Description: This course will cover the clinical concepts of managing patients who have existing foundational injuries in their temporomandibular joints. Three types of patients will be discussed: (1) those with abnormal but stable joint foundations; (2) those with abnormal but unstable joint foundations that can be rehabilitated with conservative management options; and, (3) those with abnormal and progressively unstable joint foundations that cannot be managed with occlusal therapies. Post-treatment restorative, orthodontic and orthognathic surgical occlusal failures will be shown. Treatment relapse will be analyzed from direct occlusal examination, articulated study casts, cone beam CT (CBCT) and magnetic resonance imaging (MRI). Alternative therapeutic options will be discussed for these failed cases.
Additionally, adaptation of the occlusion and the joint foundations will be sequenced into treatment decisions. Attendees will learn what type of splint therapy should be used for various degrees of joint foundational injury. Discussion will cover appropriate diagnostic workup of malocclusion patients for assessment of potential instability during treatment. Occlusal correction and stabilization through surgical reconstruction of temporomandibular joints will be shown. Growth enhancement in children with joint foundational damage will be documented, and support for earlier noninvasive management of growing children will be discussed in an attempt to avoid occlusal and skeletal instability.
This is a two-part lecture (C10 and C23) that is best attended as a full day. However, participants may take either the morning or the afternoon session.
Learning Objectives: Participants will be able to: • Recognize when functional occlusion becomes dysfunctional occlusion. • Diagnose foundational abnormalities of teeth and supporting structures. • Learn how selection of the wrong treatment options can contribute to further damage of the joint foundation and result in relapse of the occlusion. • Know how to sequence management restoratively, orthodontically and surgically in patients with stable and unstable temporomandibular joint foundations. • Understand the role of temporomandibular joint surgical reconstruction in the rehabilitation of the temporomandibular joint foundation and in the correction of malocclusion in adults and in growing children.