The Diagnosis of Temporomandibular Disorders Leading to Surgical Intervention
The ability to make a “clinical diagnosis” for temporomandibular disorders and advance to the conclusion that there is the medical necessity for a surgical correction is not an easy task. This involves many potential avenues and modalities. These would in
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The Diagnosis of Temporomandibular Disorders Leading to Surgical Intervention Vincent E. DiFabio
Abstract
The ability to make a “clinical diagnosis” for temporomandibular disorders and advance to the conclusion that there is the medical necessity for a surgical correction is not an easy task. This involves many potential avenues and modalities. These would include years of clinical and/or surgical experience, a complete clinical medical and dental evaluation and examination, elimination of minor and major overlapping maladies, undergoing conservative nonsurgical care for a period of time when medically indicated, obtaining specific imaging of the hard and soft tissues of the TMJ area, using the Wilkes Classification when appropriate for internal derangements of the TMJ, and following good, sensible medical and dental ethical practices to assure that the patient comes first. Using the correct “clinical diagnosis” when medically indicated can point us to a surgical correction at a future date.
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Introduction
The ability to make a “clinical diagnosis” for temporomandibular disorders and advance to the conclusion that there is the medical necessity for a surgical correction is not an easy task. This involves many potential avenues and modalities. These would V. E. DiFabio (*) Oral and Maxillofacial Surgery, University of Maryland School of Dentistry, Baltimore, MD, USA Monocacy Health Partners Dental Clinic, Frederick, MD, USA Private Practice of Oral and Maxillofacial Surgery, Frederick, MD, USA Private Practice of Oral and Maxillofacial Surgery, Washington, DC, USA e-mail: [email protected] © Springer Nature Switzerland AG 2019 S. T. Connelly et al. (eds.), Contemporary Management of Temporomandibular Disorders, https://doi.org/10.1007/978-3-319-99909-8_2
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V. E. DiFabio
include years of clinical and/or surgical experience, a complete clinical medical and dental evaluation and examination, elimination of minor and major overlapping maladies, undergoing conservative nonsurgical care for a period of time when medically indicated, obtaining specific imaging of the hard and soft tissues of the TMJ area, using the Wilkes Classification when appropriate for internal derangements of the TMJ, and following good, sensible medical and dental ethical practices to assure that the patient comes first. Using the correct “clinical diagnosis” when medically indicated can point us to a surgical correction at a future date. To make the correct “clinical diagnosis,” you will still need to be flexible and able to juggle multiple problems in the air at one time. These problems relate to initial presenting problems, associated problems, and disorders that encompass many symptoms, signs, pathologies, and other related associated issues that the patient brings to the consultation table. To reduce this voluminous amount of data to specific entities that will lead us to a surgical solution means that we start at a point in time when some or most of the “other problems” have been excluded and eliminated from consideration.
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