Therapies 5. Occlusal Appliance Care Instructions 6. Closure Muscle-Stretching Exercise 7. Posture Improvement Exercises 8. Laboratory Occlusal Appliance Instructions 9. Example of Dental Record Entries 10. Examples of Physical Therapy Consultations 11. Examples of Psychology Consultations 12. Working with Insurance Companies 13. Sources for Additional TMD Information Glossary Index Files on Accompanying CD Appendices Referral Criteria for Hygienists.doc Initial Patient Questionnaire.doc TMJ Disc Displacements.doc TMD Self-Management Therapies.doc Occlusal Appliance Care Instructions.doc Closure Muscle-Stretching Exercise.doc Posture Improvement Exercises.doc Laboratory Occlusal Appliance Instructions.doc Example of Dental Record Entries.doc Examples of Physical Therapy Consultations.doc Examples of Psychology Consultations.doc Working with Insurance Companies.doc Sources for Additional TMD Information.doc Appendices in Spanish Appendix 2 in Spanish.doc (Initial Patient Questionnaire) Appendix 4 in Spanish.doc (TMD Self-Management Therapies) Appendix 5 in Spanish.doc (Occlusal Appliance Care Instructions) Appendix 6 in Spanish.doc (Closure Muscle-Stretching Exercise) TMD Course Material Part I.ppt Part II.ppt Part III.ppt Part IV.ppt Part V.ppt TMD Course Manual.doc

About the Author

Edward F. Wright , DDS, MS, MAGD, is an associate professor at the University of Texas Health Science Center-San Antonio (UTHSCSA). He completed a one-year general dentistry residency and the University of Minnesota's two-year TMJ and Craniofacial Pain Fellowship. He taught TMD diagnosis and treatment to more than 100 U.S. Air Force residents in general dentistry, orthodontics, periodontics, and prosthodontics. Upon retiring from the Armed Forces, he completed a two-year research fellowship in TMD diagnosis and treatment at the South Texas Veterans Health Care System and taught TMD diagnosis and treatment to their general dentistry residents. He is now UTHSCSA's Course Director for their predoctoral dental students' TMD Course and Dental Anatomy and Occlusion Course, and Module Director for their stabilization appliance rotation. Dr. Wright is the primary author of over 25 journal articles.

Reviews

"This updated text is essential for any GDP or hospital practitioner... it contains insightful coverage, with both text and figures easily absorbed and at incredible value for money". (British Dental Journal, 25 September 2010) "The strength of this book is in the clinical detail presented in its discussion of differential diagnosis, occlusal appliance therapy and the multidisciplinary treatment approach. The personal way in which this book was written gives the interested clinician a bird's eye view of the thinking of an experienced orofacial pain practitioner in making diagnoses and constructing reasonable treatment plans. The review of the many different types of appliances including configurations, materials, techniques and lab instructions is as comprehensive a clinical discussion as I have seen in one place. Part 4, the discussion of multidisciplinary treatment also provides lots of practical information for the clinician and really frames the discussion in an easy to understand clinical way without getting lost in the description of clinical trials and research. Dr. Wright's use of case reports in section 5 helps cement the points he makes in earlier chapters. His inclusion of appendices with diagrams, forms, and instructions and the editable files on the CD gives the clinician a windfall of material from which to draw from to create printed documents and PowerPoint presentations for patient education and for potential referring doctors. To my knowledge, it is unprecedented for an author to provide his personal lecture slides (in an editable format no less) with the purchase of the book." (AAOP E-News, Summer 2010) "Dr. Wright's Manual of Temporomandiblar Disorders will be a valuable addition to the library of those who treat TMD patients and institutional libraries as well." (Oral Surg Oral Med Oral Pathol Oral Radiol Endod, August 2010)