Clinical Significance of First Phase Treatment               for TMD Patients.       16th International Congress, October ...
Four Categories of TMD Symptoms1.Pain of myogenous origin (muscle spasms)   Neck & Shoulder pain, Back pain, Facial pain, ...
Etiology of         Temporomandibular DisorderMuscle hyper function                         Myogenous TMD disorders       ...
3 Kinds of Mandibular Torque
Etiology of Temporomandibular Disorder        Pitch Torque Cause Internal Derangement of TMJ                Articular disk...
Craniomandibular Disorder                 Influence of PITCH Torque         TMJ injury and loss of muscle co-ordinationRes...
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 Clos...
First Phase of TMD Treatment   eliminate or reduce patient’s symptoms   stabilizing the mandible   physiologic rest pos...
Neuromuscular Orthotic Therapy    Aligning Body Part to improve FunctionOrthosis:    An orthopedic appliance or apparatus...
MYOGENOUSTMJBITE   DYSAUTONOMIA
Please check Box below , and circle the Number which indicate your level of painTMJ & BITE                                ...
Distribution of the Pain Intensity Score of 32 Symptoms             complained by the 40 TMD Patients                    ©...
How to caluculate Improvement Rate ?               © 2011, Toshihiko Abey, DDS,MICCMO
Improvement Rate of Pain Intensity Scoresafter the Neuromuscular Orthotic Therapy            © 2011, Toshihiko Abey, DDS,M...
Improvement rate of each TMD Symptoms        Related to TMJ disorder
Improvement Rate of TMD Symptoms related to  Muscle Disorder before and after Treatment      Symptom                      ...
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, To...
Improvement Rate of Individual PatientPt. APt. BPt. CPt. Z  Individual patient Improvement Rate (%) = (SumA - SumB)/SumA x...
Improvement Rate of Individual Patient             = Patient’s Satisfaction Rate                                          ...
Duration for individual Patient                      First Phase Treatment                                                ...
Conclusion The curability of TMD symptoms Importance of quantitative data The validity of Neuromuscular Theory.        ...
Thank you for your Kind Attention !           © 2011, Toshihiko Abey, DDS,MICCMO
The rate of response to First phase Treatment                © 2011, Toshihiko Abey, DDS,MICCMO
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Clinical significance of first phase treatment for tmd final

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Clinical significance of first phase treatment for tmd final

  1. 1. 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
  2. 2. 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.
  3. 3. 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
  4. 4. 3 Kinds of Mandibular Torque
  5. 5. Etiology of Temporomandibular Disorder Pitch Torque Cause Internal Derangement of TMJ Articular disk displacementPhysiologic Rest Position Pathologic Intercuspal Position © 2011, Toshihiko Abey, DDS,MICCMO
  6. 6. Craniomandibular Disorder Influence of PITCH Torque TMJ injury and loss of muscle co-ordinationRest position of the mandible Distorted mandibular position
  7. 7. Diagnosis of TMD PatientsHabitual intercuspal position Physiologic rest position
  8. 8. Habitual Intercuspal PositionPhysiologic Rest Position © 2011, Toshihiko Abey, DDS,MICCMO
  9. 9. 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
  10. 10. First Phase of TMD Treatment  eliminate or reduce patient’s symptoms  stabilizing the mandible  physiologic rest position. “Removable Neuromuscular Orthosis”
  11. 11. 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
  12. 12. MYOGENOUSTMJBITE DYSAUTONOMIA
  13. 13. 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
  14. 14. Distribution of the Pain Intensity Score of 32 Symptoms complained by the 40 TMD Patients © 2011, Toshihiko Abey, DDS,MICCMO
  15. 15. How to caluculate Improvement Rate ? © 2011, Toshihiko Abey, DDS,MICCMO
  16. 16. Improvement Rate of Pain Intensity Scoresafter the Neuromuscular Orthotic Therapy © 2011, Toshihiko Abey, DDS,MICCMO
  17. 17. Improvement rate of each TMD Symptoms Related to TMJ disorder
  18. 18. 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
  19. 19. Improvement Rate of Symptoms Related to muscle disorders © 2011, Toshihiko Abey, DDS,MICCMO
  20. 20. Improvement Rate of TMD Symptoms related toAutonomic Nervous System before and after Treatment © 2011, Toshihiko Abey, DDS,MICCMO
  21. 21. Improvement Rate of Individual PatientPt. APt. BPt. CPt. Z Individual patient Improvement Rate (%) = (SumA - SumB)/SumA x 100
  22. 22. 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%
  23. 23. 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
  24. 24. Conclusion The curability of TMD symptoms Importance of quantitative data The validity of Neuromuscular Theory. © 2011, Toshihiko Abey, DDS,MICCMO
  25. 25. Thank you for your Kind Attention ! © 2011, Toshihiko Abey, DDS,MICCMO
  26. 26. The rate of response to First phase Treatment © 2011, Toshihiko Abey, DDS,MICCMO

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