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Old 11-24-2003, 10:25 PM   #1
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Isobelj HB User
Tissue posterior to disc?

I saw a new maxillo facial surgeon today who was dramaticially more informative and helpful than the previous one whom I've seen three times. I'd like to go into more detail but am going away for two days and a bit rushed right now, however I did want to ask the group about something he told me.
He confirmed what I felt but what the other surgeon did not tell me despite looking at the same tomograms, my right condoyle is higher than the left (due to my molars becoming shorter on the right in Jan), and the space there between disc and fosse is 'thin', 2mm smaller than it is on the left where he said it looks completely normal (I think he said that the normal space between condoyle and fosse is 4mm). From this and feeling my joints he thinks the right disc is displaced (the annoying thing is that I believe this has happened since I began seeing that first surgeon who failed to help me), it goes into place when my mouth is wide open but slips (forward I think he said) at other times. There is no fraying he said of the disc but also he told me that totally putting it back isn't possible (without surgery which he didn't advise and which I don't want), what he thinks I can achieve is that the 'posterior tissue' to the disc will harden and effectively replace the disc. He thinks I need to wear a splint and then afterwards heighten the too short molars to give more space between condoyle and fosse on the right, this is what I've believed all along, and I'm glad to hear it confirmed, but also unhappily previous blundering doctors have not helped me prevent relatively recent (within the last ten weeks, before that both discs were in place) displacement from happening. Well, I would like to go more into this later, I'm aghast at how wrong some 'professionals' can be in proposing treatment and making (or not even getting to the point of making any) diagnosis.

What I wanted to know could anyone tell me more re this posterior to the disc tissue? I haven't read/heard anything about this so far, I thought just 'decompressing' the condoyle could enable a slipped forward disc to move back, so I'm disconcerted and a bit sad, I do want to get everything back to normal, not to feel 'damaged', even if the 'posterior tissue' can work as well as the original dics.

One interesting thing, the surgeon himself asked me to feel his discs as he opened his mouth, to my surprise I could hear loud clicking, he then told me he actually had tmj as a teenager in result of orthodontics, and his discs became dispaced and now on both sides he has this 'posterior tissue' acting as discs or transformed (naturally) to disc like material (sorry my terminology is so vague, this is such a new thing to me), he has no pain at all and can move his jaw freely, eat anything etc. I'd guess he's now about in his mid thirties. I felt this explained his genuiness and apparant real understanding as I explained my own symptoms to him, but I'm still unhappy to think my right disc won't ever be 'normal' again. Maybe I am dramatising this overly.

Last edited by Isobelj; 11-25-2003 at 01:30 AM.

 
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Old 11-26-2003, 08:17 PM   #2
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tigerlilly24 HB User
Re: Isobelj-Tissue posterior to disc?

Isobelj
I am new here, but I know where you are coming from. Within this past month I had a series of x-rays done...tomogram...and was told it was "not normal". I am convinced it is because my bite is off like yours where one side is shorter than the other. I am told that this can not be adjusted until i get some relief and return to normalcy and if adjusted now, it could cause more problems. I am currently wearing a day and night NTI splint and my bite constantly is shifting. They say surgery is not good and I need to just keep comfortable with whatever symptoms I have (headaches and facial pain) with therapy, medicine, etc. I have tried multiple muscle relaxers.

I guess my mandible bone is worn down and is not rounded like a normal one which pushed my disc forward. The disc is pushed forward and I am resting on built up scar tissue. This is good according to my dentist, as if not for this tissue build up I would be bone on bone. Yikes. I have follow up in about a week to see what the next step is. I am curious what they will recommend for you?
tigerlilly

Quote:
Originally Posted by Isobelj
I saw a new maxillo facial surgeon today who was dramaticially more informative and helpful than the previous one whom I've seen three times. I'd like to go into more detail but am going away for two days and a bit rushed right now, however I did want to ask the group about something he told me.
He confirmed what I felt but what the other surgeon did not tell me despite looking at the same tomograms, my right condoyle is higher than the left (due to my molars becoming shorter on the right in Jan), and the space there between disc and fosse is 'thin', 2mm smaller than it is on the left where he said it looks completely normal (I think he said that the normal space between condoyle and fosse is 4mm). From this and feeling my joints he thinks the right disc is displaced (the annoying thing is that I believe this has happened since I began seeing that first surgeon who failed to help me), it goes into place when my mouth is wide open but slips (forward I think he said) at other times. There is no fraying he said of the disc but also he told me that totally putting it back isn't possible (without surgery which he didn't advise and which I don't want), what he thinks I can achieve is that the 'posterior tissue' to the disc will harden and effectively replace the disc. He thinks I need to wear a splint and then afterwards heighten the too short molars to give more space between condoyle and fosse on the right, this is what I've believed all along, and I'm glad to hear it confirmed, but also unhappily previous blundering doctors have not helped me prevent relatively recent (within the last ten weeks, before that both discs were in place) displacement from happening. Well, I would like to go more into this later, I'm aghast at how wrong some 'professionals' can be in proposing treatment and making (or not even getting to the point of making any) diagnosis.

What I wanted to know could anyone tell me more re this posterior to the disc tissue? I haven't read/heard anything about this so far, I thought just 'decompressing' the condoyle could enable a slipped forward disc to move back, so I'm disconcerted and a bit sad, I do want to get everything back to normal, not to feel 'damaged', even if the 'posterior tissue' can work as well as the original dics.

One interesting thing, the surgeon himself asked me to feel his discs as he opened his mouth, to my surprise I could hear loud clicking, he then told me he actually had tmj as a teenager in result of orthodontics, and his discs became dispaced and now on both sides he has this 'posterior tissue' acting as discs or transformed (naturally) to disc like material (sorry my terminology is so vague, this is such a new thing to me), he has no pain at all and can move his jaw freely, eat anything etc. I'd guess he's now about in his mid thirties. I felt this explained his genuiness and apparant real understanding as I explained my own symptoms to him, but I'm still unhappy to think my right disc won't ever be 'normal' again. Maybe I am dramatising this overly.

 
Old 12-02-2003, 02:58 PM   #3
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Isobelj HB User
Re: Isobelj-Tissue posterior to disc?

Tigerlilly24,

Thanks for the reply. The surgeon told me also that doing permanant work on my teeth isn¡t a good idea yet, to wear a guard which makes my teeth all have contact at the same time (this is very important apparantly and something I've been without all this year) first for 3 or 4 weeks at least first would help me to bite straight and so get the dental work right. It's interesting your bite is shifting with the NTI, hopefully this is a very good sign I'm not using medication unless I get a migrain which is infrequent, I hate the way it makes me feel (upset stomach, fuzzy head, tired), I find a heat pad works really well, and showering too, and just really resting a lot.

Apparantly my bone is normal, not damaged at all, but the disc has slipped forward (only going back into place when my mouth is wide open) because there is too little space for it since the January dental work. Did your tomo's show bone wear and tear? I think if you are not at the stage of bone rubbing on bone maybe your condoyle etc. are ok so far, I hope so.

Well, so the maxillo facial surgeon recommended wearing a guard now asap (I have one but it isn't right and gives me aching which is horrible across my face), as he says its very important to bring the condoyle down that essential 2mm it has gone up, and create a normal space between condoly and fosse. Then after 3 or 4 weeks he thinks I could maybe progress to heightening the too short teeth on the right.

I am frustrated because all along I have know this was the problem, yet the previous mf surgeon and prothsodontist I saw even after seeing the tompgrams didn't tell me I have a reduction in space and displaced disc. If I had just left it and accepted their assurance my discs are in place, I would have come to having bone rubbing on bone and a frayed disc in time. The prothsodontist even wanted to now (when I am in spasm a lot) to do equilibration on my normal side (left) saying this would remove interferences in my bite, I am so glad I didn't let him because then I would have a too low bite on the left as well and my now normal left disc would not have had room either as inevitably that condoyle too would have moved up. So scary to think how wrong some professionals can be in treatment. If only these two men had been better I wouldn0't have had a displaced disc now as I was seeing them when both my discs were in place and under their 'care' the right disc has been slipping forward in the last two and half months. The experience really shows me that trusting what you feel in your own body is vital, you know what has happened to yourself and how you feel, and if someone says something which contradicts that they are surely rarely right.

Good luck, I hope things go well for you
Isobel



Quote:
Originally Posted by tigerlilly24
Isobelj
I am new here, but I know where you are coming from. Within this past month I had a series of x-rays done...tomogram...and was told it was "not normal". I am convinced it is because my bite is off like yours where one side is shorter than the other. I am told that this can not be adjusted until i get some relief and return to normalcy and if adjusted now, it could cause more problems. I am currently wearing a day and night NTI splint and my bite constantly is shifting. They say surgery is not good and I need to just keep comfortable with whatever symptoms I have (headaches and facial pain) with therapy, medicine, etc. I have tried multiple muscle relaxers.

I guess my mandible bone is worn down and is not rounded like a normal one which pushed my disc forward. The disc is pushed forward and I am resting on built up scar tissue. This is good according to my dentist, as if not for this tissue build up I would be bone on bone. Yikes. I have follow up in about a week to see what the next step is. I am curious what they will recommend for you?
tigerlilly

 
Old 12-02-2003, 03:03 PM   #4
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Isobelj HB User
Re: Tissue posterior to disc?

Tigerlilly I just wanted to add in case it helps, the surgeon I'm seeing now said actually to chew on my right more as when you chew on one side it is the muscles on the opposite side which do the work apparantly, so if I chew on my 'bad' right side, it is the normal left side which is working. I hadn't known this before and was trying to chew on the left which was probably not too good.

He also told me that the spasms pull on ligaments attached to the middle ear, this is why I have sometimes dizziness, or fullness and fluid in the middle ear, the good thing is that this apparantly is very likely to completely resolve when the bite problem is resolved.

Isobel

 
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