COMPUTERIZED SONOGRAPHY is equipment that measures how well
the joint functions while in motion. All other images such
as MRI, or X-rays are only static pictures of the joints
in certain positions. This is accomplished by placing headphones
over the joints and recording the vibrations of either soft
tissue (quiet, when disc is working properly) or movement
of the articular joint cartilage. Short of an MRI, this is
the ideal objective proof of what is happening to the joint
as it functions, and dramatically less expensive and timely
compared to an MRI. Sonography is more accurate than palpation,
a stethoscope or even the patient reports, when it comes
to recording vibration in the joints. Sonography provides
us with a picture on the extent of health or disease that
is present in the joint.
This instrument measures and analyzes the electrical activity
in the muscles that move the jaw at rest and during function.
In health, muscles rest with low levels of electrical activity
and function with high levels of balanced activity. In
TMD the reverse is often observed. Illustrative data demonstrate
the resting EMG activity before and after TENS (electrical
stimulation therapy to relax muscles) as well as the Functioning
(clench) EMG activity in the natural bite and in the corrected
neuromuscular occlusion used for treatment. EMG is a painless
test, which is performed using surface electrodes, like
band-aids on the face, forehead, side of the head and beneath
THE COMPUTERIZED MANDIBULAR SCAN (CMS)
The CMS is a tracking device that records, in three dimensions, the delicate
functioning movements of the jaw with accuracy in tenths of a millimeter. Recordings
are made of the movement of a small magnet temporarily attached to the gum
below the lower front teeth. Opening, closing, swallowing and chewing movements
can be scrutinized and analyzed. The natural occlusion and the healthy "neuromuscular
occlusion" treatment positions can be located with this computerized instrument.
This testing is used at the initiation of treatment and thereafter to evaluate
the accuracy of jaw position at the treatment occlusion.
T-Scan II is a computerized timing and force evaluation of occlusion. The sensor
is placed in the patient's mouth using a special handle. As the patient bites
on the ultra-thin sensor, the T-Scan II software dynamically scans and displays
the occlusion on a computer screen. The timing and force of the tooth contacts
are shown in easily understandable color-coded contour images. These allow
instant diagnosis of the occlusion, as well as instant MIP, center
of force, and force trajectory. The main benefit of using
the T-Scan II is achieving instant documentation of the patient's occlusion.
This diagnostic scanner features advanced electronics.
We rely heavily on TOMOGRAPHIC xrays. These allow us to take “slices” at
certain angles of the temporomandibular joint when the jaw
is at rest, or the jaw is clenching or when the jaw is wide
open. Changes to the bones of the Temporomandibular joint
such as osteo-degeneration, arthritis or fractures.
We also use the following x-rays to give us insight into
any skeletal imbalances that contribute to TMD dysfunction.
- Cervical Spine
- Lateral and Frontal Cephlametric
- Waters & Townes
- Sinus/Inner Ear