The Curve of Spee, an anteroposterior curvature of the occlusal surfaces, initiates at the incisors and follows the natural arc of the dental arch. Similarly, the Curve of Wilson, a lateral curvature, extends across the arch, contributing to the overall harmony of the occlusal plane. These curves are integral in ensuring the even distribution of occlusal forces during mastication.

Clinically, deviations from these ideal curves can precipitate a range of dental issues, including maladaptive stress on the temporomandibular joint, uneven wear patterns, and compromised occlusal function. A comprehensive understanding of these curves facilitates accurate diagnosis of malocclusions and informs orthodontic and restorative interventions. By adeptly managing these compensating curves, clinicians can enhance patient comfort, optimize functional outcomes, and ensure the longevity and efficacy of dental treatments.

For more Elaborative details, join in for our Progammes.

1. Complete Denture Hacks (online recorded session)

2. Mastering Occlusion: From Basics to Implants. A 2 day lecture cum workshop.

for further Details feel free to connect on +91-7303302651.

critics and suggestions are welcome…

Relief through skilled alignment, his pain’s enduring peak.

A 33-year-old male patient presented with pain in the right temporomandibular joint (TMJ) region and the right masseter region. Upon taking his medical history, it was noted that an implant had been placed on the lower left side 3-4 years ago following immediate extraction due to tooth decay. Additionally, another decayed tooth on the lower left side was removed and replaced with an all-ceramic bridge 2 years ago. Since then, he has been experiencing pain. The patient resides outside of India and frequently changes locations, which has prevented him from returning to his dentist for correction.

On examination, the patient first occluded on the left side before reaching the maximum intercuspal position (MIP). He had been previously advised to remove and replace the bridge. However, I decided to correct the occlusal contact, which subsequently corrected his bite and MIP. This adjustment allowed the patient to close at a single point, leading to significant improvements. To start with, relaxation of ipsilateral (same side) muscles brought harmony to the muscles and TMJ. Within half an hour, the patient experienced considerable relief.

A follow-up was conducted over one week, and the patient remained stable. He will return to us soon after his trip, and further updates will be provided.

Conclusion:

Correcting occlusion, especially on artificial crowns, can bring harmony to the muscles and TMJ.

Enjoy the case…

Critics and suggestions are welcome.

This is easily curable in 5-15 minutes in 80-90 percent patients with ALPDC Technique.( All complaints)

Sir, can you please elaborate more about the technique?

26th May, 24, where we had an Wonderful session on Occlusion and Occlusion in implants class.

Covering Basics to Advanced of occlusion and occlusion related to implants.

Stay tuned for Future updates.

Esteemed Colleagues,

I present to you a case of Temporomandibular Joint (TMJ) dysfunction, warranting detailed evaluation and management considerations.

Chief Complaint:

The patient presented with acute pain and chronic discomfort localized to the right TMJ region, characterized by pain exacerbated during mastication and restricted mandibular movement.

1. History of Presenting Illness:

The onset of symptoms in December 2023 marked a notable departure from the patient’s previously asymptomatic state. Subsequent to this, in January 2024, an acute episode ensued, manifesting as limited mouth opening upon arousal from sleep. Despite initial attempts at self-medication and conservative measures, including analgesics and heat application, the symptoms persisted, prompting professional intervention. Initial assessment by a dentist suggested a putative association between the TMJ pain and the presence of the lower right wisdom tooth. Consequently, surgical extraction of the wisdom tooth was performed, albeit without significant amelioration of symptoms. Upon incomplete satisfaction, Seeking further resolution, the patient pursued additional consultations, which yielded recommendations for a tailored regimen of pharmacotherapy and few exercises. However, despite adherence to this regimen, the patient reported only transient relief, with persistent exacerbations of discomfort and functional impairment. This protracted clinical course culminated in the patient seeking tertiary care intervention, thereby precipitating her presentation to our clinic after a lapse of four months. Concurrently, the patient reported concomitant dental hypersensitivity affecting both upper and lower posterior dentition, alongwith pain chewing from right side.

Examination Findings:

Clinical examination revealed a spectrum of relevant findings:

Evaluation of the dental arches identified a buccal cusp facial fracture localized to tooth 26, with no involvement of the cusp tip.

Provocative testing, including air blast stimulation, elicited pronounced sensitivity localized to tooth 47, with accentuated responses observed in teeth 17 and 16 as well.

Radiographic imaging via intraoral periapical radiography (IOPA) demonstrated conspicuous widening of periodontal ligament (PDL) spaces around teeth 46 and 47, indicative of underlying pathological processes, suggestive of Overloading, leading to a condition known as Frictional Dentinal Hypersensitivity.

Palpation of the right temporomandibular joint elicited localized moderate to severe tenderness and restricted range of motion.

Noteworthy tenderness was also elicited upon palpation of the right masseter (Upper fibres region – moderate pain and middle fibres region – mild pain) and of the right trapezius muscle (upper region towards shoulder – severe pain), suggestive of myofascial involvement.

The patient reported prior engagement in a structured physiotherapy program, which provided temporary symptomatic relief, albeit with recurrent exacerbations during periods of increased functional demand.

Occlusal assessment revealed aberrant interferences during centric relation positioning, accompanied by a pathologic slide upon closure, particularly evident in the molar regions, unilaterally, notably teeth 17 and 47.

Imaging Findings:

Orthopantomographic (OPG) imaging demonstrated a notable absence of radiographic abnormalities, with no overt evidence of bony pathology or structural aberrations within the maxillofacial complex.

Management Plan:

In light of the nuanced clinical presentation and multifactorial etiology, a comprehensive management strategy is warranted:

Implementation of a structured physiotherapy program tailored to address myofascial dysfunction and restore optimal musculoskeletal function, with emphasis on manual therapy techniques, therapeutic exercise regimens, and ergonomic modifications.

Consideration of pharmacological adjuncts, if needed occasionally or rarely, depending upon symptoms, includes nonsteroidal anti-inflammatory drugs (NSAIDs) & muscle relaxants for adjunctive pain management and symptom control, if required.

Collaborative liaison with advanced Dental Technology, Tscan, will be put to use. to address residual dental hypersensitivity through targeted desensitization modalities as this is due to Interference observed at 16,17, 46 and 47 region and adjunctive restorative procedures, as indicated.

Conclusion:

This case underscores the inherent complexity of temporomandibular joint disorders and underscores the imperative for a systematic, multidisciplinary approach to diagnosis and management. Further updates on the case will be provided as warranted by clinical progression.

For reference, please find attached the video presentation on  the TMJ case.

Your constructive insights and recommendations are earnestly welcomed as we endeavor to optimize patient care and outcomes.

Presenting another case with TMJ pain for 24 year old female patient with complains of pain on her right TMJ region, neck pain, finger tingling since few months.

After 1-2 session, not only he TMJ pain reduced her posture was improved. Follow up done for 3 months…

Physician of Stomatognathic System

Critics and suggestions are welcome.

We are Physician of Stomatognathic System, why?

See this case…

Pre – without Teeth

Post – With Teeth

Here, see the level of

1. Shoulder.

2. Hand length

3. Relaxed Neck Musculature

Try Observing such details, and then be ready to get stunned by the change in patients posture.

This change usually go unnoticed and if patient is asymptomatic, then it doesn’t create much of difference, but for patients who are having some neck pain symptoms, back pain, knee pain may get some percent of relief. If no relief, atleast some posture is corrected, rest other relevant physician can help the patient.

Now, I hope you may Realise to come out of shell of “Dentist” or “Dental Cavity Filler” and be Proudly Known as “Physician of Stomatognathic System“.

Visited ENT, referred to dentist.

Dentist asked not to wear Denture as this is the cause of TMJ pain and stop wearing. (She, being an healthy, aware patient regularly gets her dentures changed at regular intervals. Current denture was also 2-3 years old, slight wearing). Moment she stopped wearing, her health detoriarted, weight gone down, Hb came down, stomach upset steps in.

Visited 3 Dentists, and was suggested not to wear Dentures.

Then, pt was referred to me, given her ULF-TENS (ultra low frequency TENS unit, Bioresearch Inc) session, 1 only and some jaw manipulation with home care regime, within 10 days, her pain score (vas scale) came down from 7 to 1.

Her pain free mouth opening on Day 1 was 35 mm, with pain 40 mm, after 10 days, it went straight to 50 mm pain free and with pain 55 mm, which needs continued home regime and constant follow up.

Take away point:-

Cases which r acute in nature, can be taken care well in time and before time, especially at this tender age which can affect psychologically…

Posting her video…

Open to Comments, suggestions and queries…thank you ..

Enjoy…