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Stable Joint Relationships

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There is a relationship between the way the teeth fit together and how the joints and muscles function. This relationship will either be one of harmony or one of compromise. The bite relationship either helps promote a functional relationship or serves to compromise normal relationships. This includes the structures of the entire upper quadrant; front and back of the head/neck and upper back regions.

Here we observe the bite functioning in a harmonious relationship with the temporomandibular joint. This occurs when the joint is properly seated in the socket as the teeth come fully together. The ball of the joint will seat against the relatively avascular central region of the disc which is seated against the front wall of the socket. This is an anatomic and physiologic stable relationship.

Here is an example of a patient that has undergone conventional orthodontics with braces, retainers, etc. The treatments had been completed some 5 years prior and the results have not remained stable. The bite has “shifted” and the lower jaw deviates to the patient’s right, causing the right joint to move up and back in the socket. This up and back position of the ball of the joint compressing the biomechanical posterior “locking mechanism” is a pathologic position. The problem with this initial type of treatment is it assumes that the jaw is in the proper functional relationship. This is not the case for this patient as she is suffering headaches, popping in her jaw and associated pains.

We can observe the difference in the bite position in the functional position (below) when we compare the bite position that resulted from the first orthodontic corrections to the bite position where the joints and muscles are in balance. A diagnostic orthotic or splint was used to help determine the position where the patient no longer suffers pain or dysfunction. This position no longer compromises the joints and the muscles no longer suffer spasms or pain. This also demonstrates how far off the bite position was from the original orthodontics as compared to where it should be if the bite was made to function in harmony with the joints and muscles.

Using the TMJ-Orthodontic method allows the practitioner to maintain the function mandibular / maxillary relationship (determined by the phase I diagnostic treatment) as the teeth are approximated to support this relationship. The following photographs demonstrate the diagnostic orthotic that was used to help determine the functional position of the joints and allowed the muscles to function without pain.

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