Transcript 01. Diagnosis and treatment of patients

Diagnosis and treatment of
patients with lesions of the
musculoskeletal system maxillofacial area. Modern diagnostic
process in prosthetic dentistry.
General inspection
Dental assistant duties
The joints are
palpated as the patient
opens and closes to detect
signs of dysfunction.
Fig 1-7
Fig 1-8 The masseter
muscle can be palpated
extraorally by placing your
fingers over the lateral
surfaces of the ramus of
the mandible.
Fig 1-9 Fingers are placed over the patient's temples
to feel the temporalis muscle.
The little finger is
inserted
facial
to
the
maxillary teeth and around
distal to the pterygomaxillary,
or hamular, notch to palpate
the lateral pterygoid muscle.
Fig 1-11
The index finger is
used to touch the medial
pterygoid muscle on the
inner surface of the ramus.
Fig 1-10
The
sternocleidomastoid muscle
is grasped between the
thumb and forefingers on
the side of the neck. The
muscle can be accentuated
by a slight turn of the
patient's head.
Fig
The trapezius
muscle is felt at the base of
the skull, high on the neck.
Fig 1-12
1-13
The distance between maxillary and mandibular
incisors is measured when the patient is instructed to
open "all the way" (A). If the patient can only open part
way (B), the cause should be determined.
Fig 1-14
If opening is limited, the patient should
be instructed to use a finger to indicate the
area that hurts.
Fig 1-15
Rubber gloves, a surgical mask, and
eye protection are important for safeguarding
dental office personnel.
Fig 1-16
Extraoral examination
Palpation of masseter muscle
Auricular palpation of the posterior aspects of the temporomandibular joints.
lymph nodes examination
Palpation of TMJ
Inspection of frenulum
Tongue examination
salivary glands examination
Sternocleidomastiodeus muscle palpation
Inspection of cental line
Colour palette
Colour determination
Instrucions for a patient
Maximum opening of more than 50 mm (A) and lateral movement of
about 1 2 mm (B) are normal.
Muscle palpation. A, The masseter. B, The temporal muscle. C, The
trapezius muscle. D, The sternocleidomastoid muscle. E, The floor of
the mouth.
Palpation is best done bilaterally, simultaneously asking the patient to
identify any differences between left and right.
Smile analysis is an important part of the
examination, particularly when anterior
crowns or fixed dental prostheses are being
considered. A, Some individuals show
considerable gingival tissue during an
exaggerated smile. B, Others may not show
the gingival margins of even the central
incisors.
The "negative space" between the maxillary
and mandibular teeth is assessed during the
examination.
Orthognatic bite
Direct bite
Physiological prognathy
Physiological opisthognathy
Prognathy
progeny
Deep bite
Open bite
Cross bite
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