Nightguard vs TMJ Appliance

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A TMJ appliance is an orthopedic repositioning appliance that is fabricated based on an in-office evaluation, imaging and computer analysis.

This device functions to:
– Realign the mandible and maintain proper posture of the condyle within the mandibular fossa which is determined by the muscles, the way the teeth come together, and the TM joint itself.
– Re-establish joint space by decompression of retro-discal tissue, that often causes pain and inflammation.
– Establish and maintain proper condyle-disc relationship that eliminates the anterior disc displacement causing the movement of the condyle into the posterior-superior position. Without establishing this proper relationship, there can be limitations in opening and closing, and sometimes even “lock-jaw.”
– Stabilize the bite to decrease the adverse effects on the teeth and supporting structures caused by joint pathology, clenching and grinding. Continued trauma to the teeth due to TMJ dysfunction/clenching/grinding can lead to tooth pain, tooth fracture, abfraction lesions and even bone loss.

How is this different from a nightguard?
A nightguard is a universal piece of plastic about 2-3mm thick that prevents the teeth from rubbing together. It is fabricated from a mere impression of one’s teeth.

In treating TMJ Disorders, we use Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) to detect hard and soft tissue anomalies and destruction. These diagnostic images allow for evaluation of joint position, posterior-superior joint spacing, cervical displacement and alterations. We use a computer-based system for three-dimensional jaw tracking, surface electromyography and recording of joint sounds while the muscles are in their most physiologically relaxed state.

An orthotic functions to eliminate pain, clicking, popping and condylar impingement while holding your jaw in a specific position based on the three dimensions (yaw, pitch, roll or up/down, right/left, side to side). A nightguard simply creates some space between the teeth and eliminates occlusal wear.