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Headaches Attributed To Temporomandibular Disorders PowerPoint Presentation

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Description : Check out this medical PowerPoint presentation titled "Headaches attributed to Temporomandibular Disorders” by Bijan Movahedian Attar DDS, OMFS.

This medical PowerPoint presentation is about headaches attributed to Temporomandibular Disorders (TMD).

Temporomandibular disorders (TMD) are a group of conditions that affect the jaw joint and muscles that control jaw movement. TMD can cause a range of symptoms, including pain or tenderness in the jaw joint, difficulty opening or closing the mouth, clicking or popping noises when the jaw moves, and headaches.

Headaches attributed to TMD are typically caused by muscle tension or inflammation in the muscles that control jaw movement. This can lead to pain in the temples, forehead, or back of the head. The pain may be dull or sharp and may be accompanied by other symptoms such as neck pain, jaw pain, or tooth sensitivity.

Treatment for headaches attributed to TMD typically involves addressing the underlying condition. This may include techniques to relieve muscle tension, such as jaw exercises, hot or cold compresses, and relaxation techniques. Other treatments may include medications to relieve pain or reduce inflammation, dental devices to improve jaw alignment, or in some cases, surgery.

Its important to see a healthcare professional if you are experiencing headaches attributed to TMD, as they can help determine the underlying cause and develop an appropriate treatment plan.

Tags : Headaches, Temporomandibular Disorders, Dentistry, dental medicine, oral medicine, dental medicine PowerPoint presentation

Published on : Jun 20, 2023 | Views : 770 | Downloads : 0

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Slide 1-

Bijan Movahedian Attar DDS, OMFS Associate professor Department of Oral and Maxillofacial Surgery, Isfahan University of Medical Sciences Headaches attributed to Temporomandibular Disorders
Slide 2-

HEADACHE or TMD mimicking a HEADACHE ? A CHALENGING DISTINCTION TO MAKE
Slide 3-

Sever headache usually found in majority of TMD patients “Almost 80%”
Slide 4-

70 % of headache patients had also a clinical confirmation of TMD
Slide 5-

Association between TMD & headache International Headache Society recognizes that secondary headache can be attributed to TMD
Slide 6-

Headache and TMD are comorbid disease Presence of one increases the frequency of the other at a rate above the expected one Association between TMD & headache
Slide 7-

The treatment of TMD associated with headache facilitates the treatment of headache in varying percentage Association between TMD & headache
Slide 8-

The larger the number of sign/symptoms of TMD, the higher the frequency of migraines Association between TMD & headache
Slide 9-

The higher the frequency of headaches, the more frequent the muscular and articular sign/symptoms of TMD Association between TMD & headache
Slide 10-

When patient report a severe headache A clinical assessment of TMJ and masticatory muscles should be performed in order to exclude TMDs
Slide 11-

TMD should considered in all patients who complain of chronic “sinus headache “and do not demonstrate objective evidence of sinus, neurologic, neoplastic or vascular abnormalities
Slide 12-

Temporomandibular Disorders: An often overlooked cause of chronic headache
Slide 13-

TEMPOROMANDIBULAR DISORDERS
Slide 14-

A clinical problem involving TM joint, masticatory muscles and related structures Temporomandibular Disorders
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EPIDEMIOLOGY About 60-70% of the population have features of TMDs About 20-30% report symptoms of TMDs About 5% of people with TMD symptoms actually seek treatment The female:male ranges from 3:1 to 9:1
Slide 17-

Etiology of TMD Exact Cause is Unknown Many factors work together to initiate or aggravate the condition Occlusal Disharmony Psychological Distress Parafunctional Habits Acute Truma to Jaw Trauma from Hyperextension (after dental visit!)
Slide 18-

Condyles Articular surface of the temporal bone Capsule Articular disc Ligaments Lateral pterygoid
Slide 19-

Functional Anatomy (Shock absorber)
Slide 20-

Functional Anatomy Synovial joint Two movements: Hinge type Gliding type
Slide 21-

Temporalis Muscle
Slide 22-

Masseter Muscle
Slide 23-

Medial Pterygoid Muscle
Slide 24-

Inferior Lateral Pterygoid Muscle
Slide 25-

Superior Lateral Pterygoid Muscle
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TMD classification Type 1 Muscular disorders Type 2 intra articular , disk disorders Type 3 arthritic disorders
Slide 29-

MPD is the most common cause of masticatory pain and limited function for which patients seek dental consultation and treatment.The cause of MPD is multifactorial.one of the most commonly accepted causes of MPD is bruxism and clenching resulting from stress and anxiety, with occlusion being a modifying or aggravating factor. myofasial pain
Slide 30-

The etiology of the most common TMDs is unknown.Two hypotheses, occlusal disharmony and psychological distress have dominated the literature. ETIOLOGY
Slide 31-

Lateral occlusal interfere
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Slide 33-

Anterior teeth lingual tipping deep overbite
Slide 34-

INTERNAL DERANGEMENT Abnormal relationship of the articular disc to the mandibular condyle, fossa, and articular eminence, interfering with the smooth action of the joint Is a localized mechanical fault within the joint Synonymous with disc displacement
Slide 35-

DISC POSITION
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Slide 37-

Complete anterior disc displacement medial section Autopsy
Slide 38-

TMPDSSigns & Symptoms Pre-auricular pain that may radiate to other sites Tenderness of the joint on palpation Limited mouth movement (due to pain) Deviation of mandible on opening & closing Tenderness of muscles of mastication Joint sounds Headache
Slide 39-

Internal derangement Disc displacement with reduction Disc displaced (usually anteriorly) during opening & reduced (return back to normal) upon closing Reproducible clicking No limitation of mouth opening Deviation of jaw might be present Pain might be present Intermittent locking
Slide 40-

TMJ sounds
Slide 41-

Internal derangement Disc displacement without reduction Disc is displaced during opening & closing Disc does not reduce (does not return back to normal) Persistent limitation of mouth opening Pain No clicking
Slide 42-

Diagnosis of TMDs
Slide 43-

History Pain Joint Sounds Restriction of Opening Swelling Over the maxilla In the area of parotid gland
Slide 44-

The joint Lateral aspect Examiner should be in front of the patient A single finger is placed over each condyler head Jaw movement
Slide 45-

Clinical examination of TMD Mouth opening
Slide 46-

Opening patterns Straight Deviation (right & left) Corrected deviation Others Clinical examination of TMD
Slide 47-

Lateral deviation
Slide 48-

CONTRALATERAL PAIN SUGGESTS ARTICULAR DISEASE
Slide 49-

Muscular tenderness
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Slide 51-

Tenderness of Lateral pterygoid
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Slide 53-

Radiographic Evaluation Panoramic radiography Lateral transcranial radiography CT scan TMJ arthrography MRI Nuclear Imaging
Slide 54-

DEGENERATIVE CHANGES IN CONDYLE
Slide 55-

Bruxism (clenching) and TMD Significant association between TMD and clenching Prevalent in near 70% of patient with myofacial pain
Slide 56-

Management of TMDs
Slide 57-

Conservative therapy Patient education Splint therapy Pharmacotherapy Occlusal management Physical therapy
Slide 58-

Types of occlusal Splints Used in TMJ Disorders Stabilization splints Repositioning splints Pivot splints Soft splints Bite plane splints
Slide 59-

■ SPLINT THERAPY Stabilization splints: Stabilization splints are the most commonly used splints to treat myofascial pain
Slide 60-

Stabilization splint Treatment of TMD
Slide 61-

Repositioning splint Treatment of TMD
Slide 62-

Categories of Medications used to treat TMJ Disorders NSAIDs Corticosteroids Analgesics Muscle relaxants Antidepressants Anxiolytics
Slide 63-

TMD BoNT-A* Injections Botulinum toxin injections are placed throughout the temporalis (5-25U) and masseter (25-50U) musculature. Medial (5-25U) and Lateral (5-10) pterygoid muscles may also be injected through an intra-oral approach. *Allergan, Botox®, USA Reprinted from Freund B, Schwartz M, Symington JM. Br J Oral Maxillofac Surg 2000;38(5):466-471, with permission from The British Association of Oral and Maxillofacial Surgeons.
Slide 64-

SURGERIES OF THE JOINT Discectomy Disc repositioning Condylotomy Arthrocentesis Arthroscopy Partial and total joint replacement
Slide 65-

Lavage & Arthrocentesis
Slide 66-

HOLMLUND-HELMSING LINE
Slide 67-

ARTHROSCOPY
Slide 68-

There should be no dividing line between the knowledge of both orofacial pain specialist and headache physicians Conclusion
Slide 69-

Let us having “Team work” to treat our patient with headache Conclusion
Slide 70-

A dynamic relationship
Slide 71-

MYOFASCIAL PAIN AND DYSFUNCTION Refers to a group of poorly defined muscle disorders (eg, fibromyalgia) characterized by diffuse facial pain and episodic limited jaw opening May result from parafunctional habits and significant relationship to psychophysiologic disorders such as stress or depression
Slide 72-

Management
Slide 73-

Anterior repositioning splintWhen & How it Works! It positions the condyle anteriorly away from the fully seated joint position Used in case of trauma inducing retrodiscal edema  Guide the mandibular condyles away from retrodiscal tissues. Used in case of anterior disc displacement Help aligning the disc over the condyle (back to normal position) hoping that it will keep this relation with time.
Slide 74-

Stabilization splint Hard acrylic Technically demanding Maxillary splint is easier to adjust Worn at night Long-term use must provide ideal occlusion at rest & function (CR =CO)
Slide 75-

Useful (?) in muscular signs & symptoms Bruxism may become worse in some patients Better tolerated in lower jaw Quick and easy to make Different thickness No need for occlusal adjustment Lasts for about 6 months