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We encourage patients to include a family member, friend or other advocate in the treatment process. They will offer some objectivity, ask additional questions, provide additional information, and give you someone to talk to about your case. They also come to appreciate what you have faced. Provide a credible entry point for patients and a resource for general and specialty practices; make well founded referrals for specialty services and provide case management. Diagnosis of the TMJ System: TM Joints + Teeth + Muscles Evaluation of all three components is required when signs and symptoms are present to determine a sound medical diagnosis. Step 1. Joint analysis includes MRI and CT scans to be cross referenced to gain a three dimensional picture of the bone structures and the condition of the soft tissues. The cartilage disk may be stuck or "adheased" to the bone or slipped forward or to one side or distended and degraded. All of the soft tissue in the joint capsule is evaluated. Step 2. Occlusion analysis begins in the mouth and continues on models of the teeth mounted on measured articulators. Contact patterns and interferences are evaluated. Poor occlusion stresses the joints and unstable joints degrade the bite. Step 3. Muscle analysis identifies which muscles generate pain. Charting muscle pain helps identify problems and conflicts between hard tissues. Some muscles may overdevelop and some may weaken or cramp. Step 4. We screen for other conditions that may cause symptoms including neurological issues. Treatment of the Chewing System: In some cases surgery is needed to restore jaw-based occlusion. Surgery requires that the TM joints are stable and well adapted. Muscle pain will usually resolve or can be improved slowly over time. TM joints are resilient even when severely degraded. Treatment is predictable and the prognosis for achieving harmony and rehabilitation is a realistic goal.
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