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TMJ Prosthetic Placement

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This topic contains 2 replies, has 2 voices, and was last updated by   Jamie Hansen October 15, 2019 at 5:03 pm.

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  • October 15, 2019 at 4:40 pm #8226

    Jamie Hansen
    Keymaster

      Hi Everyone,
      Have a very interesting case that I would like to get as much feed back from everyone as possible.

      1st Order:
      Age/Sex: 29, Male
      S/X Location: Posterior neck, Lateral neck, bilateral TMJ, bilateral Temporal area.
      S/X Quality: Sharp, Achy, Spasm like
      Intensity: current 7/10, best 3/10, worst 8/10. Never a 0/10.
      Proactive: Opening Jaw, Worse as day goes on, cervical extension, “excessive talking” eating “chewy” foods
      Palliative: Stretching Jaw, and tongue exercises.

      2nd Order:
      2018 TMJ Prosthetic Placement (ill try to upload an image)
      2009 Rt Shld Labrum 2x’s

      Exam Findings: (7/15/2019)
      UCF- 12/25
      CF 35/60
      CTF 53/80
      Rot: R: 45/50%
      L: 46/51%
      Treatment has gone well and we went on maintenance with his test ranges being at:
      UCF 21/25
      CF: 64/60
      CTF: 83/90
      Rot: R 76
      L 83
      Currently is he has been having flare ups that are exacerbated by him opening his Jaw. When this happens the pain refers to his right shoulder, right chest, and up to his right temple area. I do think this is a m/s issues just looking for some input.

      Hes overall happy with how hes doing but I feel kinda at a cross roads with him.
      We have had some success treating his massater, temporalis, muscles with IAR.

      Thank you all.

      Joe

      October 15, 2019 at 4:52 pm #8227

      Carl Nottoli, DC
      Participant

        Great work on a tough case!

        “I do think this is a m/s issues just looking for some input.”
        To know for sure simply put the data into Fast Map–this is why the software exists. With that said, it appears it’s a TM joint flare up which requires time and decreased load to heal. I haven’t seen the TM joint refer to those areas however so palpate the cervical plexus area at the scalene and see if you can palpate any entrapment in the region. I would leave the joint alone.

        Based on his age and previous MSK issues, it appears he has very poor genetic durability so he may be more prone to flares.

        I wouldn’t over treat. Especially if you aren’t having any measurable changes.

        October 15, 2019 at 5:03 pm #8228

        Jamie Hansen
        Keymaster

          Thanks Carl for the quick response
          I am having problems getting the image uploaded.

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