Просмотр полной версии : Painful dysfunction VNCHS
Misters stomatologists!
Help or Assist advice or council!!!
Already almost year as at me not otkrvaetsja completely a mouth, hurt at the left in a jaw with irridatsiej in an ear, a head, a neck. Pains periodically arise and pass or take place in itself, but in due course intensity is stronger than all of them, last time I could not talk, even to swallow a saliva was sick. I live in Vladivostok, have passed or have taken place all doctors, stomatologists, gnathic surgeons, neuropathologists - me hand, and all is ineffectual. One professor has told or said, that it is necessary to be made prosthetic appliance urgently, on the right from below at me are absent 6 and 7, from above 6 tooth, but prosthetists refuse, as the mouth at the best opens on 1,5 see Now I wish to go to the professor-, was at it or him on consultation, he has told or said, that here both nerves (stress), and a teeth. And after its or his survey and some actions the mouth was slightly slightly opened, but he too does not promise hundred %-s' help. I am simple in despair - officially I do not have even records in a map, since All advising only make a helpless gesture, and doctors in a native out-patient department cannot see me, when I have addressed to the neuropathologist, except for spiteful *quot; Here ours anything ?NO*quot; I have not heard. Very much prshu, who knows how to get rid of this misfortune - write to me. To live it is simply impossible, neither to eat normally, nor to yawn, to talk.
DJ Andrey
01.09.2004, 19:30
:http: // www./forums/search.php? searchid=158417
Debatable Club of Russian Medical Server - Result of search
Dear Iren!
The rational prosthetic repair sometimes very much helps or assists. The volume of opening of a mouth can be increased blockade of anesthetics for depression of a tonus of masseters.
Find the stomatologist who does not become so easily from you to refuse, and vozmyot and will make. The question still and in that what character of a contracture at you is available, for a year not only reflex, but also cicatrical changes there could be formed. To the doctor on a place is more visible.
Something in absentia to tell or say about-very or -very much serious... But here simply think aloud..
1. It is necessary to find the expert who is engaged in a joint and an occlusion! (unfortunately, them it is a little enough...)
2. Not enough the introduction information:
- A case history: whether there was any dyscomfort in a joint before occurrence of a pain?
- Whether you put approximately about one and a half year ago new seals? koronok?
- Whether there were clicks in a joint at opening a mouth? Whether Is now?
- How long there is no teeth?
- What status of the remained teeth? I.e. whether there is on them a raised or an increased erasability? Or whether you have noticed occurrences of intervals between a forward teeth? Their mobility?
- How much easily and equally the mandible is displaced to the right and to the left?
- Whether shift n/? forward is broken or disturbed?
3. What methods of research were spent?
- Roentgenography (or a tomography) a joint?
- Studying excursions n/??
-???:confused:
Besides, concrete references I can not give, since treatment depends on factors:
1. Whether is the reason hurt a joint?
2. If yes, whether disturbance morphological or functional is
3. If this or thus morphological, obratimoe or irreversible?
Irreversible changes are corrected or adjusted surgically.
Obratimye if it, really, a joint, will demand detailed studying of your occlusion in an articulator with bracing models by means of a facial arch and long process of the treatment including nazubnuju kappu, selective prishlifovku chewing surfaces and, certainly, a prosthetic repair.
Dear Iren22,
Take in library book Dzh. G.Trevell, D.G Simons MIOFASTSIALNYE PAINS, in 2 volumes, Per. With English, Moscow "Medicine" 1989.
The matter is that in overwhelming majority of cases at DB VNCHS is available miofastsialnyj a syndrome which defines or determines the basic clinical picture and the majority of complaints.
Can call to me 8(846) 242-4807
Can be it is not necessary address to manualshchiku, and follow a policy of blockade. On sew to faculty tactics such and patients very soon start to feel simplification. Probably on the sick party or side there is a hypertrophy of masseters. Certainly it is important to study or investigate other possible or probable pathology VNCHS and if it is really painful syndrome of dysfunction it is necessary for you rational:) a prosthetic repair.
In general it is difficult to disagree with the previous orators, especially with last paragraph in post Dr S. I likely even should keep silent
Dysfunction VNCHS is complex or difficult, since mentions or touches;affects multicomponent system.
1. Mentality (at long pains and muscular dysfunctions suffers almost always)
2. Anatomy (congenital and got sosbennosti sutava)
3. Dentitions (a status, an occlusion, including dynamic!)
4. A neurology
5. A status of muscles
6. Features and habits of a motor performance (a pose the general or common, a pose of a head, oral habits..)
7. Systemic factors
Probably, that that important has missed, since I write without preparation.
Disturbances in nervously-muscular system come practically always - either primarily, or again.
Manualshchik can help or assist vsema. But if he does not know trigger points mozhe to make active or activate their and a status uhuhdshitsja (such observed itself).
Disturbances in nervously-muscular system come practically always - either primarily, or again.
Precisely!
Dysfunction, as a rule, passes or takes place on the following mechanism, irrespective of an etiology:
As is known, surfaces VNCHS soveershenno nekongruentny, also demand presence of an articulate or a joint disk. It or he provides rotary movement of LF concerning a disk the first 1-1.5 sm of opening of a mouth, then there is a progress of LF forward together with a disk.
At shift of LF forward shift of a disk forward occurs or happens due to a muscle, and return back - due to ligament or cord;sheaf. It is important to remember, that shift of LF forward occurs or happens not due to a disk, and due to masseters irrespective of a disk, and the disk is displaced forward and back in itself, an own fascicle of muscles and the ligament or cord;sheaf working, as a returnable pulling spring. Owing to a coordination of movement, the disk and LF are displaced simultaneously.
At an overload of masseters of any etiology (whether it be a malocclusion, a seal - besides the occlusion, or a hypertonus of muscles as a result of a trauma, habits, etc. as wrote SergeyPlyasunov), occurs or happens diskoordinatsija in movement, and the disk is displaced earlier, than it is necessary. As - the articulate or joint head of LF presses result not on the middle of a disk, and on its or his edge or territory, it is literally *quot; ?aOaOUoan*quot; edge or territory, transforming a disk from the concave form in biconcave. At this stage at opening a mouth it is audible shchelchyok in a joint.
At any moment the ligament or cord;sheaf pulling a disk back, is stretched or dragged out and does not function any more. There comes the moment when the disk does not come back any more to a place and remains ahead of an articulate or a joint head. SHCHelchyok vanishes, thus the load in a joint goes by a disk in general. The mouth opens freely on 1-1.5 sm due to rotation, then, at progress, the articulate or joint head will come across the disk located ahead and, in some cases, to drop in on it or him cannot because of deformation of a disk any more.
Treatment depends on a stage. If the disk is mobile and if overlapping a disk and an articulate or a joint head make the apparatus which positions LF is possible or probable so that the articulate or joint head was on a disk. It, naturally, demands an open bite and shift of LF forward. Further the apparatus is gradually corrected or adjusted, and LF comes back to a place.
If the disk is not displaced, i.e. there is an ankylosis, treatment only surgical. Apparatus and surgical treatment at which the shorting of ligament or cord;sheaf is spent is sometimes combined.
The dear colleague,
It is represented to me, that you describe very narrow problem or task without an estimation of other components of system.
Could not inform - whence at you such algorithm?
At *quot; At an overload of masseters any YO??u??*quot; they need to be treated first of all. Or at least in parallel with correcting position of a disk. If dysfunction of muscles is not cleaned or removed, manipulations with a disk will deadlock or call, since muscles all time will change a parity or ratio of the interactions.
Basically the description of a subluxation of an articulate or a joint disk as I have understood. It seems to me that this mechanism just explains complaints of the patient. I even think, that development miofastsialnogo a syndrome (occurrence of trigger points) - classical (though all this synonyms, I think you me will understand) - will occur or happen hardly later as consequence or investigation when there will be kompensatornaja a myopachynsis and so forth I Am sorry for confusion
Basically the description of a subluxation of an articulate or a joint disk as I have understood. It seems to me that this mechanism just explains complaints of the patient. I even think, that development miofastsialnogo a syndrome (occurrence of trigger points) - classical (though all this synonyms, I think you me will understand) - will occur or happen hardly later as consequence or investigation when there will be kompensatornaja a myopachynsis and so forth I Am sorry for confusion
Myopachynsis? Did not read about it or this.
Here colleague Dr_S writes:
*quot; At an overload of masseters of any etiology... Occurs or happens diskoordinatsija in movement... *quot;
Here also it is necessary to clean or remove this diskoordinatsiju, namely to clean or remove the etiological factor (if it or he managed to be established or installed), to clean or remove auxiliary factors (stress, long frequent watches:), bad habits...).
Yes you call to me, if are interested, and look or see ZHanet Trevel is better.
At an overload of masseters all over again develops *quot; u?NOO?O?*quot;, and then kompensatorno and a hypertrophy. I can and not the rights, but at us, at a palpation try to distinguish, when the muscle is simply strained, and when is increased in volume (especially after blockade on Bershe). In words - certainly, sounds on idiotski.
Will tell or say too! To clean or remove watches!
The dear colleague,
It is represented to me, that you describe very narrow problem or task without an estimation of other components of system.
Could not inform - whence at you such algorithm?
At *quot; At an overload of masseters any YO??u??*quot; they need to be treated first of all. Or at least in parallel with correcting position of a disk. If dysfunction of muscles is not cleaned or removed, manipulations with a disk will deadlock or call, since muscles all time will change a parity or ratio of the interactions.
The algorithm is taken from okljuzionnogo and TMJ Peter Dausona's center in city of Item of state of Florida Pererburg (ha-, a twist of fate:))
http: // www.dawsoncenter.com/
You are right, it is the isolated mechanism. But retell more than 600 pages Dausonovskogo of a management or manual I here I can not.
Yes, to treat it is necessary muscles. But without elimination of an etiology it is simply impossible. If the occlusion has played in it or this a role, even such thing as premature okkljuzionnyj contact on one party or side, will cause or call the instant muscular answer. Therefore definition of the central parity or ratio of jaws at diseases VNCHS can become enough a difficult problem or task. It is done or made with the separated dentitions then it is made kappa with the necessary occlusion, changing muscular memory of a chewing musculation.
Unfortunately domestic stomatologists often neglect manufacturing kappy
Unfortunately domestic stomatologists often neglect manufacturing kappy
I in a course... In *quot; O??*quot; I taught a life otropedicheskuju an odontology on faculty, a sign with the program. But for 10 years though something has changed??
By the way, from shtatovskih stomatologists with problems VNCHS it is familiar percent or interests 20, and even it is less...
On faculty just one magic person broadcast about standardization and mimohodom in a clinical example as at it or him the patient in kappe went. Now he manager. Other faculty. For me - the sample of the orthopedist. But such it is not enough and to treat correctly economically it is not favourable.
Has changed, which that. But not all that well.
Rychenkov
01.09.2004, 19:30
The algorithm is taken from okljuzionnogo and TMJ Peter Dausona's center in city of Item of state of Florida Pererburg (ha-, a twist of fate:))
http: // www.dawsoncenter.com/
You are right, it is the isolated mechanism. But retell more than 600 pages Dausonovskogo of a management or manual I here I can not.
Yes, to treat it is necessary muscles. But without elimination of an etiology it is simply impossible. If the occlusion has played in it or this a role, even such thing as premature okkljuzionnyj contact on one party or side, will cause or call the instant muscular answer. Therefore definition of the central parity or ratio of jaws at diseases VNCHS can become enough a difficult problem or task. It is done or made with the separated dentitions then it is made kappa with the necessary occlusion, changing muscular memory of a chewing musculation.
You have in view of the book:
Evaluation, Diagnosis, and Treatment of Occlusal Problems - Peter E. Dawson. She has left in 1989 (2 the edition).
If you look or see at site Amazon.com now there show, that this book buy with book Dzhefri Ouksona - Management of Temporomandibular Disorders and Occlusion - by Jeffrey P., Okeson which has left in 2002 (5 the edition).
Here my knowledge basically from last book, which I partially (more than half) have translated or transferred.
If you are interested (I am very interested) we could exchange with you repetitions of our books.
...
Yes, to treat it is necessary muscles. But without elimination of an etiology it is simply impossible. If the occlusion has played in it or this a role, even such thing as premature okkljuzionnyj contact on one party or side, will cause or call the instant muscular answer. Therefore definition of the central parity or ratio of jaws at diseases VNCHS can become enough a difficult problem or task. It is done or made with the separated dentitions then it is made kappa with the necessary occlusion, changing muscular memory of a chewing musculation.
The dear colleague!
You write, that without elimination of an etiology to treat muscles it is impossible. Not absolutely with you it agree. The matter is that etiological factors can be a little. I even am assured or confident, that more often them a little.
For example, we shall consider or examine me:).
1. At me congenital very deep occlusion. It is already contributing factor. Which can be and the reason of dysfunction VNCHS.
2. The bruxism seldom, but happens.
3. The mental factor - when I am nervous, *quot; tumours OnnO*quot;, as speak associates. And at greater or big loads physical and mental (in the same way as at Brookses) the pain and gravity in masseters is.
4. Now imagine, that to me it is wrong zaprotezirovali a teeth (thanks God such while is not present) - here then there will be a present or true failure!
Agree?
Therefore, even if the etiological factor precisely is not visible, and the pathology is... Muscles to treat it is necessary.
Something I am fast to a conclusion have passed... It is tired.
4. Now imagine, that to me it is wrong zaprotezirovali a teeth (thanks God such while is not present) - here then there will be a present or true failure!
Agree?
Absolutely!! I just also meant the visible reasons:)
I often do or make to patients selective prishlifovku chewing surfaces to eliminate or erase;remove this factor.
I apologize, if somewhere has crumpled the answer. I respond in a quickly way in breaks between patients... At us now 13:47, the job:)
As to the book, I can scan it or her in pdf a format and throw off to you, or send on a disk. But it will borrow or occupy some time...
Aladushek
01.09.2004, 19:30
The citation:
The report from bruksa
Unfortunately domestic stomatologists often neglect manufacturing kappy
I in a course... In *quot; O??*quot; I taught a life otropedicheskuju an odontology on faculty, a sign with the program. But for 10 years though something has changed??
By the way, from shtatovskih stomatologists with problems VNCHS it is familiar percent or interests 20, and even it is less...
About, so you in staffs or states. And I thought, that JUBK is a southern coast of Crimea:)
The wife at me is hardly sick, here and I have borrowed or occupied in an odontology:
http: // tmd.megamir.ru/
Can here kappy look or see it or her.
About, so you in staffs or states. And I thought, that JUBK is a southern coast of Crimea:)
I in the south of state of California, city Dignity Diego. JUBK is a southern coast of California, and to its or his call so in memory of Crimea where I was born and has grown:)
Alex1234
01.09.2004, 19:30
One and a half month your wife passed or took place without an occlusion in general. The prosthetic repair of dentitions top and a mandible is simultaneously unacceptable (if in my head something or something else from an orthopedics remains) I any more do not speak about a time or temporary prosthetic repair
nastia176
01.09.2004, 19:30
...
As to the book, I can scan it or her in pdf a format and throw off to you, or send on a disk. But it will borrow or occupy some time...
I shall be extremely grateful to you.
If you use archivers it is possible to send archives on 3-6 Mb to me on a mail box.
At me Management of Temporomandibular Disorders and Occlusion - by Jeffrey P., Okeson in an electron kind. I shall send also the original and that has translated or transferred. Only we recently had a problem - in staffs or states have ceased to accept to transfer laser disks. They motivate with that de fragile. However, if to you reception on Y-mail I can send a disk with a private concern is inconvenient.
There is at me still a book for patients (too on Amazone is registered as the best seller):
TAKING CONTROL of TMJ - ROBERT O. UPPGAARD, D.D.S (1998).
The algorithm is taken from okljuzionnogo and TMJ Peter Dausona's center in city of Item of state of Florida Pererburg (ha-, a twist of fate:))
http: // www.dawsoncenter.com/
....
I for a long time was on this site.
Has now looked or seen - there there are videocourses!!!
But, as I have understood, they are on sale only to participants of internal courses. Simply on the Internet I cannot buy or purchase them?
Do not know, maybe, where that is videocourses on TMD?
However, you I shall not distract, you work now. Write, when there will be time.
I shall be extremely grateful to you.
If you use archivers it is possible to send archives on 3-6 Mb to me on a mail box.
I soskaniruju also shall look or see, that will turn out. Possibly, I shall break under chapters or heads, there them either 24, or 26, I do not remember precisely. All in English, the truth...
Your book I shall not refuse. It is possible for me only the original...
But, as I have understood, they are on sale only to participants of internal courses. Simply on the Internet I cannot buy or purchase them?
I learn or find out
Powered by vBulletin™ Version 4.2.0 Copyright © 2024 vBulletin Solutions, Inc. All rights reserved. Перевод: zCarot
