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CFH
01-30-2007, 11:14 AM
from what understand disc displacement is cause by the muscle going into spasm and the pulling the disc forward(or in any direction) and it seems like this would be easy to correct and in theory it sounds like a pull forward splint would be the cure. i was injured after boxing and have yet to be put into a reposiontitioning splint and so far all the doctors give me is a splints for grinding(nti)

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Thelma-Louise
01-30-2007, 05:28 PM
Have you actually been told you have a displaced disc?

CFH
01-30-2007, 07:15 PM
yes one doctor said i had bilateral non reducing anterior mensicus sublaxtion and another after him said i was reducing based on mouth opening(50mm) and a pop when i open and close my mouth. for symptoms i have popping,pain, jaw deviation to the left and when bring my lower jaw forward,and my jaw used to lock and i would have to move it around to fully open. i also have an overbite but i think this is due to genetics

Thelma-Louise
01-30-2007, 10:29 PM
I have seen some info on the web which discusses various ways to recapture discs and reposition them so you might want to research disc recapture - mainly on ortho tmj sites. I'm not sure why you are being repeatedly fitted for a splint that is not helping you recapture the disc - you should be asking the drs that question. Not all drs are good at making the splints so you may want to look for one trained in FJO. You're correct though that in theory what needs to be done is that jaw needs to be brought forward and slightly downward.

CFH
01-30-2007, 10:49 PM
why are there different phases if a pull forward splint corrects the problem

CFH
01-30-2007, 10:51 PM
the second doctor i went to who was a tmj specialist who said i was non reducing originally told me his plan for treatment was to put me in a mora splint so i agreed with the treatment and out of pocket $750 for the splint the day i got the splint however he told me he changed his mind and instead gave me an nti i have not gone back to him since i feel he ripped me off


what is FJO?

Thelma-Louise
01-30-2007, 11:07 PM
I hear you - I think the MORA splint would have been better - I did not have much luck with an NTI and was later told by my 5th and current tmj dr that people with overbites ( I have one deep too, despite braces previously) do not respond well to the NTI since its purpose is to basically not let the back teeth meet and that people with over bites develop a neuromuscular tendency to use their back teeth in maintaining their overall body or structural balance, so an NTI just makes things worse.

I'm not sure I understand your question regarding different phases of treatment - could you elaborate a bit?

FJO means functional jaw orthotics.

CFH
01-30-2007, 11:16 PM
i have read that once you are put into a repositioning splint you then need orthodotics like braces or crowns to maintain the bite

it seems like the splint should cure the problem allowing everthing to heal and tighting back up without the need for further treatment

i do not even know if im reducing or non reducing which doctor do i believe?

Thelma-Louise
01-30-2007, 11:34 PM
Some people choose not to make any permanent changes and instead opt to just keep wearing the splint. Others do make it permanent either through crowns, overlays or braces, or surgery to keep the disc from slipping. The issue really becomes about teeth contact - this is what I have been told keeps your teeth and jaws aligned and in balance and allows the disc to function properly. I have the same issue in terms of figuring out who is right or wrong and what to believe - many of the drs sound so convincing in their diagnoses and recommendations and believe they are truly right - its one of the reasons so many of us see so many drs in treating this. I have seen many, many drs and have never gotten the same diagnosis more than twice.

CFH
01-30-2007, 11:42 PM
so it never heals even with a repositioning splint?

Thelma-Louise
01-30-2007, 11:54 PM
From what I have read from other members usually a disc that is recaptured will remain so unless there is some abnormality preventing it from doing so. So if it slipped out or is displaced due to an injury I would think recapturing it would be the end of it unless the injury has done damage which would prevent the disc from staying in place.

CFH
01-31-2007, 12:09 AM
thanks for your help you have made me feel better:)

CFH
01-31-2007, 11:28 AM
i called the doctor who said i was reducing today after seeing my xrays he said that one side is worse than the other so does that mean one side is reducing and the other is non reducing or does that mean one side is normal and one side is reducing?


i am scared

CFH
01-31-2007, 04:26 PM
Orthodontic treatment has as its goal in most patients to achieve a cosmetic and functional result. There are functional goals for all orthodontic treatment and in some few cases the functional outweigh the cosmetic; an example would be a cleft-palate case. Orthodontic finishing to a specific condylar position is not routinely a goal of orthodontic care. The reason for this is that only patients who have pain, dysfunction and a negative change in quality of life from their temporomandibular apparatus need this tangential type of treatment. Research has shown that most patients suffering from a temporomandibular disorder (TMD) have displacement of the temporomandibular disk(s). Research has shown that when the mandibular condyle is repositioned to the Gelb 4/7 position that the temporomandibular joint disk is recaptured to a normal position between 85% and 96% of the time. The Gelb 4/7 position has been equated to the physiologic position of the mandibular condyle in the glenoid fossa. TMJ condyle repositioning to the physiologic position has been correlated to disk recapture proven by magnetic resonance imaging (MRI). A case is shown in which a displacement without reduction is manipulated into reduction and maintained with orthodontic correction. TMJ disk displacement without reduction is usually preceded by TMJ disk displacement with reduction. Pumping of the upper joint compartment can assist in reducing the TMJ disk displacement without reduction. Magnetic resonance imaging before and after the manipulation and after orthodontic treatment are shown. A detailed method of orthodontic finishing that maintains a specific condylar position and TMJ disk recapture is shown.

PMID: 11921841 [PubMed - indexed for MEDLINE]

seems like even non reducing can be fixed to reducing so what is all of these doctors problems? do they not know what they are doing?

Thelma-Louise
01-31-2007, 05:14 PM
To be honest - maybe its b/c I have brain fog - but I still get very confused with the technical apsects of the problem even when explained from what you have posted and also b/c (supposedly) I do not have a disc or joint problem but a neuromuscular dysfunction (myofacial spasms and dystonia) so I really haven't had to delve too deeply into treatments of joint and disc function.

Based on experience I have found though that any dr can take a few seminars in tmj and claim himself a specialist and that there is a wide margin between theories and knowledge of tmj and treatments and the actual application and experience by the specialist. The fisrt dr I let treat my problem wrote several published books on tmj and had a mile long list of credentials & associations he belonged to and was a teaching professor at a dental college yet all he wanted to do was crown my back teeth. When that failed to abate any of my pain and symptoms he told me I had a "jaw problem" and could no longer help me. It was a very rude awakening for me.

CFH
01-31-2007, 06:33 PM
i guess you are lucky then that you dont have displaced discs

Thelma-Louise
01-31-2007, 08:07 PM
Not necessarily - muscular dysfunction with jaw deviation and facial spasms is no easier to treat but is just as painful but and since it does not appear on xrays its hard to determine exactly what is causing it. At least disc displacement is definitive - so you know what you are dealing with and see proof of its correction (or not) on xrays.

GoodThings
01-31-2007, 09:34 PM
from what understand disc displacement is cause by the muscle going into spasm and the pulling the disc forward(or in any direction)

Hello,
The muscles do spasm. But what caused the muscles to spasm? The joint. It is because the joint is sitting too far back and up.

GT

CFH
01-31-2007, 09:35 PM
so what causes the jaw deviation? i think its affecting my speech even though i did have a lisp before the injury

CFH
01-31-2007, 09:38 PM
by joint do you mean disc or the bone? my disc are placed forward the jaw bone

GoodThings
01-31-2007, 09:42 PM
seems like even non reducing can be fixed to reducing so what is all of these doctors problems? do they not know what they are doing?

Very good question. My opinion is that they know, but they don't want to help you. Period.

GT

GoodThings
01-31-2007, 09:49 PM
I do not have a disc or joint problem but a neuromuscular dysfunction (myofacial spasms and dystonia) so I really haven't had to delve too deeply into treatments of joint and disc function.


Isn't your current doctor trying to move your joints down and forward? Seems like your current treatment deals with joint issues and not muscular issues.

I still don't know why you believe it's a muscular problem.

GT

GoodThings
01-31-2007, 09:52 PM
by joint do you mean disc or the bone? my disc are placed forward the jaw bone

By joint, i meant the condyle. It is sitting too far back and up the fossa. But it is ultimately your bite that's causing this. Causing your joint to be back there.

GT

CFH
01-31-2007, 09:57 PM
how is my bite causing this? i was hit in the face a few times when boxing

GoodThings
01-31-2007, 10:01 PM
This is the answer.

i also have an overbite but...

This overbite i believe has pulled your lower jaw back a little causing the joint the sit back there.

GT

CFH
01-31-2007, 10:02 PM
what about the getting hit in the face part?

CFH
01-31-2007, 10:03 PM
is it possible to have one side reducing and the other side non reducing because my new doctor today said after seeing my xrays one side is worst than the other

GoodThings
01-31-2007, 10:08 PM
what about the getting hit in the face part?

if your wearing a mouth guard, you should be ok. Have you seen any pro boxers getting tmj?

But since your bite is off, it will stay off unless you fix it. Will boxing make it worse even with the mouth guard? i don't know.

GT

CFH
01-31-2007, 10:09 PM
if your wearing a mouth guard, you should be ok. Have you seen any pro boxers getting tmj?

But since your bite is off, it will stay off unless you fix it. Will boxing make it worse even with the mouth guard? i don't know.

GT

boxing is what caused it when i was 17 im now 21 and have not boxed since

GoodThings
01-31-2007, 10:10 PM
is it possible to have one side reducing and the other side non reducing because my new doctor today said after seeing my xrays one side is worst than the other

Yes it's very possible. It just means that the disc on the non reducing side has no room for it to go back. While the reducing side has room for the disc to pop back.

GT

CFH
01-31-2007, 10:11 PM
Yes it's very possible. It just means that the disc on the non reducing side has no room for it to go back. While the reducing side has room for the disc to pop back.

GT

so how do they make room(with the correct splint?) and can it still heal back to normal?

GoodThings
01-31-2007, 10:17 PM
so how do they make room(with the correct splint?) and can it still heal back to normal?

Yes. The goal is to try to move your condyle near the "Gelb 4/7" with the splint so that disc will hopefully sit nicely on top of the condyle once again.

GT

CFH
01-31-2007, 10:19 PM
so why have i yet to be put into this treatment? i just dont understand and in all i have paid over $1500 between 3 doctors

GoodThings
01-31-2007, 10:32 PM
so why have i yet to be put into this treatment? i just dont understand and in all i have paid over $1500 between 3 doctors

What doctors have you seen? Finding the right doctor is the hardest part. Treatment, like you for example, is very simple. But not many doctors know or want to help. Actually many of them are pretty much in it for the money. I would say over 95% of them are in it for the money. I think you will have some luck with a FJO dentist since they're trained in keeping the joints healthy. But once again, if you don't know a thing, they will most likely try to milk as much as possible out of you. Then if you're lucky, they'll fix you. Most time, they'll say i can't help you anymore and just tell you to see another doctor. But because there is no regulation on the form of treatment, you can't really do anything about it unless you can prove what they did is wrong. That's is why you should bring a tape recorder with you and get copies of every visit. All i can say is that be very careful. There are a lot of bad intentioned dentists out there.

GT

CFH
01-31-2007, 11:16 PM
the second dentist i saw for this was going to put m into a repostioning splint and i agree with the treatment and the cost of $750 the day i went into to get the splint he told me he changed his mind and gave me an nti which is used for grinding if that is not a rip off i dont know what is

Thelma-Louise
01-31-2007, 11:36 PM
Isn't your current doctor trying to move your joints down and forward? Seems like your current treatment deals with joint issues and not muscular issues.

I still don't know why you believe it's a muscular problem.

GT

GT - I have brought my actual MRIs, ICAT and tomogram to many drs and they all say my joints are properly positioned and there is no disc displacement - nothing remarkable or significant at all. What does appear abnormal though is that my hyoid bone is misplaced (its pushed upward) and my airway has become very narrowed. I also have a rotated atlas or C1 and now I am feeling cranial bone movement - I am hearing popping noises under my nose like way in the back part of the hard palate and am told the sphenoid bone has been displaced as well. This is why I still sometimes think I have more than tmj going on but have been repeatedly told its just a complicated form of it. I would certainly welcome any suggestions but I have been to just about every well known tmj dr in NYC and several neuros as well. When drs ask who I have been to and I tell them - they raise their eyebrows and ask "And they didn't find anything?" so tehy look at the tests (films) and usuually then say they can't help me. Its very frustrating.

CFH
02-01-2007, 09:11 AM
Yes. The goal is to try to move your condyle near the "Gelb 4/7" with the splint so that disc will hopefully sit nicely on top of the condyle once again.

GT

if one side is non reducing doesnt that mean that there is damage to the disk and it wont recapture?

GoodThings
02-01-2007, 02:04 PM
GT - I have brought my actual MRIs, ICAT and tomogram to many drs and they all say my joints are properly positioned and there is no disc displacement - nothing remarkable or significant at all. What does appear abnormal though is that my hyoid bone is misplaced (its pushed upward) and my airway has become very narrowed. I also have a rotated atlas or C1 and now I am feeling cranial bone movement - I am hearing popping noises under my nose like way in the back part of the hard palate and am told the sphenoid bone has been displaced as well. This is why I still sometimes think I have more than tmj going on but have been repeatedly told its just a complicated form of it. I would certainly welcome any suggestions but I have been to just about every well known tmj dr in NYC and several neuros as well. When drs ask who I have been to and I tell them - they raise their eyebrows and ask "And they didn't find anything?" so tehy look at the tests (films) and usuually then say they can't help me. Its very frustrating.

Hello thelma,
I am sorry if i came off as being rude or trying to discredit you and your knowledge about tmj. That was not my intention at all. I guess i just want people to understand what causes tmj and maybe somehow they can find an answer and not being duped by those bad dentists out there. Believe me when i say there are a lot of them out there. It's mind boggling how many of them can sit there and just blatantly lie to your face.
I do understand that it is very frustrating. Especially finding a good, well-intentioned doctor. I don't doubt the doctors told you that your joints are fine. But i still don't buy it. They don't add up because one you have a bad bite, and two your muscles are still in spasms. Both of them point to your joints being out of position. Unless you have structural abnormalities, those two things should not occur.
How was the tomogram taken? first, fully closed? then, almost half open? then , fully open? That's how my tomo's were taken. But i seriously doubt your joints are in good position. That is near the "Gelb 4/7." BTW, does your condyle look worn out? Or is it normal looking?

take care,
GT

GoodThings
02-01-2007, 02:09 PM
if one side is non reducing doesnt that mean that there is damage to the disk and it wont recapture?

What sort of damage are you talking about? Are you able to open fully?

GT

CFH
02-01-2007, 03:14 PM
i have an opening of 50 mm. the third doctor that i saw that said i was reducing , after seeing an xray he said over the phone one side was worse than the other so im assuming i have a reducing side(left side and the same side of jaw deviation) and a non reducing side(right side) but i wont know what he meant until the 7th

i dont want to live with this my entire life

GoodThings
02-01-2007, 10:13 PM
i have an opening of 50 mm. the third doctor that i saw that said i was reducing , after seeing an xray he said over the phone one side was worse than the other so im assuming i have a reducing side(left side and the same side of jaw deviation) and a non reducing side(right side) but i wont know what he meant until the 7th

i dont want to live with this my entire life

50mm is very normal. I wish i can post a copy of my tomogram here for everyone to see because my right side is fine and my left side is missing a little bit of vertical dimension and the tomo illustrates this. If you do a search on the popular and biggest search engine (can't say the name of it because it's against site policy), type in "anterior disc displacement," and go to page 3 and you'll see clips of patients with reduction and without reduction. From the clips, it's pretty clear that patients' condyles (without reduction) are a bit higher up the fossa than patients' with reduction. What's also clear is that their joints are far from the "Gelb 4/7." Most of them have severely worn out condyles. Especially the back. Look how flat the condyles are in the back. Ouch.

GT

CFH
02-01-2007, 10:37 PM
what about the disc though in non reducing can they be recaptured?im thinking about killing myself over this

GoodThings
02-01-2007, 11:54 PM
what about the disc though in non reducing can they be recaptured?im thinking about killing myself over this

Yes, they can be recaptured. Even if it doesn't, you will be fine if you move the condyle to the "gelb 4/7."

GT

CFH
02-02-2007, 08:27 AM
how will i be fine and what about degenerative changes to the disc if there is any?

CFH
02-02-2007, 02:11 PM
im going to see an orthodontist monday and they are going to tak tomograms(how much do those cost?) hopefully this guy will know what to do im going to print out a bunch of articles and see what he says

CFH
02-02-2007, 09:02 PM
http://www.cfoo.com/research.php#pivsplint doesnt this site say that this can be treated and cured through non surgical treatment

CFH
02-02-2007, 10:28 PM
does it sound like my disc are in good shape with the wide opening or is that bad?

GoodThings
02-02-2007, 11:19 PM
http://www.cfoo.com/research.php#pivsplint doesnt this site say that this can be treated and cured through non surgical treatment

Yes. Splint is Phase 1 and the braces is phase 2. But there are other ways to achieve a permanent bite. I don't believe in surgery to achieve a permanent bite unless there is abnormal growth in jaw bone.

GT

CFH
02-02-2007, 11:20 PM
is the wide opening a good sign?

GoodThings
02-02-2007, 11:27 PM
does it sound like my disc are in good shape with the wide opening or is that bad?

I think the side with reduction is in better shape than the side without reduction since the disc is able to pop back to its original form. Don't really know the long term consequences though.

GT

GoodThings
02-02-2007, 11:28 PM
is the wide opening a good sign?

Yes, it's a very good sign.

GT

CFH
02-02-2007, 11:30 PM
of the discs being in good shape?i have really been worried. im going to see an ortho monday and he's going to take tomograms and hopefully he will know how to fix me

GoodThings
02-02-2007, 11:35 PM
of the discs being in good shape?

Yeah, on the non reduction side. I have to check what is it (the disc) made of. I think it will return to normal. Not sure though

GT

CFH
02-02-2007, 11:37 PM
how do you know so much about tmj?

GoodThings
02-02-2007, 11:39 PM
of the discs being in good shape?i have really been worried. im going to see an ortho monday and he's going to take tomograms and hopefully he will know how to fix me

Get the diagnose in writing. Report back to us what he said. Hopefully he is able to help you. Good luck.

GT

CFH
02-02-2007, 11:40 PM
how much are tomograms?

GoodThings
02-02-2007, 11:44 PM
how do you know so much about tmj?

Actually, i just know the basics. And about 90% of dentistry is basically common sense.

I got most of my knowledge, about 95%, from a trilogy written by Dr. Terrance Spahl. His third volume is dedicated to treating tmj. That's how i know. But what's more important is that this method really works and they make SENSE.

GT

CFH
02-02-2007, 11:45 PM
it seems like bringing the jaw down and forward would fixed the problem whether it was reducing or non reducing

GoodThings
02-02-2007, 11:47 PM
how much are tomograms?

I don't really know. My consultation included the tomograms. But they're xrays. So i don't think they should cost that much. Maybe someone else here can chime in. If you have insurance, i believe they'll cover the cost.

GT

GoodThings
02-02-2007, 11:51 PM
it seems like bringing the jaw down and forward would fixed the problem whether it was reducing or non reducing

Yes that's how i feel as well. What's different between the two, reducing and non reducing, is that one is farther up in the fossa. But both condyles are sitting back.

GT

CFH
02-02-2007, 11:52 PM
how have you been treated?

GoodThings
02-03-2007, 12:02 AM
do you have tmj?

Yes. I have a mild case of tmj. I have no wisdoms and a curve of spee. In a nut shell, broke my lower left second molar. Thus loss of vertical dimension. Like you, my jaw deviated. I felt my left condyle was going over a bone. I bet you feel that too. Got a crown to add some vertical dimension. Waht do you know, no muscle spasms, and my left side doesn't deviate as much. The crown only helped slightly. That's because i was being duped. But that's another story.

GT

CFH
02-03-2007, 12:04 AM
i need to get this resolved before i go crazy





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