Temporomandibular Joint (TMJ) Disorders are one of the rare disorders in which patients go from doctor to doctor but helpless. Physicians that patients mostly refer to are ENT specialists, Physiotherapists, Neurologists and then dentists. The most important reason for the emergence of TMJ disorders and their progressive progression is various early contacts in the teeth. The upper and lower teeth close by rotating around the jaw joints like a door hinge, but they do not fit into the frame of a good door exactly. There is a process in which the recesses and protrusions on the chewing surfaces of the teeth overlap each other in the lower and upper jaws, and then the lower and upper teeth come into maximum contact with each other. In other words , first the lower and upper teeth come into contact at one point , then the contact points gradually increase , and finally the closure of the lower jaw to the upper jaw ends with the maximum contact number and area .
In dentistry, this process is called the occlusion process. While this process is developing, these irregular contact points, which appear as an increase in the pressure intensity at an already existing point under extreme stress, with treatments such as a high filling, veneer or orthodontic treatment during the time from the first contact point to the maximum closure, become foreign and foreign in the neuromuscular mechanism. are considered as points to be destroyed. This is a purely reflex mechanism, and they are managed from the area called the cerebellum, just below the brain. The formation of this point is sent to the cerebellum by the nerve endings on and around the teeth. This early and overpressured point, which is perceived as a foreign point by the cerebellum, is first tried to be destroyed; The command “Contract !!!” is sent to the muscles via motor nerves and it is aimed that the chewing muscles will contract and destroy this foreign point on the teeth. However, due to the durability of the materials used for filling, veneer and other restorations, these extremely high points cannot be easily eroded.
These teeth clenching and grinding movements, which start small in the patient, increase gradually, but because the problem cannot be eliminated, the pain threshold is eventually exceeded and pain begins in that area. In this squeezing and grinding of teeth, there is excessive contraction of the chewing muscles in the area where there is a problem until the pain begins. However, when the pain starts, the information that there is pain goes to the cerebellum, and since the problem cannot be resolved and pain occurs, this time the patient reflexively tries to close his jaw in the opposite direction of that area, and this time the chewing muscles on the opposite side of the problem area begin to contract excessively, causing excessive contraction of the teeth on that side. pressure increases. This situation is now the advanced state of the TMJ problem and the pressure on the teeth on the overcuffed side begins to directly affect the joint on that side and cause pain in that joint.
As a result of excessive squeezing, the pain that occurs especially in the temporal muscle region manifests itself as a headache, at this stage, patients begin to complain of chronic migraine pain and seek treatment in that direction. In the second phase, while the contractions on the other side continue for a while, this time the pain occurs and the knowledge of whether the problem persists even if the pressure on the first side is gone is constantly checked by the cerebellum. If the problem is not resolved, excessive closing continues on the opposite side. The patient is now a typical TMJ patient, and unless that tiny spot, which is the source of the problem, is removed, this problem will gradually develop. If the problem persists, the ear nerve passing through the joint socket is also affected, and the patient begins to experience tinnitus and hearing loss.
Nowadays, a splint to be used at night is usually applied to the patient to eliminate such discomforts. These splints, which initially relieve the patient because they disrupt the muscle nervous mechanism, are faced with a discomfort caused by the splint after 3-5 days and the problem may become more severe. The most basic treatment is to eliminate the source of the problem. However, for this, it is necessary to find out which tooth is where the elevation causing the problem is located. For this purpose, until the last 10 years, occlusion analysis was performed on instruments called semi-adjustable ariculators, and then necessary abrasions were made on the teeth in the mouth. However, since this method is very complex and requires a lot of expensive equipment and information, unfortunately, it could not be performed frequently in every dentist. For this reason, dentists still generally use one side blue and the other red bite paper, as it is both an easy and practical solution. However, even if these papers show the contact points, they cannot inform the physician which point is first and which point is after. In addition, they do not give information about the intensity of the contact points at that time. Therefore, they have no therapeutic value in relation to TMJ disorders.
Today, T-Scan III Computerized occlusion analysis method is an important and revolutionary discovery in this field for the diagnosis of closing disorders that cause TMJ disorders. In the T-Scan III Occlusion Analysis method, it is possible to monitor which point first and which point contacts later and the relative pressure amounts at the moment of contact, and the necessary abrasions in the mouth can be done from the right places and properly. When the source of the problem is eliminated, the symptoms quickly disappear. In order to reach the most accurate result during the application of this method, the elimination of the contractions of the overly contracted muscles provides convenience to the physician. For this purpose, while the patient used a hydrostatic posterior splint for 24 hours and the muscle was relaxed, Ozone therapy can be applied to the area where the painful and contracted muscles are, and the muscles can be relaxed within 10 minutes. Then, by performing T-Scan III occlusion analysis, the source of the problem is accurately reached and the early contact point that causes excessive pressure is eliminated.
