- •Isbn 978-5-7487-1437-2 ббк 81.2Англ.Я7
- •Методическая записка
- •Rendering a Scientific Paper
- •Discussing an Article Starting the Сonversation
- •Discussing the Contents
- •Making things clear
- •Impressions
- •Bioinformatics
- •Biological engineering
- •Bioprocess technology
- •Biotechnology - solution or problem?
- •Branches of biotecnology
- •Cell factories
- •Divisions of biotechnology
- •Elements
- •Genetic engineering technology
- •Modern biotechnology
- •Overview and brief history of biotechnology
- •The definition of biotechnology
- •What is biotechnology?
- •What is the biotech project?
- •Pharmaceutical products
- •Reduced dependence on fertilizers, pesticides and other agrochemicals
- •Vitamin
- •Chemical industry
- •Dyes are now classified according to how they are used in the dyeing process
- •Food industry
- •Aspirin
- •Glucose
- •Citric acid
- •Metamizole sodium
- •Ratiopharm
- •Sanofi-aventis
- •Novartis international ag
- •Menarini
- •Merck serono
- •Факультет высшего сестринского образования definition and aims of nursing
- •Documentation of the nursing process
- •From the history of nursing in the usa
- •Nursing care plan
- •Nursing care plan
- •Nursing education in russia
- •Nursing education in the united states
- •Nursing process: four major steps
- •Nursing theory
- •Pain management: non-pharmacological nursing interventions
- •Pressure sores: definition, etiology, prevention and treatment
- •Professional nurses associations
- •Qualities of the caring helper
- •The mission of nursing. Major functions of the nurse
- •Факультет клинической психологии cognitive-behavior therapy
- •Emotion
- •Classification
- •Theories of emotions
- •Neurobiological theories
- •Psychotherapy
- •Emphasizing stress
- •Progressive relaxation
- •Факультет медико-профилактического дела air pollution and health problems
- •Bubonic plaque
- •Classifying water pollution
- •Malaria in russia
- •Ecological problems nowadays
- •Hygiene promotion
- •Keeping fit
- •Pollution control
- •Protect yourself from foodborne illness
- •Russia major infectious diseases
- •Russia water quality
- •Smoking
- •The effects of acid rain
- •Water supply systems
- •World health organization
- •Лечебный и педиатрический факультеты
- •Раздел 1. Учеба на педиатрическом факультете. Педиатрия – моя будущая специальность. Личностные и профессиональные качества детского врача
- •I study at the pediatric faculty
- •The kursk state medical university
- •Becoming a pediatrician
- •Раздел 2. Из истории педиатрии. Современные проблемы педиатрии overview of pediatrics
- •Scope and history of pediatrics
- •Pediatrics
- •Growth of specialization
- •Pediatrics as a science
- •Doctor spock
- •Раздел 3. Рост и развитие ребенка. Педиатрическое обследование и лечение. Общение с больным ребенком
- •Unique character of the pediatric clinical evaluation
- •Guidelines for evaluation
- •Some notions of therapeutics
- •Talking with children
- •Chronic illness in childhood
- •Hospital of the future
- •Факультет социальной работы aspects of social service in russia
- •Clinical social work
- •Definitions
- •Epidemiology
- •Rehabilitation process
- •Rehabilitation team
- •Rehabilitation social worker
- •Personnel needs
- •Developmental stages: psychosocial implications
- •Discharge planning
- •Quality assurance and program evaluation
- •Future implications
- •System of social service of the population
- •The poverty problem
- •Eighty is the new fifty
- •Children of the quake: single kids and orphans
- •Suffer, the children
- •A case of euro envy
- •Dinner for eight
- •Not yet on the medal stand
- •Working with children and their parents
- •Стоматологический факультет temporomandibular joints
- •Signs and symptoms
- •Bruxism
- •Biofeedback
- •Dietary supplements
- •Dental surgery
- •Electric toothbrush
- •Visual Stimuli
- •Orthodontic headgear
- •Pedodontics
- •Early toothpastes
- •Tooth powder
- •Dentistry in the united kingdom
- •Лечебный факультет и факультет экономики и управления здравоохранением activities of who
- •Management is art or science?
- •Evolution of marketing
- •Health and safety advice for russia Health Advice & Necessary Vaccinations.
- •Health system
- •International marketing
- •Culture
- •Political and legal factors
- •Level of economic development
- •Medicine, public health and human rights in russian federation
- •Organizational orientation
- •Principles of the management
- •Recruitment
- •Practical application: Designing a curriculum vitae or resume
- •An example of Curriculum Vitae
- •4 Skills
- •5 Activities
- •6 References
- •The letter of application
- •Russian health system
- •Содержание
- •305041, Г. Курск, ул. К. Маркса, 3.
- •305041, Г. Курск, ул. К. Маркса, 3.
Signs and symptoms
Signs and symptoms of temporomandibular joint disorder vary in their presentation and can be very complex. Often the symptoms will involve more than one of the numerous TMJ components: muscles, nerves, tendons, ligaments, bones, connective tissue, and the teeth.[l] Ear pain associated with the swelling of proximal tissue is a symptom of temporomandibular joint disorder. Temporomandibular joint disorder is sometimes mistaken for pain arising from impacted third molars.
Muscles
TMJ diagram
Disorders of the muscles of the temporomandibular joint are the most common complaints by TMD patients. The two major observations concerning the muscles are pain and dysfunction. The dysfunction can present as trismus or limitation of jaw movement ranging from minor to severe. In milder cases, the only representation may be joint sound such as clicking or popping. These symptoms of TMD are often caused by overusage of the muscles of mastication. Common causes include chewing gum continuously, biting habits (fingernails and pencils), grinding habits, and clenching habits.
Most cases of TMJ, however, are not so simple. Deep-space infections with resulting trismus or neoplams about the joint may mimic TMJ dysfunction. Muscle pain can sometimes be associated with trigger points in muscle tissue. These trigger points can be localized by digital palpation, both intraorally and extraorally. This is known as Myofascial pain syndrome.
Over-opening the jaw beyond its range for the individual or unusually aggressive or repetitive sliding of the jaw sideways (laterally) or forward (protrusive). These movements may also be due to parafunctional habits or a malalignment of the jaw or dentition. This may be due to:
Trauma
Repetitive unconscious jaw movements called bruxing.
Malalignment of the occlusal surfaces of the teeth due to dental defect or neglect.
Jaw thrusting (causing unusual speech and chewing habits).
Excessive gum chewing or nail biting.
Size of foods eaten.
Degenerative joint disease, such as osteoarthritis or organic degeneration of the articular surfaces, recurrent fibrous and/or bony ankylosis, developmental abnormality, or pathologic lesions within the TMJ
Myofascial pain dysfunction syndrome
Treatment
Restoration of the occlusal surfaces of the teeth
If the occlusal surfaces of the teeth or the supporting structures have been damaged due to dental neglect, periodontal diseases or trauma, the proper occlusion should be restored.
Pain relief
While conventional analgesic pain killers such as paracetamol (acetaminophen) or NSAIDs provide initial relief for some sufferers, the pain is often more neuralgic in nature, which often does not respond well to these drugs.
An alternative approach is for pain modification, for which off-label use of low-doses of Tricyclic antidepressant that have anti-muscarinic properties (e.g. Amitriptyline or the less sedative Nortriptyline) generally prove more effective.
Long-term approach
It is suggested that before the attending dentist commences any plan or approach utilizing medications or surgery, a thorough search for inciting para-functional jaw habits must be performed. Correction of any discrepancies from normal can then be the primary goal.
An approach to eliminating para-functional habits involves the taking of a detailed history and careful physical examination. The medical history should be designed to reveal duration of illness and symptoms, previous treatment and effects, contributing medical findings, history of facial trauma, and a search for habits that may have produced or enhanced symptoms. Particular attention should be directed in identifying perverse jaw habits, such as clenching or teeth grinding, lip or cheek biting, or positioning of the lower jaw in an edge-to-edge bite. All of the above strain the muscles of mastication (chewing) and results in jaw pain. Palpation of these muscles will cause a painful response.
Treatment is oriented to eliminating oral habits, physical therapy to the masticatory muscles, and alleviating bad posture of the head and neck. A flat-plane full-coverage oral appliance, e.g. a non-repositioning stabilization splint, often is helpful to control bruxism and take stress off the temporomandibular joint, although some individuals may bite harder on it, resulting in a worsening of their conditions. The anterior splint, with contact at the front teeth only, may then prove helpful. This method of treatment is often referred to as "splint therapy."
According to the National Institute of Dental and Craniofacial Research (NIDCR) of the National Institutes of Health (NIH), TMJ treatments should be reversible whenever possible. That means that the treatment should not cause permanent changes to the jaw or teeth. Examples of reversible treatments are:
Over-the-counter pain medications, used according to manufacturers' instructions. Prescription medications prescribed by a healthcare provider.
Gentle jaw stretching and relaxation exercises you can do at home. Your healthcare provider can recommend exercises for your particular condition, if appropriate.
Feldenkrais TMJ Program, uses a unique understanding of human neurology to reduce chronic tension in the jaw, face, neck, and upper back, and to reverse long-standing movement habits responsible for the original TMJ symptoms.
Stabilization splint (biteplate, nightguard) is the most widely used treatment for TMJ and jaw muscle problems; however, the actual effectiveness of these splints is unclear. If an oral splint is recommended, it should be used only for a short time and should not cause permanent changes in the bite. If a splint causes or increases pain, stop using it and tell your healthcare provider. Avoid using over-the-counter mouthguards for TMJ treatment. Ifa splint is not properly fitted, the teeth may shift and worsen the condition.
Mandibular Repositioning Devices can be worn for a short time to help alleviate symptoms related to painful clicking when opening the mouth wide, but 24-hour wear for the long term may lead to changes in the position of the teeth that can complicate treatment. A typical long-term permanent treatment (if the device is proven to work especially well for the situation) would be to convert the device to a flat-plane bite plate fully covering either the upper or lower teeth and to be used only at night.
What may be concluded is that there are various treatment modalities which a well-trained experienced dentist may employ to relieve symptoms and improve joint function. They include:
Manual adjustment of the bite by grinding the teeth
Mandibular repositioning splints which move the jaw, ligaments and muscles into a new position and myofunctional therapy
Reconstructive dentistry
Orthodontics
Arthrocentesis (joint irrigation)
Surgical repositoning of jaws to correct congenital jaw malformations such as prognathism and retrognathia
Replacement of the jaw joint(s) or disc(s) with TMJ implants (This should be considered only as a treatment of last resort.)
Attempts in the last decade to develop surgical treatments based on MRI and CAT scans now receive less attention. These techniques are reserved for the most recalcitrant cases where other therapeutic modalities have changed. Exercise protocols, habit control, and splinting should be the first line of approach, leaving oral surgery as a last resort. Certainly a focus on other possible causes of facial pain and jaw immobility and dysfunction should be the initial consideration of the examining oral-facial pain specialist, oral surgeon or health professional. One option for oral surgery, is to manipulate the jaw under general anaesthetic and wash out the joint with a saline and anti-inflammatory solution in a procedure known as arthrocentesis. In some cases, this will reduce the inflammatory process.