This pathology is usually diagnosed through physical exam or through complementary exams, and it is more common in young female adults. Once diagnosed, the patient can look for a qualified professional to start an specific treatment, which, preferable, is noninvasive.
TMD & TMJ
Picture 1 - Trigger factors for TMD
The Hiperboloide in TMD therapy
The Hiperboloide is an auxiliary instrument in the TMD treatment, providing incredible results for the patients. Several scientific studies prove its efficacy, showing an evolution after the first month of use.
The treatment focuses on restoring the balance of structures that compose the TMA articular, strengthen or stretching the masticatory muscles, moving back the articular disc in the appropriate anatomic position, and promotes relaxation and analgesia of painful structures.
The evidences on the efficacy in awake and sleep bruxism treatments have been highlighted in several scientific studies published by several professionals in the Dentistry and Physiotherapy fields.
Some scientific articles published in specialized magazines can be downloaded and checked below:
Scientific articles published on the efficacy of Hiperboloide in TMD treatment:
Before starting the protrusive movements exercises (jaw moves forward) and the latero-protrusive exercises (when the jaw is dislocated to the chewing side or to promote this, also moving forward) with the Hiperboloide (HB), the following exercises must be performed:
A - Introductory relaxation, flexion and extension:
In order to relax the extension and flexion musculature of the head, start a flexion movement in 20°, move it back, slowly. Relax, move back to the starting position. Then, a smooth extension, equally slow, relaxing, 3 to 6 times each, until the relaxation of the musculature is felt, specially in the sternocleidomastoid:
Exercises for TMJ with Hiperboloide
TMD can be characterized by several signals and symptoms we have already seen, as several factors can affect the dynamic balance of the structures of this articulation.
All the stomatognathic system and the TMJ have influence in a wide set of factors, which is why we say TMD has a multifactorial etiology.
As much as the patient presents clinical signals that indicate TMD, they are not totally reliable, thus, it is necessary evaluate the psychofunctional state of the patient.
B - Movement against the inframandibular masculature resistance (actioning supra and infrahyoid muscles):
Indicated to reposition the hyoid bone allowing the rebalance of the head position in relation to the cervical spine. The jaw stays in rest position, the anterior tongue's back stays in the hard palate region, next to the incisive papilla and the bilabilal closing is performed in order to reduce the internal pressure - articular. Then, with the hand closed and put under the chin, apply resistance to the flexion and start a rotation to the front of the cranium against the resistance, for 8 seconds. The resistance is isometric.
After submitting the patient to a thorough evaluation and discussing his/her case with a multidisciplinary team, the Hiperboloide is the ideal mastication apparatus to assist in the TMD patients treatment.
With the assistance of this masticatory stimulator, it is possible for the patient to perform exercises, increasing movements amplitude, rebalancing the masticatory muscles dysfunctions, changing the articular metabolism and reducing the algic state.
For this reason, it is necessary to develop specific exercises to each individual case, but, in general, the masticatory activity with Hiperboloide must be done on both sides (R and L) following the protocol proposed by the therapist.
EXERCISE 1: LATERO-PROTRUSIVES
The Hiperboloide is put in the position (median), tighten the Hiperboloide, and, in the lateral direction, move the jaw, dislocating the Hiperboloide in the median, going as far as possible and stop. Move the jaw back to the median and release (repeat). The movement is repeated 5 times, slowly, 4 times a day, both on right and left sides. The movements must last up to 3 minutes. If the patient has a deviation in the median line, he/she must do the movement to the opposite direction.
EXERCISE 2: PROTRUSION
The Hiperboloide is put on the median line. When the patient presents deviation in the inferior median line, center the median line in the deviation median to start from a position where the mandibular heads (condyle) are placed especularment to the median sagittal plan, the musculature on each side as opposite especular image, in the same angle as in the beginning. Then move slowly forward up to the limit of the articular safety (without pain and no exaggerated effort). Squeeze the Hiperboloide, slide it a little, move it back and slightly release it. Repeat the movement 6 times. The exercises must be repeated 6 times a day.
C - Against the resistance of mandibular musculature laterality:
This exercise aims toning the lateral pterygoids, which are affected by the muscle incoordination due to the articular disc displacement, with or without cracking and noise, due to the weakness of the ligaments.