Dentures and TMJ Arthrosis

トップへ » Considering Dentures? » Dentures and TMJ Arthrosis

Might you have TMJ arthrosis?

Do you suffer from any of the following symptoms?
+ Do you clench or grind your teeth?
+ Do you feel pain or stiffness in your jaw?
+ Do you often get headaches or pain in the neck? And is it worse when clenching?
+ Does the pain when clenching get worse when you feel stressed?
+ Does your mouth pop or creak when you open it? Is it difficult to open your mouth?
+ Do you have any other types of arthrosis or problems in your joints?
+ Is it difficult to clench your teeth for a long time?
+ Does your bite alignment change from time to time?
+ Is it difficult to clench or tear food with your front teeth?
+ Are your teeth sensitive? Do they move, crack, or are they worn down?

If you are suffering from any number of the symptoms listed above, it is likely that you may have TMJ arthrosis. Since there are many causes of TMJ arthrosis, it is almost always very difficult to know whether or not the jaw is the source of the problem.

Symptoms of TMJ arthrosis

☑tooth wear
☑nerve pain from tooth wear (sting when touching hot or cold)
☑inflamed gums　☑root pain　☑grinding
☑pain in jaw joints　☑pressure pain in jaw joints　☑neck or head pain
☑ringing in the ears　☑difficulty hearing　☑loss of sensation in hands or feet
☑uneven posture (unable to keep balance)

TMJ arthrosis treatment varies according to the symptoms.
Treatment begins with a detailed search for the causes.

TMJ arthrosis caused by dentures

Some patients complain saying, "I cannot open my mouth wide", or "There is pain in the joints around my jaw". Upon further examination the number of middle-aged patients who complain of the following symptoms is increasing:
+ "I have stiff shoulders."
+ "My back aches."
+ "I have lost sensation in my arms and legs."
+ "There is ringing in my ears."
+ "I get terrible migraines."
These are all symptoms of TMJ arthrosis.

TMJ arthrosis is a condition in which the area around the jaw hurts, opening the mouth becomes difficult, and a clicking or scraping noise can be heard coming from the jawline area. TMJ arthrosis is considered an ailment common in people in their 20s and 30s due to bad tooth alignment, or an unbalanced bite caused by wisdom teeth.

However, cases of TMJ arthrosis in middle-aged patients are mostly attributed to poor bite alignment due to silver crowns and especially dentures.

If you wear dentures and suffer from any of the symptoms listed above, please contact us for consultation. We can fix your bite alignment and help alleviate your discomfort.

Cases of TMJ arthrosis caused by dentures

A patient who came in complaining of pain in the right jaw and the inability to open his mouth straight.

[state of the mouth when opened]
Seen from the front, it is obvious that the jaw has shifted to the left.

[state of dentures]
Looking at the dentures, it can be seen that the teeth on the left side are more worn down than those on the right side.

We took an X-ray of the joints in the jaw. We were able to diagnose that the articular disk on the left-hand side was shifted forward and had lost function.


Since this treatment method was to be carried out before making new dentures, we duplicated the patient's dentures, lowered the front of the lower jaw and raised the right side of her bite by 2 millimeters to give her smooth movement. We confirmed that she was able to open her mouth straight using the duplicate dentures and after making sure there was no more pain in the jaw, we remade her dentures.

We take a mold of Inaba-style full dentures using the maxillomandibular simultaneous impression method.

What are full dentures made using the maxillomandibular simultaneous impression method?

We used the PDRI Insert of the KaVo PROTAR actuator, a device used to measure bite alignment, to adjust the patient's bite alignment by lowering the front of the lower jaw in order to provide her with smooth jaw movement.

Dentures were made after we confirmed that the right jaw needed to be lowered by 2 millimeters during the jaw function exam by creating a graph using CADIACS and setting the PDR insert to 0 and then again to 2 millimeters.


We were able to alleviate the patients jaw pain with these dentures and they also allowed her to open her mouth straight.

This treatment method produces dentures that allow movement of the jaw joints. This particular case was rather complicated and required Dr. Shigeru Inaba's wide range of knowledge. It is very likely that using dentures that do not fit correctly over a long period of time may lead to TMJ arthrosis.

The process of treating TMJ arthrosis (an actual case)

During the initial exam we found that the patient could not open her mouth and that she experienced pain when she tried to do so. Her right jaw made a snapping noise. She shared with us that she was constantly worried about the area in front of her right ear and that it was effecting her work.

At first glance, it seemed that there were no obvious problems with the inside of her mouth. To the right is an X-ray image of the inside of her mouth. The many crowns and fillings in her molars stand out, but there was no problem with the shape of her jaw.

We examined the joints of her jaw using a Doppler stethoscope. We listened to find out whether the snapping noise occurred when she opened her jaw or when she closed it. In this patient's case, a snapping sound occurred in the joints on the right side when she opened her jaw. She was also unable to open her jaw straight.


The second time she came to the clinic we took a mold and examined it. This is after we added plaster to the mold of her upper and lower jaw and neatly trimmed it.

We then attached the mold to a device called an actuator, which can accurately reproduce jaw movements. The angle of jaw movement is different in each person. The jaw movement is always quite complex when people grind their teeth. The jaw rotates and moves back and forth and to the left and right. It is necessary in TMJ arthrosis patients to undergo this detailed examination.

This is a face-bow transfer. It is a device used to attach the upper jaw mold to the actuator. We can use it to examine whether or not the bite alignment plane is vertically aligned with the midpoint of the body. It is important to use the face-bow transfer even when making just a single crown or filling.

This is how we transfer the recorded data to the actuator. The relationship between the midpoint of the body (midpoint of the actuator) and the bite alignment is transferred accurately.

It is not enough that the upper and lower bite alignment meet at only a particular location when biting. We record the central position (the original position where the jaw is most relaxed) and then attach the upper and lower teeth.

Then we check to see if there are any changes between the position of the jaw when relaxed and the position when biting. In this patient's case, the reconstructed (fixed) fillings and crowns turned out to be the cause of her symptoms. This mold examination is extremely important and teaches us a lot about the condition. A high level of skill is required to master this examination technique.（IPSG）


There are many grooves hidden inside of the shape of teeth. These are not random imperfections, but they actually follow rules.

The third time the patient visited the clinic we record the movements of her jaw in 3-D and examined her jaw function. We record how her jaw movement has changed after treatment compared to before treatment.

It varies per case, but usually during the fourth visit we administer sprint therapy or instruct the patient on how to perform home therapy. In this patient's case, since the cause of her symptoms was unbalanced bite alignment due to fillings and crowns, we carried out occlusal adjustment.

Occlusal adjustment needs to be monitored and is usually complete after being carried out 1 to 3 times.


After adjustment, the patient was cured of the snapping noise in her right jaw joints. She also regained the ability to open her mouth straight. You can see from the image to the left that her jaw was barely moving at all. The image to the right shows that she was able to move and open her jaw widely after adjustment.

The patient was very pleased. She told us that she initially thought the pain was a result of being tired from work, but after treatment she was able to happily return to work in good health.

*TMJ arthrosis treatment is not covered by national health insurance and we charge 10,000 yen (tax not included) for the first examination.

カテゴリー一覧

We hold free consultations for dentures.

---

トップへ » Considering Dentures? » Dentures and TMJ Arthrosis