The temporomandibular joint (TMJ) is the anatomical articulating region between the condyle of the mandible and its corresponding fossa in the sphenoid bone of the skull. This complex gliding hinge joint involves the surrounding ligaments and interposed cartilaginous disc and synovial fluid lubricant. With several moving parts and given its complex nature it is no wonder than many people experience temporomandibular disorder (TMD). A number of signs and symptoms including clicking, popping, crunching (crepitus), and pain in the joint and surrounding musculature combine to define this often debilitating disorder. Proper evaluation of the joint and surrounding tissue as well as the occlusion of the teeth is critical in establishing a proper diagnosis and treatment plan. Because the mutual protection of the anterior and posterior teeth in functional working and nonworking movements is critical in the balancing of the TMJ in its proper anatomical position, the evaluation of the teeth and bite is a starting point in evaluating TMD. Diagnosis and treatment often involve the fabrication of occlusal guards and orthotic devices in order to regain stability in a joint destabilized by the occlusion.
Occlusal Guards and Splints:
Many times teeth appear to be their own worst enemies, and rub against each other in a process known as grinding or bruxism. When this happens they wear each other down over time causing damage and an unsightly appearance. When crowns rub against natural teeth the teeth wear even faster. To prevent this a resin appliance known as an occlusal guard or splint is fabricated and worn, usually at night. Resin is much friendlier to the enamel than crowns or natural teeth and occlusal guards can preclude the need for expensive restorative procedures such as crowns that are sometimes needed to restore tooth structure lost to abrasive wear.