DIAGNOSTIC TECHNOLOGY

"Relax the Muscles First, Then Take a Bite"

One of the most under estimated aspects in dentistry is an ability to find the proper physiologic bite of our patients.  For years the clinical dentist and academicians have debated the cause of the multi-faceted intra and extra oral musculoskeletal occlusal problems.

Technological advances have made it possible to measure and record physiologic responses  and posture of the jaw, head and cervical/neck before, mid and after treatment.  Based on objective measured recordings computerized instrumentation allows the clinician to make better decisions to diagnose and treat the TMJ/occlusal problem before irreversible treatment is rendered.

Many theories, opinions and assumptions are made daily by experts based on static data, e.g. x-rays, subjective evaluation, palpation examinations.  Computerized technology today allows the dentist to see the patient's jaw muscles in dynamic activity, function and at resting modes making these "dynamic" pieces of data extremely valuable to the diagnostic and clinical decision making process.  It is similar to an EKG or EEG of a patient with a heart muscle condition using only manual palpation and/or a stethoscope to listen to the heart alone to make a diagnosis of a heart condition. 

The masticatory muscles and temporomandibular joints are no different, neither no less of importance to dental health.  Computerized Mandibular Scanning (CMS), electromyography (EMG), electro-sonography (ESG) and low frequency TENS are scientific tools which can assist the clinician to observe and validate dynamics jaw activity.

Since few clinicians actually measure their patients muscle activity and/or physiologic jaw position responses prior to treatment, decisions are made and treatment is rendered, never once recognize what small changes they maybe making to the patient may in actually be making significant changes to physiology and muscle dynamics of their patients. 

Clinicians often do not realize that a majority of TMD problems are related to unhappy masticatory muscles.  These tight and over active muscles produce acute and chronic pain problems which can contribute to tender muscles, depression, anxiousness, difficulty sleeping and insomnia. 

How does the dentist best establish a bite position to start effective treatment? 

Dr. Chan uses such scientific measuring technology that is ADA (American Dental Association) and FDA (Food and Drug Administration) approved.  He has found that using this type of diagnostic instrumentation better informs him and his patients accurately as to their condition and how best to proceed with treatment.

Establishing HOMEOSTASIS of the masticatory muscle system is critical and important before any treatment is rendered. 

MUSCLE RELAXATION:

J5 Myomonitor TENS (Transcutaneous Electro-neural Stimulation) is a simple device that calmly stimulates the muscles (pumping action) neurally.

Muscle Relaxation Therapy is used in our office to calm hyperactive muscles which is often an underlying factor of muscle fatigue, muscle tension, myofacial pain and tenderness.  Low frequency TENS (0.67 Hz) is found to be most effective to establish "Homeostasis" of the masticatory and cervical neck system.

When these muscles are tight and hyperactive, it will produce abnormal jaw opening and closing patterns to contribute to torques and strains.  Rejuvenating the muscles to neutral is key to finding a proper lower jaw position.

MANDIBULAR TRACKING AND TELEMETRY:

• Myotronics K7 - Computerized Mandibular Scanning

A light weight sensor array allows Dr. Chan to locate scientifically and objectively the lower jaw position.  Objective recording of muscle activity can be observed to identify an optimal physiologic relationship to the cranium.  Recording a bite relationship is done with measuring computerized technology. MUSCLE ACTIVITY RECORDING:

• Electromyography (EMG) is used to record and objectively measure resting and functional modes of muscle activity.

Head Rotations - Left and Right will induce masticatory and postural neck muscle EMG activity (measured in micro volts).

Hyper-extension of the head will induce hyperactive EMG muscle responses.

TEMPOROMANDIBULAR JOINT SOUND ANALYSIS:

• Electrosonography records joint sound and vibrations (high frequency from low frequency sounds) within the temporomandibular joints, suggesting condyle/disc dysfunction and/or degenerative joint changes.

RADIOGRAPHIC IMAGING:

• Technology allows Dr. Chan to visualize numerous views of our patients joint and oral maxillo-facial anatomy that is critical for him to understand.  With hard film tomography, cephalograms and lateral cervical spine views he is able to correlate anatomy with muscle physiology.
• He uses both the I-CAT cone beam high resolution 3 D imaging system and the Panoramic CMT (complex motion tomography) imaging system providing imagery of lateral, frontal TMJ views, coronal views of the left, right and paranasal sinuses.
  
• I CAT Digital Imagery

• Dr. Chan captures 3 dimensional scans of the maxillo-mandibular and temporomandibular joints.

• Panoramic CMT Imagery

Hard film radiographs may also be taken of the cervical neck region for additional studies as to cervical bone asymmetries.  Cephalogram views are taken for orthodontic/orthopedic analysis.

 

@2006 Dr. Clayton Chan

9061 WEST POST ROAD · LAS VEGAS · NV · 89148