Method and device for treatment of temporomandibular dysfunction syndrome and facial/dental deformities

Abstract

A method for treating maxilla/cranial base to mandibular axis discrepancies in the temporomandibular joints (TMJs) of a patient such as caused by mandibular, temporomandibular dysfunction syndrome (MTDS) or developmental facial/dental deformities without performing open jaw joint surgery. The method includes (1) repositioning the patient's mandible into a stable relationship with the cranial base using a craniomandibular orthopedic repositioning orthotic which over time deprograms the patient's jaw into the stable mandible to cranial base relationship; (2) constructing a model of the patient's mouth on a jaw joint simulator which replicates the patient's jaw joint true hinge axis of rotation in the repositioned and stabilized mandible to cranial base relationship; (3) planning on the model a surgical procedure comprising total maxillary osteotomy which substantially treats the MTDS or developmental facial/dental deformities; and (4) performing the surgical procedure to treat the discrepancies.

1  to  7 . (Cancelled)  
   
   
       8 - An orthotic for stabilizing the condylar positions in the temporomandibular joints of a patient with temporomandibular dysfunction syndrome comprising a base portion with an upper and a lower surface, an anterior and posterior surface, and having a generally U-shaped plan form and including opposite integrally formed side arms adapted for location between the orthotic and mandibular teeth of the patient, the base having an inner flange along its trailing edge and an outer flange along its leading edge wherein the inner flange and outer flange extend upward from the base so as to form a channel for accepting the maxillary teeth of the patient wherein the bottom surfaces of the maxillary teeth are in contact with the surface of the channel, and wherein the width of the channel is adapted to the width of the maxillary teeth of the patient, and wherein the base has a vertical thickness sufficient that when the maxillary teeth are engaged in the orthotic there is complete disclusion of the posterior maxillary and mandibular teeth during eccentric jaw movements, and wherein the thickness of the base in the position where the anterior maxillary teeth are engaged defines a downwardly extending ramp with anterior and posterior surfaces of sufficient thickness to allow the superior surface of the central and lateral incisors to glide freely along the posterior surface of the ramp to simulate the guidance of normal central and lateral incisors against the lingual surface of normal anterior maxillary teeth in a condition of no wear and normal vertical anatomy and to provide anterior guidance of the patient's mandible in excursive movements by contact of the superior surface of the central and lateral incisors with the posterior surface of the ramp so as place the posterior maxillary and mandibular teeth out of contact.  
   
   
       9 - An orthotic for maintaining the mandible to maxilla/cranial base alignment and stability in the temporomandibular joints of a patient during or following a surgery which verifies stable condylar position in the temporomandibular joints of the patient comprising a base portion having a generally U-shaped plan form and including opposite integrally formed side arms adapted for location between the maxillary and mandibular teeth of the patient, the base having an inner flange along its trailing edge and an outer flange along its leading edge and extending upward and downward from the base so as to form an upper channel for accepting the maxillary teeth and a lower channel for accepting the mandibular teeth of the patient and which when fitted to the patient's teeth maintains the mandible to maxilla/cranial base alignment and stability in the temporomandibular joints of the patient.  
   
   
       10 - An apparatus for planning a surgical method for treating the cranial base to mandibular axis discrepancies in a patient comprising an artificial jaw simulator including an upper member with a downwardly facing surface and having a pair of spaced sockets at one end, which represent the sockets of the patient's glenoid fossae, pivotally mounted on a pair of spaced spherical styluses, which represent the simulated horizontal or hinge axis of the patient's condyles, on a frame vertically mounted on one end of a lower member with an upwardly facing surface, and a model of an upper dental arch of the patient with a base, which is parallel on all sides to the upper dental arch model and is delineated with horizontal and vertical reference lines, mounted with a separating media to a mounting stone mounted on an upper plate which is mounted to the downwardly facing surface of the upper member of the artificial jaw simulator, and a model of a lower dental arch of the patient mounted on a mounting stone, which is parallel on all sides to the lower dental arch model and is delineated with horizontal and vertical reference lines, mounted using a settable material on a lower plate which is mounted to the upwardly facing surface of the lower member of the artificial jaw simulator, wherein the relative motion between the upper and lower plates with the models mounted thereon is the same as the relative motion between the patient's upper and lower jaws, and wherein the true axis of rotation of the temporomandibular joints of the patient have been maintained.