[Khannadds]

The first thing to determine what type of TMD exists is to fully do a proper diagnostic analysis. First you need to load the joint in centric to determine if pain is originating from the intracapsular area. Second you need to palpate all muscles associated with the joint along with mastication. Most TMJ issues [80%] are caused by malocclusion. If there is a click, then one must find out if is a Medial pole or Lateral pole click and the severity. You can also us a “doppler” to listen to joint sounds to determine this. This means that a simple equilibration may correct the problem, and an appliance may not be needed. For patients that have parafunction issues, a flat plane occlusal splint is idea with equal intensity contacts. If there is joint damage, then MRI is recommended for further diagnosing.

        

[Khannadds]

To start with, you will need the following:
1] 3 Lead EKG
2] pulse oximeter
3]BP Cuff

all must be connected to the same machine. Also, armrest cushion that can be strapped to the dental chair to allow your patient to comfortably rest there are for the IV. Wrist restrainers, elbow imobilizer, IV pole. The most important armamentarium is to have a crash cart with all the intubation equipment you need, along with medications to treat various cardiac situations[ V Fib, etc.]. Hope this helps, and good luck.

        

[Khannadds]

When I first read the findings, I suspected pericoronitis in the third molar area. After seeing the Panorex, it appears to be cyst origin. The coronoid process has almost completey resorbed along with the retromolar area. My recommendations would be to removed the third molar, and biopsy the soft tissue. If a older panorex can be viewed to see the progress of the lesion. I would be curious to find out what the histology report finds. The lesion does not have well defined outline, and appears to be soft tissue in origin. When you treat the case, post the diagnosis.

        

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