TMJ radiology and occlusion: vertical dimension, intra-articular disorders, centric relation

Lesson 1. Vertical dimension of occlusion

How do we know when should we increase VDO and how much?

• Vertical dimension of occlusion (VDO)
• Increasing VOD in excessive tooth wear
• Full mouth reconstruction and TMD1-1,3-2-3 relation in increasing VDO
• What is the dentoalveolar compensation
• The effect of raising VDO on the cervical spine and pain in the trigeminal nerve nuclei

Cephalometric analysis of the cervical spine (analysis of intervertebral spaces and the cranio-cervical angle) and the position of the hyoid bonecrucial for achieving muscle balance and making it possible to raise occlusion successfully

• Basic photo protocol for aesthetic planning
• Establishing the height of the deprogrammer platform using a modified DSD protocol
• DSD in patients with significant tooth abrasion (teeth not visible when patient smiles). How to establish the right aesthetics at the preliminary stage
• VDO checklist – if you follow this you can increase the VDO as much as you need.

Duration: 1 h 14 min

Lesson 2. TMJ radiology. Basic

• Anamnesis vitae and morbie
• Two important steps before deciding to order radiographs
• Analysis of pantomographic imagesare 2D images suitable for the assessment of the temporomandibular joint?

• Analysis of condyle hypermobility on the basis of radiographs
• Structure of the temporomandibular joint in the context of radiology
• Assessment of the condyle position in the joint based on CBCT.

Duration: 54 min

Lesson 3. TMJ radiology. Advanced

Why position 4/7 did not fulfill its role?

• Cortical bone erosion on CBC
• Twhat is it and how to assess it?

• Joint degeneration in the CBCT image – arthritis vs arthrosis – a key difference from a clinical point of view
• Idiopathic condyle resorption – why does an open bite suddenly appear?

• Subcortical cysts, ankyloses and developmental defects in the CBCT image
• What to look for when analyzing cephalometry for respiratory disorders?

What is the hyoid triangle and how to assess the pathology of the cervical vertebrae on cephalometry?

• Magnetic resonance imaging (MRI) – normal anatomy important from the point of view of TMD
• Displacement of the disc with and without reduction, lateral and posterior displacement of the disc – detailed analysis of MRI images
• Analysis of mobility in the joint based on MRI
• Joint effusion and double disc image – detailed MRI analysis
• Three words about ultrasound – why MRI is much better
• Stabilization of the condyle as seen by magnetic resonance imaging.

Duration: 1 h 43 min

Lesson 4. Clinical application of CR in prosthodontics and orthodontics

• MRI and CBCT positioning of the condyle – when does it make sense?4/7 position and rearmost position – why they were used and why they were stopped
• Centric slide – a physiological phenomenon or a big mistake?

Constricted Chewing Pattern (CCP) and the “long centric”– Compression and decompression in TMJ – is the joint space important for us?

Rotation / translation – are we actually separating these two movements?

• Defining the Central Relation – dental cabaret
• Adapted centric posture. How do I know when an intervention is needed?

• Muscle vectors of the stomatognathic system
• Establishing a centric relation (deprogrammers and maneuvers)
• Triple centric relation and determining the position of the articular fossa
• Forward position – splint reposition, functional orthodontics, apnea treatment
• Neuromuscular position – main principles and doubts
• What position should we choose and when should we look for it?

Does an incorrect position in the joint guarantee TMD?

Duration: 1 h 47 min