TMD

TMDDefinitionEtiology (Multiple factors)Diagnosis TMDPrevalenceตรวจHistory takingClinical and Physical examinationTMJ imagingอาการPainHeadacheTMJ soundTMJ lockingEar painDiff dxtrigeminal neuralgiacentral nervous system lesionsodontogenic painsinus painotological paindevelopmental abnormalitiesneoplasiasparotid diseasesvascular diseases myofascial paincervical muscle dysfunctionEagle’s syndrome Other common medical conditionsstyloid process ยาว กด vessel, nerveอ้าปากยากไหม? ,มีเสียงข้อต่อไหม?, ปวดตรงหูหรือแก้มไหม?, กินข้าว พูดได้ไหม?Muscle of masticationEvaluation of jaw movementEvaluation of TMJDirect palpationFunctional ManipulationMandibular range of motionMaximum unassisted/assisted openingMaximum lateral excursionMaximum protrusive excursionMandibular opening patternDeviation (return to midline)Deflection (no return to midline) InspectionpalpationJoint soundfacial symmetry/asymขณะ joint เคลื่อน/อยู่นิ่งClick (single sound of short duration)Pop (single sound relatively loud)Crepitus (Multiple gravel-like sound)indicationDeveloping facial asymmetryPainful symptomCrepitusConservative treatment failureimaging techPanoramicCBCTMRIUltrasoundMandibular radiograph: Oblique viewGood screening of condyleTo detect bony abnormalities and fracturesTo assess asymmetry of TMJGold standard for evaluating soft tissue of the TMJ, especially disc positionsuperficial lateral aspects of the TMJArthrography ไม่แนะนำTreatmentDiangnosisTMJ disorderMastcatory disorderJoint painJoint disorderJoint diseaseGold of txrestoration of functiondecreased pain, decreased aggravating or contributing factors,and improved quality of lifeIn childrenConservative and reversible therapyReversible txIrreversible txPatient educationPhysical therapy ex. jaw excercise, thermal/coolant txBehavior therapy ex. relaxing trainning, เลี่ยง habit ที่ทำให้เกิด Prescirption medication: NASAID, Anxiolytic agent, muscle relaxerOcclusal splint: hard/softOthers: nerve block, acupunture, botoxMigraineOcclusal adjustmentOrthodonticSurgeryBruxismAwake/ asleepEtiology: mutifactorial ex. emotional stress, malocclusionComplicatonattritionheadaceTMDsoreness of masticatory muscleIn childrenself-limiting and does not persist in adultsOSA สัมพันธ์กับภูมิแพ้
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