COURSE CONTENTS:
Day 1 - Wednesday
10.00 Introduction to the temporomandibular disorders
Terminology in TMD treatment & Occlusion concepts
Centric relation position: Old and new concepts
Physiologic centric relation position
The role of vertical dimension and posterior support
Normal Jaw movement and the role of canine guidance
The Principle of Tripodization.
Occlusal plane. How many planes do we have?
12.30 – 14.00 Lunch
14.00 A. DIFFERENTIAL DIAGNOSIS
Normal and abnormal TMJ. X-ray interpretation
Video Film: The Joints Story
B. TREATMENT MODALITIES
FIRST PHASE OF TREATMENT (ORTHOPEDIC PHASE)
Splint therapy. What splint do we use? Why using mandibular splint?
The Bangkok Splint. Fabrication of The BKK Splint &
Mandibular Orthopedic Repositioning Appliance (MORA)
Wax bite construction in non-clicking position
Amount of vertical dimension raised. Thick vs. Thin splint
Amount of mandibular advancement: How far do we go?
The use of fixator. Control of the vertical dimension
Splint Adjustment ; Grinding. Relining
SECOND PHASE OF TREATMENT (ORTHODONTIC FINISHING)
Treatment planning
Orthodontic mechanotherapy and Finishing
Initiation of the treatment in the maxilla
BKK Splint still in place
Initiation of the treatment in the mandible
ADJUNCT TREATMENTS
Exercises, stretching, massage, moist heat and cold therapy
Massage and Acupuncture
Loading in the joint in Symmetrical/Asymmetrical Extraction vs. Non-extraction therapy and its relationship to TMD
Iatrogenic effects of dental and orthodontic treatment
Iatrogenic effects of medical and surgical treatment
Blow, accident, whiplash injuries and TMD
Condylar fracture and the new concept of treatment
GET READY WITH THE TYPODONT
17.30 Class finish
Day 2 - Thursday
09.45 CLINICAL EXAMINATION
TMD signs and symptoms
Abnormal sounds: Clicking & Crepitus
Pain and Muscle Spasm
Deviation. Limitation of mouth opening. Locking
Deep-bite and TMD. Loss of molars and vertical dimension concept
Long Class II elastics and the Bite plate
Optimal overbite and over jet
Arch wire sequence in TMD cases
12.30 –14.00 Lunch
14.00 Wire bending exercise: Torque control in the anterior segment
0.016 x 0.016 SS or 0.016 x 0.022 TMA Intermediate arch wire
Get more Torque control with intrusion step
0.016 x 0.022 or 0.017 x 0.022 SS and tie-back loops with posterior torque
for max. 2nd molars
Open bite and TMD - Molar fulcrum concept
Long Class III elastics
High pull headgear vs. High pull chin cap
Surgical case and TMD
17.30 Class finish
Day 3 - Friday
09.45 DEMONSTRATION
The use of semi-adjustable SAM articulator
Face bow transfer
Wire Bending Exercise
The control of the maxillary 2nd molars
0.016 x 0.022 or 0.017 x 0.022 FAW with tie-back loops
12.30 –14.00 Lunch
14.00 The Adjustment phase
Final Tooth Positioning with 0.016 x 0.016 SS or 0.016 x 0.022 TMA FAW
with tie-back loops
Fine tuning of the occlusion. Grinding (to improve intercuspidation, and
marginal ridge relationship leveled)
Midline correction
15.00 Class finish
WHAT TO BRING ALONG?
Clinical and Laboratory Pliers
Wire Bending Exercise Book
1 glass pencil (white)
1 Typodont with acrylic white teeth
1 set of 018 slot Mini WICK Brackets bonded
Washbon ORMCO bands with Alexander 018 slot 1st & 2nd molar attachments
GET SET WITH THE TYPODONT
The treatment of a unilateral Class I case with TMD
Please set up your Typodont in a unilateral Class I Molar relationship with the contralateral
side in Class II Molar relationship. Palatal cusps of the maxillary 2nd molars are hanging
down.
Slightly anterior crowding of both arches. deep over-bite, and maxillary and
mandibular retroinclination of the anterior segments.
Band all 2nd molars
1 Pair of Model in Class I or Class II case for practicing wire bending
0.7 mm hard SS 6 triangle clasps for repositioning splint
1 Super glue
1 Set cementation kit
1 "Stabilo" Waterproof Marker, Black
Wires: 0.016" SS round wire, 0.016" x 0.016" SS
0.016" x 0.022" SS or
0.017" x 0.022" SS
0.7 mm SS hard for triangle clasps