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Clinical significance of first phase treatment for tmd final
 

Clinical significance of first phase treatment for tmd final

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    Clinical significance of first phase treatment for tmd final Clinical significance of first phase treatment for tmd final Presentation Transcript

    • Clinical Significance of First Phase Treatment for TMD Patients. 16th International Congress, October 20, 21 Vancouver Canada Toshihiko Abey D.D.S,MICCMO © 2011, Toshihiko Abey, DDS,MICCMO
    • Four Categories of TMD Symptoms1.Pain of myogenous origin (muscle spasms) Neck & Shoulder pain, Back pain, Facial pain, Tension Headache, etc.2.Symptoms related to TMJ Clicking, Popping, Difficulty opening, Jaw tiredness, Jaw stiffness, etc.3.Symptoms effected on the autonomic nervous system Insomnia, Dizziness, Short breath, Constipation, etc. ( Dysautonomia )4.Mental disturbances Depression, Anxiety, Insomnia, Nervousness, Despair, etc.
    • Etiology of Temporomandibular DisorderMuscle hyper function Myogenous TMD disorders Musculoskeletal disorder • Nerve and Vascular Entrapment • Muscle Ischemia • Distalization of the condyles © 2011, Toshihiko Abey, DDS,MICCMO
    • 3 Kinds of Mandibular Torque
    • Etiology of Temporomandibular Disorder Pitch Torque Cause Internal Derangement of TMJ Articular disk displacementPhysiologic Rest Position Pathologic Intercuspal Position © 2011, Toshihiko Abey, DDS,MICCMO
    • Craniomandibular Disorder Influence of PITCH Torque TMJ injury and loss of muscle co-ordinationRest position of the mandible Distorted mandibular position
    • Diagnosis of TMD PatientsHabitual intercuspal position Physiologic rest position
    • Habitual Intercuspal PositionPhysiologic Rest Position © 2011, Toshihiko Abey, DDS,MICCMO
    • Prescription to a TMD Patient:1) Match Habitual Path of Closure to Neuromuscular Path of Closure2) Adjust torque of mandible to meet Relax musculature and TMJ3) Establish Stable mandibular Position © 2011, Toshihiko Abey, DDS,MICCMO
    • First Phase of TMD Treatment  eliminate or reduce patient’s symptoms  stabilizing the mandible  physiologic rest position. “Removable Neuromuscular Orthosis”
    • Neuromuscular Orthotic Therapy Aligning Body Part to improve FunctionOrthosis:  An orthopedic appliance or apparatus  support, align, prevent or correct deformities  improve the function of movable parts of the body © 2011, Toshihiko Abey, DDS,MICCMO
    • MYOGENOUSTMJBITE DYSAUTONOMIA
    • Please check Box below , and circle the Number which indicate your level of painTMJ & BITE “0” = No Pain, no discomfort “1” =Sometimes Bothered “2” = All the Time Bothered “3” =Severe Pain and Discomfort MYOGENOUS section DYSAUTONOMIA section
    • Distribution of the Pain Intensity Score of 32 Symptoms complained by the 40 TMD Patients © 2011, Toshihiko Abey, DDS,MICCMO
    • How to caluculate Improvement Rate ? © 2011, Toshihiko Abey, DDS,MICCMO
    • Improvement Rate of Pain Intensity Scoresafter the Neuromuscular Orthotic Therapy © 2011, Toshihiko Abey, DDS,MICCMO
    • Improvement rate of each TMD Symptoms Related to TMJ disorder
    • Improvement Rate of TMD Symptoms related to Muscle Disorder before and after Treatment Symptom before after Improve . Rate (% ) Facial pain 19 3 84 % Back eye pain 34 8 76 % Headache 54 19 65 % Back pain 47 17 64 % Fingertip numbness 18 7 61 % Pain in the hips 45 18 60 % Stiff shoulder (s) 76 32 58 % Cervical pain 75 34 55 % © 2011, Toshihiko Abey, DDS,MICCMO
    • Improvement Rate of Symptoms Related to muscle disorders © 2011, Toshihiko Abey, DDS,MICCMO
    • Improvement Rate of TMD Symptoms related toAutonomic Nervous System before and after Treatment © 2011, Toshihiko Abey, DDS,MICCMO
    • Improvement Rate of Individual PatientPt. APt. BPt. CPt. Z Individual patient Improvement Rate (%) = (SumA - SumB)/SumA x 100
    • Improvement Rate of Individual Patient = Patient’s Satisfaction Rate 0~39%Improvement Rate No. of Patients 5 70~84% 70~88% 16 40% (13%) 60~69% 7 18% 40~49% 6 16 50~59% 6 15% (15%) N-40 (40%) 40~49% 6 15% 0~39% 5 13% 50~59% 6 TOTAL 40 100% (15%) 7 (18%) © 2011, Toshihiko Abey, DDS,MICCMO 60~69%
    • Duration for individual Patient First Phase Treatment 2-monthMonth No.of Pt. % 14~month 5 2 5 13% 7 3 6 15% 4 6 15% 3-month 5 3 8% 13-month 6 6 2 5% 4 N=40 7 1 3% 10 5 13% 12-month 12 1 3% 5 13 4 10% 6 4-month14~ 7 18% 10-month 3 40 100 2 6-month 5-month
    • Conclusion The curability of TMD symptoms Importance of quantitative data The validity of Neuromuscular Theory. © 2011, Toshihiko Abey, DDS,MICCMO
    • Thank you for your Kind Attention ! © 2011, Toshihiko Abey, DDS,MICCMO
    • The rate of response to First phase Treatment © 2011, Toshihiko Abey, DDS,MICCMO