Temporomandibular Disorders - Robin J. M. Gray

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is for a patient to have anterior crowns placed when he or she has a very tight anterior occlusion such as seen in a patient with an Angle's class II, division II, basal bone and incisal relationship. If crowns are placed on the upper anterior teeth, which are even marginally thicker palatally than the natural teeth were, the effect is to push the mandible distally, thereby compressing the sensitive posterior bilaminar zone of the disc and producing, sometimes severe, pain.

      It is important not only for clinical reasons but also for medicolegal reasons to keep accurate and contemporaneous notes of all aspects of your clinical examinations. Remember that it may be several months or even years later when you might be asked to produce them.

      1 Al‐Ani, M.Z. and Gray, R.J. (2004). Evaluation of three devices used for measuring mouth opening. Dent Update 31: 346–348. 50.

      2 Davies, S.J. and Gray, R.J.M. (2001). The examination and recording of the occlusion: why and how. Br Dent J 191: 291–296. 299–302.

      3 Gallagher, C., Gallagher, V., Whelton, H., and Cronin, M. (2004). The normal range of mouth opening in an Irish population. J Oral Rehabil 31: 110–116.

      4 Gray, R. and Al‐Ani, Z. (2010). Risk management in clinical practice. Part 8. Temporomandibular disorders. Br Dent J 209: 433–449.

      5 Gray, R. and Al‐Ani, Z. (2013). Conservative temporomandibular disorder management: what DO I do? – frequently asked questions. Dental Update 40: 745–756.

      6 Gray, R.J., Davies, S.J., and Quayle, A.A. (1994). A clinical approach to temporomandibular disorders. 2. Examination of the articulatory system: the temporomandibular joints. Br Dent J 176: 473–477.

      7 Gray, R.J., Davies, S.J., and Quayle, A.A. (1994). A clinical approach to temporomandibular disorders. 3. Examination of the articulatory system: the muscles. Br Dent J 177: 25–28.

      8 Gray, R.J., Davies, S.J., and Quayle, A.A. (1994). A clinical approach to temporomandibular disorders. 4. Examination of the articulatory system: occlusion. Br Dent J 177: 63–68.

      9 Gray, R.J., Davies, S.J., and Quayle, A.A. (1994). A clinical approach to temporomandibular disorders. 5. A clinical approach to treatment. Br Dent J 177: 101–106.

      10 Juniper, R.P. (1984). Temporomandibular joint dysfunction: a theory based upon electromyographic studies of the lateral pterygoid muscle. Br J Oral Maxillofac Surg 22: 18.

      11 Klineberg, I. and Jagger, R. (2004). Occlusion and Clinical Practice: An Evidence‐Based Approach. London: Wright.

      12 Turp, J.C. and Minagi, S. (2001). Palpation of the lateral pterygoid region in TMD – where is the evidence? J Dent 29: 475–483.

      13 Wilson, P.H. and Banerjee, A. (2004). Recording the retruded contact position: a review of clinical techniques. Br Dent J 196: 395–402. quiz 426.

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