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1/40. Hyperaeration of the sphenoid sinus: cause for concern?

    A case of exuberant pneumatization of the left sphenoid sinus into the pterygoid process and floor of the middle cranial fossa is presented. The fact that pneumatization of the sphenoid sinus is frequently atypical is of clinical import because there is an intimate relationship between the contents of a hyperaerated sinus and adjacent vital facial and cranial structures. It is imperative that clinicians determine the location and extent of the walls of the sphenoid sinus and its relationship to adjacent vital structures whenever endoscopic sinus surgery is contemplated to avoid morbid consequences during surgery.
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ranking = 1
keywords = relation
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2/40. Case report of malocclusion with abnormal head posture and TMJ symptoms.

    Abnormal cervical muscle function can cause abnormal head posture, adversely affecting the development and morphology of the cervical spine and maxillofacial skeleton, which in turn leads to facial asymmetry and occlusal abnormality. There can be morphologic abnormalities of the mandibular fossa, condyle, ramus, and disk accompanying the imbalance of the cervical and masticatory muscles activities. Two normally growing Japanese female patients with Class II Division 1 malocclusion presented with TMJ symptoms and poor head posture as a result of abnormal sternocleidomastoid and trapezius cervical muscle activities. One patient underwent tenotomy of the two heads of the sternocleidomastoid muscle and the other patient did not. In addition to orthodontics, the 2 patients received physiotherapy of the cervical muscles during treatment. Both were treated with a functional appliance as a first step, followed by full multi-bracketed treatment to establish a stable form of occlusion and to improve facial esthetics with no head gear. This interdisciplinary treatment approach resulted in normalization of stomatognathic function, elimination of TMJ symptoms, and improvement of facial esthetics. In the growing patients, the significant response of the fossa, condyle, and ramus on the affected side during and after occlusal correction contributed to the improvement of cervical muscle activity. Based on the result, early occlusal improvement, combined with orthopedic surgery of the neck muscles or physiotherapy to achieve muscular balance of the neck and masticatory muscles, was found to be effective. Two patients illustrate the potential for promoting symmetric formation of the TMJ structures and normal jaw function, with favorable effects on posttreatment growth of the entire maxillofacial skeleton.
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ranking = 5.6767211487125
keywords = jaw
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3/40. tooth wear and loss: symptomatological and rehabilitating treatments.

    The authors report a clinical case that presented tooth wear and absence, with painful muscular and articular symptomatology, and also alteration in deglutition, mastication and speech. The clinical procedures used were re-establishment of vertical dimension of occlusion, mandibular centric relations, and occlusal contacts through therapeutic removable partial dentures. The condyle position was analyzed in habitual occlusion and in occlusion with dentures, through transcranial radiographs of the temporomandibular joints. Oral rehabilitation was achieved with dental restoration and removable partial dentures.
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ranking = 0.5
keywords = relation
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4/40. The Garcia Distraction Appliance: treatment of the TMD patient with an anterior open bite.

    A temporomandibular joint case with an anterior open bite and a high mandibular plane angle was treated by erupting the posterior teeth after creating a posterior open bite using a Garcia Distraction Appliance and a Garcia Pivot Splint.
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ranking = 12.342645673208
keywords = bite
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5/40. Locating the centric relation prematurity with a computerized occlusal analysis system.

    Locating the first tooth contact that interferes with freedom of movement in and out of centric relation has been the diagnostic and treatment objective of most occlusal therapies. The centric relation prematurity can be located by various methods, which involve operator-guided mandibular positioning combined with the patient's subjective assessment of his or her perceived first tooth contact. The method known as bimanual manipulation has been widely recognized and accepted as a predictable method of determining and verifying the centric relation position. The first occlusal contact that results when the mandible is closed on a correct centric relation axis is known as the centric relation prematurity. An alternative procedure combines bimanual manipulation with the simultaneous recording of the sequence of resultant tooth contacts using a computerized occlusal analysis system. This alternative offers a significant improvement in the precision of locating the first tooth contact. This article describes a method of identifying the first tooth contact while not relying on the patient's subjective assessment of his or her perceived occlusal feel.
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ranking = 4.5
keywords = relation
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6/40. Myofascial pain syndrome misdiagnosed as odontogenic pain: a case report.

    The aim of this report is to illustrate the case of a patient whose myofascial pain syndrome was misdiagnosed as odontogenic pain, and who was treated using irreversible dental procedures. Even if dental pain commonly has an odontogenic etiology, it is also possible that pain arising from different orofacial sites such as jaw muscles, maxillary sinus, or nervous structures can be referred to the teeth. When the etiology of a dental pain condition cannot be clearly identified, it is necessary to consider all possible causes of dental pain, which may also be nonodontogenic. The need for comprehensive examination and careful diagnosis before irreversible dental treatment is emphasized.
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ranking = 5.6767211487125
keywords = jaw
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7/40. acupuncture treatment of pain dysfunction syndrome after dental extraction.

    A successful treatment with acupuncture of a patient with Pain Dysfunction syndrome is presented. The patient developed restricted mouth opening after removal of a third molar in the lower jaw. Despite orthodox treatment no improvement was noticed after three months, and his general practitioner was contacted. After two acupuncture sessions the patient felt normal and the jaw movement was within the normal range. A follow-up four weeks after the first treatment showed a further increase in the jaw movement. If restricted movement in the temporomandibular joint occurs after operative procedures in the mouth, acupuncture should be considered at an early stage.
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ranking = 17.030163446138
keywords = jaw
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8/40. Occlusal rehabilitation of a patient with hereditary multicentric osteolysis.

    This article describes the fixed prosthodontic rehabilitation of a 53-year-old male patient with multicentric osteolysis. Before treatment, the patient exhibited signs and symptoms of temporomandibular disorder and had recurrent tension-type headaches and pain in the neck and shoulder area. One of his chief complaints was frequent fracture of restorations. After extensive occlusal rehabilitation, occurrence of headache and pain ceased, and other signs and symptoms of TMD diminished. The long-term prognosis depends on the stage of the genetic disorder, which cannot be determined.
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ranking = 2.0571076122014
keywords = bite
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9/40. Tiagabine may reduce bruxism and associated temporomandibular joint pain.

    Tiagabine is an anticonvulsant gamma-aminobutyric acid reuptake inhibitor commonly used as an add-on treatment of refractory partial seizures in persons over 12 years old. Four of the 5 cases reported here indicate that tiagabine might also be remarkably effective in suppressing nocturnal bruxism, trismus, and consequent morning pain in the teeth, masticatory musculature, jaw, and temporomandibular joint areas. Tiagabine has a benign adverse-effect profile, is easily tolerated, and retains effectiveness over time. Bed partners of these patients report that grinding noises have stopped; therefore, the tiagabine effect is probably not simply antinociceptive. The doses used to suppress nocturnal bruxism at bedtime (4-8 mg) are lower than those used to treat seizures.
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ranking = 5.6767211487125
keywords = jaw
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10/40. chiropractic treatment of temporomandibular disorders using the activator adjusting instrument and protocol.

    OBJECTIVE: To describe the chiropractic management of a 30-year-old woman with temporomandibular joint (TMJ) pain and to discuss the general etiology and management of TMJ conditions. CLINICAL FEATURES: The patient suffered from daily unremitting jaw pain for 7 years, which was the apparent sequela of a series of 8 root canals on the same tooth. Pain radiated from her TMJ into her shoulder and was accompanied by headache, tinnitus, decreased hearing, and a feeling of congestion in her right ear. Symptoms were not reduced by medication or other dental treatments. OUTCOME AND INTERVENTION: The patient underwent a series of chiropractic treatments using the instrument and protocol of Activator methods, International. During the first 5 months, her VAS rating of jaw pain decreased from 60 (on a scale of 0 to 100) to 9, her ability to eat solid foods increased, headache intensity and frequency diminished, and her maximum mouth opening without pain measurement increased from 22 to 28 mm. overall, 20 months of chiropractic treatment along with 2 concurrent months of massage therapy yielded slow but continual progress that finally resulted in total resolution of all symptoms except some fullness of the right cheek. CONCLUSION: Use of the Activator methods protocol of chiropractic treatment was beneficial for this patient and merits further study in similar cases.
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ranking = 11.353442297425
keywords = jaw
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