Joint Vibration Analysis in Routine Restorative Dentistry

[DrAnil]

Technological Implications of
Joint Vibration Analysis

Lou Shuman, DMD
Dr. Peter Dawson wrote, on page 3 of his latest text Functional Occlusion: From TMJ to Smile Design, that “all occlusal analysis begins with the TM joints.” The temporomandibular joint (TMJ) is widely considered to be the skeletal base of the stomatognathic system. As dentists, we understand that TMJ stability is critical to a stable and predictable occlusion. It has become clear that a key component of the stomatognathic health is the interplay among the teeth, muscles, and the TMJs. Without a pair of stable TMJs, a stable occlusion is next to impossible, and this has a direct and obvious impact on the success or failure of our restorative, cosmetic, and orthodontic treatments. Without a clear objective and detailed assessment of TMJ function, we cannot predict the future success (or failure) of our dental treatments, nor can we determine if subsequent TMJ pathologies previously existed, or were the result of our dental work.
     We need a tool that can alert us to subclinical pathology before we begin treatment, one that can quickly and accurately assess TMJ function (or dysfunction) and compare it to previous screenings to see if our patients’ TMJs are improving, stable, or getting worse. We also need a tool that can immediately assess the impact of our treatments on TMJ function. A suitable device for screening, assessment of pathology progression, and treatment outcome analysis has been hard to find.
     The TMJ has been the subject of much confusion because the quick and inexpensive methods of screening for TMJ pathology are either subjective and unreliable (auscultation, palpation, patient report, and Doppler); or they are expensive, invasive, and provided only static images of the joint with no information on the dynamic function of these unique joints (computed tomography scans, cone beam tomography, magnetic resonance imaging). In fact, the most recent research from the British Institute of Radiology indicates that the interobserver agreement on MRI scans is “fair” at best.1
     Enter Joint Vibration Analysis (JVA) (BioRESEARCH). The JVA system brings objectivity and predictability to the assessment of TMJ function and stability. Normal TMJs have smooth, well-lubricated surfaces in a proper biomechanical relationship and produce almost no vibration. But surface changes, such as those caused by degeneration, tears, or displacements of the disk, generally produce friction and vibration. Different disorders can produce different vibration patterns or “signatures.” PC-assisted vibration analyses helps identify these patterns and helps you distinguish among various TM disorders.
     JVA provides a fast, noninvasive, and repeatable measurement of TMJ function to aid in the diagnosis of TMJ condition. Understanding TMJ function is vital any time you are changing the vertical, lateral, or the anterior/posterior position of the mandible. Common dental treatments can change mandibular position. In addition to TMD treatment, orthodontics, prosthodontics, restorative, and sleep dentistry can all benefit from JVA testing.
      A JVA recording takes 10 seconds of patient time, and less than 2 minutes of staff time. In less than 5 minutes, your staff can be trained to take accurate, repeatable data. Simply searching “JVA 60-second instructional video” on youtube.com will give you an idea of how fast and easy it is to get this data on every one of your patients.