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Tmj pain after dental procedure: Effect of Lengthy Root Canal Therapy Sessions on Temporomandibular Joint and Masticatory Muscles


Effect of Lengthy Root Canal Therapy Sessions on Temporomandibular Joint and Masticatory Muscles

J Dent Res Dent Clin Dent Prospect. 2010 Summer; 4(3): 95–97.

Safoora Sahebi

1 Assistant Professor, Department of Endodontics, Faculty of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran

Fariborz Moazami

2 Associate Professor, Department of Endodontics, Faculty of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran

Masoomeh Afsa

3 Post-graduate Student, Department of Oral Radiology, Faculty of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran

Mohammad Reza Nabavi Zade

1 Assistant Professor, Department of Endodontics, Faculty of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran

1 Assistant Professor, Department of Endodontics, Faculty of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran

2 Associate Professor, Department of Endodontics, Faculty of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran

3 Post-graduate Student, Department of Oral Radiology, Faculty of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran

Received 2010 Mar 17; Accepted 2010 Sep 9.

Copyright © 2010 The Authors; Tabriz University of Medical SciencesThis is an open-access article distributed under the terms of the Creative Commons Attribution 3.0 License(http://creativecommons.org/licenses/by/3.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.This article has been cited by other articles in PMC.


Background and aims

Trauma is one of the major factors associated with temporomandibular joint disorders (TMD). These disorders result from macro-trauma or micro-trauma. Macro-trauma might be iatrogenic; for example, from intuba-tion procedures, third molar extraction procedures, and lengthy dental appointments. The aim of this study was to evaluate the effect of lengthy root canal therapy (more than 2 hours) on TMJ and its supporting structures.

Materials and methods

Eighty patients whose root canal therapy session lasted more than 2 hours were examined for the status of TMJ and masticatory muscles. After one week the second part of the examination was carried out for TMJ problems and pain and tenderness levels of masticatory muscles. Data was analyzed using Wilcoxon statistical test.


Women showed more pain compared to men. There was a significant increase in pain in the external acoustic meatus examination one week after root canal therapy. Patients who were treated for their posterior teeth suffered more pain than those who were treated for the anteriors and premolars. Other aspects of the examination were not affected significantly by lengthy root canal therapy.


Lengthy dental treatments can harm TMJ and masticatory muscles and wide opening of the mouth during such appointments can worsen the situation. Therefore, it is wise to break the appointment into shorter intervals and let the patients rest during treatment to close their mouth to prevent iatrogenic damage to TMJ.

Keywords: Long duration, mouth opening, root canal therapy, temporomandibular dysfunction


The masticatory system is the functional unit of the body primarily responsible for chewing, speaking and swallowing. This system is made up of bones, joints, ligaments, teeth, and muscles. Functional disturbances of the masticatory system are identified by the term temporomandibular disorders (TMD). This term does not suggest merely problems that are confined to the joints but includes all the disturbances associated with the function of the masticatory system. TMD is identified as a major cause of non-odontogenic pain in the orofacial region and is considered to be a sub-classification of musculoskeletal disorders.1

Some studies have reported a high prevalence of functional disorders in the masticatory system. These studies report that on average 40-60% of the population have at least one detectable sign associated with TMD.2
A range of symptoms may be linked to TMD; pain, predominantly in the masticatory muscles and/or jaw joint, is the most common symptom. Probable indications of TMD include limited movement or locking of the jaw, radiating pain in the face, neck, or shoulder muscles, painful clicking or grating sounds in the jaw joint when opening or closing the mouth, and a sudden change in occlusal status. Symptoms such as headaches, earaches, dizziness, and hearing problems may sometimes be associated with TMD.4

A review of literature reveals five major factors associated with TMD: (1) occlusal condition; (2) trauma; (3) emotional stress; (4) deep pain input; and (5) parafunctional activities. Trauma can be divided into two general types: (1): macro-trauma and (2) micro-trauma. Micro-trauma refers to any small force that is repeatedly applied to the structures over a long period of time. Activities such as bruxism or clenching can lead to micro-trauma. Macro-trauma is considered any sudden force to the joint that can result in structural alterations. Macro-trauma may be indirect, referring to the injury inflicted on the TMJ secondary to a sudden force; it may be direct, such as a blow to the chin. This type might be iatrogenic. Whenever the jaw is overextended, elongation of the ligaments can occur. A few common examples of iatrogenic trauma are intubation procedures, third molar extraction procedures, and lengthy dental appointments. In fact, any lengthy wide opening of the mouth (e.g. a yawn) has the potential of elongating the disc ligaments.1

Although it has been claimed that TMD is a result of manipulations related to routine dental examinations, oral endotracheal intubation for general anesthesia, and lengthy dental procedures, including lengthy wide opening of the mouth, stretching or forcing the mouth to open for restorative and orthodontic treatments, tooth extraction or orthognathic surgeries, there is no scientific evidence that common or routine dental or medical procedures lead to TMD.5

Although it has been reported that there is little causal relationship between third molar removal and TMJ injury,6 some authors suggest that mouth opening for a long period of time and the exertion of a variable force on the mandible during some surgeries can traumatize one or both TMJs.7

It has been reported that one of the causes involved in TMD is lengthy opening of the mouth;5therefore, we decided to evaluate the effect of lengthy root canal therapy sessions (more than 2 hours) on TMJ and its supporting structures.

Materials and methods

Eighty patients with no significant systemic problems and no severe TMJ disorders were randomly selected from those patients who were referred to the Department of Endodontics at Shiraz Faculty of Dentistry. A consent form was signed by each patient following clear explanation of the steps of the study. The patients underwent root canal treatment which lasted for more than 2 hours; the patients could not close their mouth during the procedure because rubber dam was applied.

Before commencing the treatment, a demographic form was filled for each patient to record general information including age, gender, systemic disorders the patient suffered from and the tooth to be treated. In addition, the history of prior trauma and TMD, evidence of bruxism or clenching, missing teeth, and existing prosthetic appliances were recorded.

Preoperative examination of the TMJ and masticatory muscles was carried out for each patient. These examinations included palpation of masseter, temporalis, medial and lateral pterygoid, sternocleidomastoid and trapezius muscles to detect any tenderness or spasm. Maximum jaw opening without pain or discomfort was measured as inter-incisal distance (the distance between the incisal edges of upper and lower central incisors). Both TMJs were examined for jaw sounds, such as clicks or crepitus. In addition, periauricular palpation and intraacoustic meatus examinations were carried out to rule out pain in the region.

One week after treatment, the second part of the form was filled which included all parts of the first examination. At this time, patients were asked if they experienced TMJ problems such as pain, masticatory muscles tenderness, jaw sounds, and locked jaw. Again maximum jaw opening was measured for each patient to detect limitation of mouth opening after root canal therapy.

Finally, pre- and post-operative data was compared statistically using Wilcoxon test, as the outcome values were not normally distributed.


Statistical analysis showed that one week postoperatively external acoustic meatus pain increased significantly (P=0. 007). The results also revealed that pain was reported more frequently in patients who were treated for their molar teeth than those who were treated for their anterior or premolar teeth. The results also showed that after treatment women experienced more pain compared to men.

The other aspects of examination were not affected significantly by the lengthy root canal therapy session.


Root canal therapy, especially for multi-rooted teeth, by an inexperienced student is usually a lengthy treatment. The presence of rubber dam in the mouth does not let patients close their mouth during treatment. Our results revealed that wide opening of the mouth during lengthy endodontic treatment sessions (more than 2 hours) can give rise to signs and symptoms associated with TMD.

In this study female subjects complained of more pain postoperatively than males. With the exception of some sporadic series, most studies have reported that TMD is common in women than in men, with female-to-male ratios between 1. 75:1 and 3:1,8consistent with our findings. Biological, cultural, hormonal or environmental factors acting alone or in combination may be responsible for the reported association between TMD and female gender.9 Women have smaller mouths and their maximum jaw opening is smaller relative to men, resulting in more discomfort after wide opening of the mouth for a long time.

As mentioned previously, wide opening of the mouth for a long time can be a major trauma to TMJ with its consequences.1 Although we could not find any study specifically evaluating the effect of lengthy root canal therapy on TMJ, there are studies reporting that lengthy surgical procedures such as third molar tooth removal can give rise to TMD in patients undergoing such treatments.6
During such procedures, muscles of mastication and articular ligaments are stretched for an extended period of time, which can cause muscle spasm, pain and discomfort during mouth opening and chewing, limiting mouth opening.

In root canal therapy for posterior teeth patients need to open their mouth wider and for a longer period of time. In this situation, more force is applied to the muscles and ligaments, resulting in more TMJ pain and dysfunction after treatment.

Procedures that need lengthy mouth opening are not confined to dental appointments.

One situation in which the patient undergoes lengthy mouth opening is endotracheal intubation because of general anesthesia during surgical procedures. Endotracheal intubation has been reported as a risk factor for TMD, in which symptoms may result from forces applied with the laryngoscope, or may be related to the duration in which TMJ structures are stretched.10


Lengthy dental treatment sessions and wide opening of the mouth during such procedures can harm temporomandibular joints or worsen the TMD which is already present. Therefore, it is prudent to break treatment session into shorter appointments and also let the patient rest and relax the muscles during treatment to prevent iatrogenic damage to TMJs.


1. Okeson JP. Management of Temporomandibular Disorders and Occlusion. 5th ed. Louis: Mosby; 2003. [Google Scholar]2. Nourallah H, Johansson A. Prevalence of signs and symptoms of temporomandibular disorders in a young male Saudi population. J Oral Rehabil . 1995;22:343–7. [PubMed] [Google Scholar]3. Hiltunen K, Schmidt-Kaunisaho K, Nevalainen J, Narhi T, Ainamo A. Prevalence of signs of temporomandibular disorders among elderly inhabitants of Helsinki, Finland. Acta Odontol Scand . 1995;53:20–3. [PubMed] [Google Scholar]4. Nunez SC, Garcez AS, Suzuki SS, Martha SR. Management of mouth opening in patients with temporomandibular disorders through low level laser therapy and transcutaneous electrical neural stimulation. Photomedicine Laser Surgery . 2006;24:45–9. [PubMed] [Google Scholar]5. Goldstein BH. Temporomandibular disorders: a review of current understanding. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999;88:379–85. [PubMed] [Google Scholar]6. Contar CM, de Oliveira P, Kanegusuku K, Berticelli RD, Azevedo-Alanis LR, Machado MA. Complications in Third Molar Removal: A retrospective study of 588 patients. Med Oral Patol Oral Cir Bucal. 2009;15:e74–8. [PubMed] [Google Scholar]7. Huang GH, Rue TC. Third-molar Extraction as a Risk Factor for Temporomandibular Disorder. J Am Dent Assoc . 2006;137:1547–54. [PubMed] [Google Scholar]8. Huang GH, Leresche L, Critchlow CW, Martin MD, Drangsholt MT. factors for diagnostic subgroups of painful temporomandibular disorders (TMD) J Dent Res . 2002;81:284–8. [PubMed] [Google Scholar]9. Poveda-Roda R, Bagan JV, Jimenez-Soriano Y, Fons-Font A. retrospective study of a series of 850 patients with temporomandibular dysfunction. Clinical and radiological findings. Med Oral Patol Oral Cir Bucal. 2009;14:e628–34. [PubMed] [Google Scholar]10. Martin MD, Wilson KJ, Ross BK, Souter K. Intubation risk factors for temporomandibular joint/facial pain. Anesth Prog . 2007;54:109–14. [PMC free article] [PubMed] [Google Scholar]

What Really Causes TMJ Disorders, and How Can You Treat Them?

Do you frequently feel a clicking sensation in your jaw? You might feel it most when you yawn widely or chew during meals. Occasionally, those pops and clicks are painful, and your jaw muscles almost always feel tense.

What you’re feeling may come from a temporomandibular joint (TMJ) disorder. But just how did this problem happen? Are you doing something wrong when you chew? Did you inherit the condition? You’re not sure. You just know that it’s not enjoyable.

Where is Your Temporomandibular Joint, and What Does It Do?

If you put your index finger just in front of your ear, then open your mouth, you’ll feel a slight depression in front of your ear. If you move your jaw slightly from side to side (or up and down), you’ll feel the motion of your temporomandibular joint, a flexible but complex structure that moves multi-directionally during chewing, yawning, or speaking.

Your jaw hinge has rounded bones, or condyles, that glide over the temporal bone each time you chew or speak. In a healthy jaw, the condyles simply resume their resting position when the mouth closes.

In between the temporal bone and condyle, there’s a flexible disc that acts as shock absorber during jaw movements. This disc is important, because it also shields jaw and joints from tremendous biting forces.

Common TMJ Problems

Because of its sophisticated movement, the TM joint and surrounding muscles are vulnerable to several problems:

  • Joint disorders – These can occur if you experience a dislocated jaw, disc slippage, or condyle injuries.
  • Muscular pain – You may feel masseter muscle pain (just under the cheek bone) or in any other muscle of the head or neck.
  • Arthritis – This condition causes inflammation of joints, including the TM joint.

Other common culprits that attack temporomandibular function include fibromyalgia, rheumatic diseases, chronic fatigue, and stress-related conditions.

In tandem with the typical popping or clicking, watch for chronic jaw stiffness, a grating sensation during chewing, pain throughout the jaw and face, and difficulty opening the jaw. You may also notice changes in your bite or overall teeth alignment.

On the other hand, if jaw clicking is your only symptom, you may not have a TMJ disorder at all. Clicking and other jaw noises are fairly common.

How to Assess Your Problem and Find Relief

For whatever reason, nearly 90 percent of TMJ disorder sufferers are women. Many are middle aged, although dentists also see TMJ disorders in teens and older patients.

No matter your sex or age, if you’re worried about your symptoms, it’s time to see a dentist for a thorough assessment. Your dentist may ask you about your habits, lifestyle, and family’s medical history. He or she may then examine your jaw and facial muscles for signs of wear or tenderness. If needed, the dentist may refer you to a specialist.

If you began noticing TMJ disorder symptoms after getting braces or a new crown, mention this during your TMJ exam. Dental work doesn’t cause TMJ disorder, but it can aggravate symptoms if your bite feels odd after the work and you overcompensate by clenching your jaw muscles.

TMJ Disorder Treatment Options

According to a 2009 New York Times report, several scientists from the National Institute of Dental and Craniofacial Research suggest that less is more when treating most TMJ disorder patients.

Because so many factors play a role in these disorders, too much therapy-particularly if it’s irreversible or surgical-can backfire and cause further trouble. Many dentists suggest self-care strategies instead. Here are a few:

  • Resting the jaw
  • Eating gentle, soft foods
  • Using hot and cold therapy (heat pads, ice packs)
  • Avoiding gum chewing
  • Reducing stress responses like jaw clenching through meditation, yoga, and similar practices
  • Following a conservative regimen for stretching jaw muscles (ask your dentist or a physical therapist first)
  • Taking OTC medications short term (ibuprofen, NSAIDs) if your dentist recommends it
  • Fitting a mouth guard to your teeth to alleviate jaw clenching, particularly at night

Sleeping on your stomach can cause tension in your jaw that aggravates your symptoms. Similarly, if you play a brass musical instrument, you might experience more stress on your jaw. Try changing your sleep position and relaxing your facial muscles in between practice sessions to alleviate jaw pain caused by these two activities.

If your situation requires more assertive therapy, your doctor or dentist may prescribe Botox injections to tighten, then relax, the muscles in your jaw. Your doctor or dentist may also use ultrasound treatments or diathermy to retrain your muscles.

Your dentist will likely only consider surgery if the jaw is malformed or bone fragments need to be removed. For the majority of TMJ disorder patients, rest and self-care are usually the best options.

Talk to your dentist today if you think you may have a TMJ disorder. He or she can tell you about the latest advancements in jaw an d dental care and prescribe the treatment that best fits your situation and disorder. Before long, you’ll have a plan for greater jaw comfort and better oral health.

Is Jaw Pain after Dental Work a Bad Sign?

It’s not uncommon to experience some discomfort after dental work. Procedures like tooth extractions take time to heal, and something as simple as a filling can leave your mouth tender for a day or so.

Even regular dental cleanings may cause temporary discomfort – if that’s what you’re experiencing, we wrote post about it just for you! You can read it here: Do You Have a Toothache after Dental Cleaning?

The staff at My Family Dentistry works hard to make all of your dental procedures as comfortable as possible.

If we think that you might have some pain after a procedure, we’ll make sure you have care instructions or medications to help manage it. If the discomfort is minor, over-the-counter medications and basic home treatments like cold compresses can reduce your pain until the natural healing process takes over.

But if jaw pain after dental work is significant or persistent, there may be an underlying cause. If you’re experiencing serious pain, don’t hesitate to contact us about your symptoms.


Swelling is very common, particularly in the first 18 hours after a tooth extraction or oral surgery. Cold therapy can help reduce swelling and discomfort; just place something cold against the cheek for a 25 minute period, then remove the cold compress for 5 minutes before starting again.

You can use an ice pack, a bag of frozen peas or corn, or even a bag of crushed ice – just make sure you wrap anything frozen in a towel or washcloth to protect your skin. If the swelling doesn’t diminish or the area becomes more painful, an infection may have developed (see below for more symptoms of infection), and it’s important to contact your dentist immediately.


A little bit of bleeding is also common after a tooth removal or surgery. Direct pressure on the site will typically stop the bleeding – for example, try biting down gently on a piece of gauze. The bleeding should stop within an hour or so.

If bleeding persists for several hours, becomes worse, or if the flow of blood is heavy, contact us immediately.

Some medications that prevent blood from clotting, like warfarin (commonly sold under the brand name Coumadin), will make bleeding more difficult to stop. We’ll ask you if you’re on an anticoagulant (an anti-clotting medication) before performing any oral surgery, but be careful about taking over-the-counter medications like aspirin and ibuprofen that may prevent your blood from clotting if you are experiencing any bleeding. Acetaminophen (Tylenol) doesn’t affect clotting but will help with your pain.


Since the mouth is never sterile, take care to prevent infection after any dental procedure. At My Family Dentistry, we follow very strict sterilization procedures, but you may still contract an infection when you’re exposed to bacteria after you return home.

Using a new toothbrush and practicing careful dental hygiene will reduce your risk, but it’s still possible for infections to develop. Oral infections can occur in the gums, teeth, and even the jaw bone.

Common symptoms of infection include:

  • pain and swelling that last for longer than a day or two after your procedure
  • a throbbing sensation
  • fever or chills
  • an oral abscess (a swollen pocket of pus, likely on your gums around a tooth)

If you’ve recently had dental work and experience an aching pain in your jaw that’s accompanied by fever or chills, contact us immediately. In rare cases, an infection of the bone known as osteomyelitis can occur, and it’s important to treat it as soon as possible. If you were recently treated for an abscessed tooth or another oral infection, be especially vigilant.

Antibiotics may be needed to control a serious infection, so if you experience the symptoms of an infection, don’t wait to get treatment.

Jaw and Muscle Soreness

During long procedures like root canals and some fillings, the patient’s mouth can remain open for an extended period of time. This can put stress on the muscles of the jaw and cause soreness later. Applying cold and/or heat to the painful area can help relieve the discomfort.

Dry Socket

If you have recently had a tooth removed, jaw pain may be caused by a condition called “dry socket.” When a tooth is removed, a blood clot forms to protect the newly-exposed bone. Dry socket occurs when that blood clot dissolves or gets dislodged, exposing the bone and nerve.

The pain often begins about 2 days after the removal of the tooth, sometimes radiating to the ear. You may also have a bad taste in your mouth and unpleasant breath.

If you have dry socket, it’s very important to take action to prevent infection. Your dentist can clean the empty socket to remove any food debris, and may use a medicated dressing to protect it and help the pain. Aspirin or ibuprofen can help with the swelling and discomfort, but in some cases the pain may be severe. If you have the symptoms of dry socket, contact us immediately.

Need to know more about jaw pain after a dental procedure? Get in touch with us today.

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Pain After Dental Work? Here Are a Few Reasons Why

You probably expect your mouth to feel sore – or at least a bit tender – after a dental procedure. But you may not have expected a locked jaw, nausea, fever sores, or clogged ears following treatment. And even if you just experience some swelling and soreness, sometimes it’s hard to tell what symptoms are normal and which ones require a call to the dentist.

We’ve listed some of the more common issues and their causes below, but please bear in mind that your best resource for dental health will always be your own dentist. Call your dentist if you are experiencing pain, bleeding, swelling or other pain/discomfort following treatment. And follow the aftercare instructions you received from your dentist to avoid many of the complications below.


This is typically a response to the numbing medications your dentist uses during an extraction or other treatments. Nausea is especially common after multiple extractions and may linger for three to five days. If your procedure involved getting temporary or permanent dentures, you might think the dizziness and nausea is caused by your gag reflex triggering. This may be true, but initially it’s more likely to be an anesthesia issue. If you’re still feeling sick to your stomach five days after getting new dentures, your dentist may need to reshape the back part of your dentures.

Ear Ache:

Pain in your ears, ringing or buzzing sounds, or the feeling that your ear is clogged can be related to muscle strain after having your mouth open during treatment (see above). You may also have an infection, your teeth may not be aligning properly (bad bite), or you may have a cold/allergy that is actually causing the symptoms. Call your dentist.


If you got a white filling, you may experience a little more irritation than you do with a silver filling. The process used to affix and harden white fillings (dental glue and UV light treatment) results in shrinkage the composite filling material. This can cause a sensation of pressure in your tooth along with sensitivity when you bite down. The problem should solve itself within a few weeks, but if you are uncomfortable, or are experiencing pressure with a throbbing sensation, check in with your dentist.

Increasing Pain:

If pain suddenly worsens several days following an extraction, you may have “dry socket” and should see your dentist immediately for treatment. It’s important to follow your dentist’s aftercare instructions to encourage the formation of the blood clot that covers the extraction site and allows the area to heal. Additionally, without the clot, nerve endings and bone near the extraction site are exposed to air, food and liquids causing significant pain. A medicated dressing placed in the extraction site by your dentist will almost instantly relieve the pain. You may need to get the dressing changed daily or every two days, or you may get a dressing that stays in and dissolves over time. You may also need antibiotics and/or pain medication.

Sore Jaw:

Any dental procedure that requires you to keep your mouth open for an extended period can result in jaw soreness and stiffness due to muscle strain. A slightly sore jaw is normal following dental treatment. If the pain is severe (example: it isn’t controlled by over-the-counter pain medication), call your dentist. He or she may suggest warm, moist compresses and gentle stretching exercises.


“Stuck” Jaw:

If you notice that you are having problems opening and closing your mouth, or that your jaw sometimes feels frozen in place, you may have a condition called trismus (lockjaw). This is caused by a muscle injury that can happen following a dental injection, particularly when treating your lower teeth. It can also be caused by the effects of the local anaesthetic solution, or by muscle tremors due to jaw strain. Typically, trismus may last for two to three weeks, but call your dentist for treatment advice. The treatment for trismus is the same for sore jaws (see paragraph above) but in more severe cases you may need muscle relaxants.

Sore Throat:

A tender throat may be caused by dehydration due to having your mouth open for an extended period. Drink lots of plain water (skip flavored water or carbonated drinks for a few days following dental treatment), or consider drinking coconut water. If your throat is seriously sore, and rehydrating doesn’t help, you are likely having a response to the dental ananaesthesiaOr you may have an infection. Check with your dentist.

Sores/Blisters around Lips:

If you have experienced several bouts of “cold sores” (painful fluid-filled blisters occur and then eventually scab or crust over before they heal) around your mouth you probably have been exposed to the herpes simplex virus type 1 (HSV-1), a very common viral infection. After exposure, the virus can lie dormant for years until it is reactivated following an illness or stressful situations like getting dental work. A reaction to the dental anesthesia can also cause a flare-up. If you have a history of getting cold sores, tell your dentist prior to getting treatment.


Some swelling immediately following dental procedures is normal, as your body sends extra blood to any injured area to help accelerate healing. Holding an ice pack – try a bag of frozen peas or corn as it will shape better to your face – in the first day or two following treatment can help. If swelling persists or worsens after 3 days and/or are in pain, you may have an infection and should contact your dentist.

Throbbing Pain:

This may indicate an infection, or a small fracture in the treated tooth or nearby teeth. Call your dentist for treatment ASAP.

The Importance of Preventive Care

Skipping dental checkups and cleanings often results in the need for restorative care, and the longer you avoid the dentist the more likely you are to need expensive, lengthy treatments. If budget constraints are keeping you from seeing your dentist, consider getting a dental discount plan.

An alternative to traditional dental insurance, dental savings plans offer plan members savings of 10-60% on a wide variety of dental treatments. To learn more about affordable dental savings plans., contact us today!

What Might Be the Cause?

You just got a dental filling to fix a cavity and now you have pain in your jaw. What gives? Wasn’t the point of the filling to fix your problem? While a filling should restore the tooth and improve your comfort, there are instances where people may experience jaw pain after a filling, as well as other issues. Knowing what to expect after your dentist restores a tooth can help you tell if something’s gone wrong. Then, you can take the action you need to protect your mouth and overall health.

What to Expect After a Filling

The goal of a filling is to repair the damage caused by tooth decay. Although a dental filling should help to fix your problem, you might notice a bit of sensitivity immediately following the treatment. The Cleveland Clinic notes that this tooth sensitivity is common after fillings and that it usually resolves on its own after a couple of weeks.

There are some cases when people do feel tooth pain or pain in the area surrounding their tooth after getting a filling. As the Cleveland Clinic points out, tooth pain after a filling can be a sign that the filling is affecting your bite or that the decay was severe enough to require more extensive treatment, such as a root canal. If that’s the case, you might want to see your dentist to discuss your options.

Possible Causes of Jaw Pain After a Filling

What if you don’t have tooth sensitivity or a toothache-type pain after a filling but instead have pain in your jaw? In some cases, the tenderness might be a side effect of having a dentist working in your mouth. Simply keeping your mouth open for an extended period can cause your jaw to become sore. In some cases, keeping your mouth open as your dentist works can contribute to trismus, or “lockjaw,” as the Canadian Dental Association (CDA) notes, which is a condition that makes it difficult to open your mouth fully.

In certain instances, jaw pain might develop because of a problem with the filling or another issue in the mouth. A case report published in the European Journal of General Dentistry describes how one woman developed jaw pain after a restoration, suggesting that the restoration she received was “jagged,” which might have contributed to her pain. She also had signs of inflammation in the gums, which may have played a role, too. Smoothing and reshaping the filling helped to reduce her pain.

How to Get Relief From Jaw Pain

It might be a relief to know that jaw pain after a filling usually resolves itself quickly. But what if you want relief from your pain now, rather than in a couple of weeks? There are a few things you can do.

If you’re experiencing lockjaw, StatPearls suggests applying heat to the jaw area, or try gentle stretching exercises. Talk to your dentist to learn more about how to perform the exercises.

Ibuprofen and other analgesics may also help to minimize your jaw pain, according to the CDA. Talk to your dentist or doctor before trying them to be sure that you get the dose right and that the pain relievers won’t interfere with any other medication you’re taking. If ibuprofen or similar medication doesn’t help, your dentist or doctor might prescribe a muscle relaxant to ease the pain.

When to See a Dentist About Jaw Pain

Any sensitivity or discomfort you feel after a filling should let up after a couple of weeks. If more than two weeks have passed and you’re still noticing that your jaw hurts, it’s a good idea to schedule a follow-up visit with your dentist. During your visit, they can inspect your mouth and look for potential causes of your jaw pain, such as inflammation in the gums or a rough-edged filling.

Together, you and your dentist can discover the cause of your continued jaw pain and can discuss what you can do to alleviate it.

Can Oral Surgery Cause TMJ?

TMJ disorder (TMD) is a painful condition that can cause muscle soreness, joint discomfort, headaches, limited range of motion, popping, and clicking. Although everyone “has” a TMJ joint, only certain people suffer from TMJ disorder.

The causes of TMJ disorder vary. Some of the most frequent reasons we see in our Lafayette oral surgery practice include:

      • Malocclusions (misaligned teeth),
      • Traumatic injuries,
      • Bruxism (grinding and clenching), or
      • Sleep apnea

Can oral surgery cause TMJ? Although uncommon, it’s a possibility. Since oral surgery requires spending an extended length of time with your mouth open, it can strain your TMJ, causing soreness for several days afterwards. However, it’s highly unlikely that oral surgery will cause TMD, especially when you see an experienced specialist for your procedure.

Treatments for TMJ Pain

Are you looking for treatment for TMJ disorder in Lafayette? Oral surgery is one of the last steps when it comes to managing chronic TMD pain. In most cases, experts like Dr. Hayes recommend non-invasive therapies such as orthodontic treatment, massage, physical therapy, bite splints, or Botox injections. When used together, these strategies lessen the strain on your TMJ muscles and alleviate the source of pain.

In severe instances of TMD, oral surgery can be an effective solution for treating TMJ pain, rather than causing it.

When to See a Surgeon

If you’re already following your dentist’s recommendations and trying home remedies for TMJ pain without any improvement, it’s time to book a consultation at our Lafayette, CO oral surgery center.

During your evaluation, Dr. Hayes will assess the anatomy of your TMJ and the tissues around it. In rare situations, surgery is required for treating TMD; but it doesn’t cause it!

Book your consultation at Coal Creek Oral Surgery and Dental Implant Center in Lafayette today to learn more.

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Hidden TMJ Disorder Causes Tooth Pain

By Jennifer DeChant, DDS | Updated 9.1.2021

Many say there is nothing worse than a nagging toothache!

Your pain may be due to multiple factors, such as genetics, arthritis, or a jaw condition. It may be caused by a hidden TMJ disorder. Some individuals who suffer from ongoing jaw pain also tend to clench or grind their teeth (bruxism). While many people never develop a TMJ disorder from habitually clench or grind their teeth, others do.

The Minnesota Head & Nead Clinic can help diagnose chronic conditions that need pain relief. We are skilled at determining the root causes of persistent pain and pain disorders. People ask why after having a painful tooth treated, the pain still persists. At times the patient didn’t even have tooth pain until AFTER a filling or crown was placed. We’ll start with answering some common questions.

Why Does my Tooth Hurt After Completing Dental Treatment?

Our body’s are intricately connected. Many people are unaware of the work our jaw muscles do to help us chew, open our mouth wide, etc. The TMJ pain comes from the soft tissues that attach to the bone.

When a dentist places a restoration on a tooth, she or he generally needs to remove some tooth structure and decay (a cavity) before filling the tooth. There are three layers to your teeth. Enamel is the hardest layer and makes up the outside layer of your tooth. The middle layer is Dentin. Dentin is what gives your tooth its yellow color. And the inside layer is called the Pulp. The nerve of the tooth is in the Pulp and extends into the roots of your tooth.

When your dentist places a filling, usually part of the enamel and dentin layers are removed. This can cause some irritation to the nerve of the tooth. This irritation can cause cold or hot sensitivity. The more tooth structure that is removed, the higher chance that the nerve could become irritated. This is why it is very important to see your dentist regularly for a check-up. If you have a cavity in the tooth, it will continue to get bigger and bigger over time. The larger the cavity, the higher chance for temperature sensitivity after the filling is placed.

There are several reasons why a tooth could hurt after dental treatment. The most common complaint is temperature sensitivity in the tooth directly following a filling or crown. Your dentist can address questions and solutions for this.

Can TMJ Tooth Pain be Triggered by Bite Changes?

at times, a Hidden TMJ Disorder started by changes in the patient’s bite.

If your bite becomes slightly different after a new crown or filling than it was before, this may impact your chewing and jaw. New crowns or fillings with a slightly different shape than original teeth affect the way your teeth come together. Because of the change in your bite, you may experience a slight twinge in the tooth when you bite. This usually settles down after a couple of days or weeks.

However, if you cannot bring your teeth together or have extreme pain when biting or chewing directly following this type of treatment, call your dentist. If not provided or lost, ask for information about patient self-care after receiving novocaine for dental work. It may be necessary to be evaluated for a bite adjustment. Teeth crowns or fillings may have a touchpoint that is too tall or too high. In this case, a slight adjustment to the restoration often is the fix. Once peples’ bite is adjusted, the pain typically resolves.

If it persists then your dental may refer you to our team of pain specialists. We’ll evaluate your jaw’s temporomandibular joint among other things.

What is my Temporomandibular Joint?

Your temporomandibular joint is a highly functioning hinge that connects your jaw to the temporal bones of your skull. These are located in front of each ear. It is the mechanical arm that moves your jaw up and down and side-to-side. This is what enables you talk, chew, scream, whistle, and yawn.

If facial nerve pain sensitivity develops after your tooth treatment, definitely request a doctor appointment. If an abscessed abscess is ruled out, you may have developed something called “irreversible pulpitis”. That is just a fancy way of saying that the nerve in your tooth is very inflamed and will not resolve itself. A tooth that has a large filling or crown can sometimes lead to an abscessed tooth or irreversible pulpitis. Other causes are trauma to the tooth or a history of clenching and/or grinding your teeth. This is where a temporomandibular disorder should be checked.

TMJ refers to an array of conditions that relate to your TM joints, jaw muscles, and facial nerves. TMJ may occur when the jaw twists during opening, closing or side-motion movements.

When you clench or grind your teeth, you are putting excessive pressure on your teeth which could lead to nerve damage. Once you develop an abscess or irreversible pulpitis, the usual treatment is to have a root canal on the tooth. When a root canal is performed, your dentist or endodontist will place a small hole in the top of the tooth after it is numb, and then he or she will place some small files down inside the roots of the tooth to clean out the diseased nerve tissue. Once all of the diseased tissue is cleaned out, they will place a rubber material into the roots of your tooth and then close up the tooth with a filling or cover the tooth with a crown. If a root canal cannot be performed on the tooth, then the tooth will most likely need to be extracted.

TMJ Treatment may Start by Reviewing X-Rays of Teeth & Jaw

Following a root canal, your tooth could be a little sore for a few days or weeks. This is very common. But what if your pain does not resolve? What if the pain increases? What if you had your tooth pulled, but the pain still persists? This is more common than you could probably believe.

Professionals that treat jaw pain estimate that over 680,000 teeth per year are treated with root canals unnecessarily. Although you could feel certain that the pain is coming from your tooth, there just may be another cause.

Here’s what a tooth looks like on an x-ray after having a root canal. The white lines in the roots of the tooth indicate that the tooth has been treated with a root canal. The lines are the rubber material that was placed down inside of the tooth after the diseased nerve was cleaned out. The white on the top of the tooth is a crown. (Some people call them a “cap”.)

Now take a look at this patient’s x-ray. Can you see that EVERY tooth has had a root canal? It’s hard to believe, isn’t it? This patient would experience a toothache and then have a root canal. And then another tooth would hurt. And then another and another. This continued until every tooth had a root canal. And yet, surprisingly, this patient still had persistent tooth pain. And that is where our chronic pain treatment can be your answer!

Believe it or not, tooth pain could actually be coming from your jaw muscles. Here’s why.

How do Jaw Muscle Bands Cause Painful Teeth?

When a muscle is injured, overused, or overloaded, it can develop taut bands in the muscle called trigger points. These trigger points can, in turn, refer pain to other parts of your body. For example, if you develop trigger points in your masseter muscle in your jaw (possibly from clenching or grinding your teeth), these trigger points could cause pain in your back teeth as illustrated below.

If you develop trigger points in your temporalis muscle, they could cause pain in any of your upper teeth. Both the masseter muscle and the temporalis muscle are activated when you use your jaw for talking or chewing. They can also be activated if you are clenching or grinding your teeth.

Trigger points in muscles can cause many other issues beyond toothaches, such as tension headaches and ear pain. Trigger points are often a sign of temporomandibular joint (TMJ) disorder, a disorder causing pain in your jaw joint and the muscles that control jaw function. Some other signs of TMJ disorder include pain with chewing, clicking or popping, or grating noises in your joints, facial pain, locking of your jaw, or an ache or ringing in your ears.

Oftentimes TMJ disorders goes undiagnosed. Sometimes a patient has TMJ disorder for years without knowing. They often present with tooth pain, earaches, jaw pain, and headaches that they have been living with for years and years. Once they are treated for TMJ disorder, the accompanying symptoms resolve. At MN Head and Neck Pain clinics, we perform a thorough exam on your head and neck to identify if you are suffering from TMJ disorder. We then establish a treatment plan specifically tailored to you in order to address your complaints.

MN Head and Neck Pain Clinic’s Treatment Plan for TMJ

A hidden TMJ disorder can spread to the head, neck, and shoulders, interfere with everything a person we does all day. It may disrupt sleep, and cause problems at work. One of the most insidious things about TMJ pain is that it may suddenly surface and seemingly for no reason.

We establish a treatment plan through multiple avenues, depending on what we deem as the correct treatment for your particular case.

Types of treatment for a hidden TMJ disord may include:

1. Patient education and self-care

2. Physical therapy

3. Injections such as Botox or Acupuncture

4. Medications

5. Behavioral modification

“Temporomandibular jaw (TMJ) problems cause clicking and locking of the jaw, difficulty chewing, and generally makes eating miserable. It affects many people intermittently throughout life, and tends to get worse as we age: between 45-70% of people older than 65 show signs of TMJ deterioration, according to previous research in the field.” – University of Connecticut

CONCLUSION: Get Help Diagnosing a possible Hidden TMJ Disorder

Once you have been evaluated by one of our providers, our team works together to take an interdisciplinary approach to reduce your symptoms. No worries if traveling to our clinic is challenging for a time; we provide telemedicine doctor appointments. So, if you are suffering from persistent tooth pain after dental treatment and not finding any relief, you could very well have TMJ disorder.

Call 763-577-2484 for a deep diagnosis for a possible TMJ disorder or

Dr. Jennifer DeChant is passionate about treating patients with TMJ disorders, jaw pain, and obstructive sleep conditions at the MN Head and Neck Pain Clinic. She graduated with honors from the University of Minnesota in 1999 with a Doctor of Dental Surgery degree.

90,000 Dislocation of the temporomandibular joint (TMJ)

What is TMJ dislocation?
The temporomandibular joint (TMJ) is located just in front of the lower part of the ear. It provides movement of the lower jaw. The temporomandibular joint has a hinge device, similar to the shoulder and hip joints. When the mouth opens wide, the articular head (called the condyle) exits the glenoid fossa and moves forward. When the genus closes, the articular head returns to its place.

Temporomandibular joint dislocation occurs when the condyle is extended too far, gets stuck in front of a part of the bone called the articular tubercle, and cannot snap into place. This most often occurs as a result of a weakening of the ligaments that are designed to hold the condyle in place. In this case, adjacent muscles often cover convulsions and they hold the condyle in a displaced position.

The jaw is stuck open and you cannot close your mouth.This inconvenience persists until the joint returns to the correct position.

The dentist makes a diagnosis based on the position of the jaw and the patient’s ability to close the mouth. X-ray examination is used to confirm the clinical diagnosis.

Expected duration of dislocation
The inconvenience persists until the joint returns to the correct position. However, the surrounding tissue may remain hypersensitive for several weeks.

Dislocation of the TMJ can recur in people with weakened joint ligaments. To prevent such cases from occurring too often, dentists recommend limiting the width of the jaw opening. For example, a person with a similar problem should prop up their chin with a fist when yawning to prevent their mouth from opening too wide.

Traditional surgical treatments can prevent dislocation from recurring.In some patients, the jaws are held in a closed position with a wire for a specified period. This helps to strengthen the ligaments and limits their movement.

In certain cases, surgery may be required. One of the procedures is called eminectomy. It involves the removal of the articular tubercle so that the articular head can no longer get stuck in front of it.

Treatment Procedure
To return the condyle to the correct position, the muscles around the temporomandibular joint must be relaxed.For this, some people require an injection of a local anesthetic into the jaw joint, which may be followed by an injection of a special drug, such as diazepam, to relieve tension and stop seizures. The muscle relaxant is injected intravenously (into the vein of the cubital fossa).

When the jaw muscles are sufficiently relaxed, the surgeon or dentist can return the condyle to the correct position. To do this, he pulls down the lower jaw and puts pressure on the chin from the bottom up to release the condyle.After that, the articular head returns to the glenoid fossa.

In rare cases, the dislocation needs to be repaired in the operating room under general anesthesia. Thereafter, the jaws are sometimes wired in a closed position or an elastic splint is placed between the upper and lower teeth to restrict the movement of the jaw after the dislocation has been repositioned.

For several weeks after the dislocation is repositioned, it is required to eat only soft or liquid food – this will reduce the movement of the lower jaw and the pressure on it.Avoid chewing hard foods such as tough meats, carrots, hard caramel, and ice cubes. Also, try not to open your mouth too wide.

When do you need to see a specialist?
If you have a dislocated TMJ, see your doctor, dentist, or hospital emergency department right away to get your joint back. You may be referred to a dental or oral surgeon for treatment.

The forecast for the return of the displaced articular head to the glenoid fossa is very favorable.However, in some people, joint dislocation may recur. In such cases, surgery may be required.

© 2002-2013, Aetna, Inc. All rights reserved.

© 2002-2018 Aetna, Inc. All rights reserved.

Temporomandibular joint dysfunction

The connection of the lower jaw with the skull occurs due to the temporomandibular joint (in the English language literature – TMJ Temporomandibular joint).This is a paired joint that is located in front of the ears.

When it doesn’t work properly or causes pain, doctors use the term temporomandibular joint dysfunction.

Problems in the joints or nearby muscles can lead to TMJ dysfunction. Your doctor can give you more information about the tests you need and your treatment options.

Temporomandibular joint dysfunction symptoms may include:

  • jaw pain
  • neck pain
  • headaches
  • ear pain
  • limiting the volume of opening the mouth, clenching the jaws
  • accompanied by pain, sounds in the jaw area: clicking, cracking or creaking.

To find out the cause of the dysfunction, your doctor will need to evaluate many parameters:

  • Review of dental, medical history of the disease; especially, where there is information about chronic pain syndrome of any other localization

  • Drawing up a short socio-psychological history

  • Objective examination of the head and neck, including muscles, nerves, TMJ joints and mouth

  • Additional testing, which may include x-ray, CT, MRI, laboratory tests, diagnostic injections, or other tests

Studies have shown that dysfunction is most often caused by a combination of several factors that can act simultaneously, including jaw injuries or joint diseases:

  • Jaw injury. Occurs when a blow to the jaw is received or when the mouth is wide open while eating, prolonged dental procedures, or the introduction of a breathing tube during anesthesia

  • Abnormal habits. Gritting, grinding your teeth, biting your nails, and chewing gum can lead to dysfunction in some people.These habits can make it difficult to deal with pain.

  • Bite. Research has shown that malocclusion is rarely the cause of dysfunction.

  • Psychological factors. Emotional stress, depression and anxiety have been shown to increase pain.

  • Prescription drugs. Certain medications can increase muscle tension, which in turn increases pain.

  • Diseases of the joints.There are diseases that involve connective tissue, including the TMJ structures, in the pathological process.

Pain in dysfunction can come from both the structures of the TMJ itself and from the muscles that move the lower jaw. For this reason, examination of the muscles of the head and neck is mandatory.

Normal Anatomy of the TMJ

Temporomandibular joint (TMJ) causes the movement of the lower jaw up and down and from side to side. There is a shock-absorbing disc between the head of the lower jaw and the skull, which moves with the jaw and protects the bones at the moment of opening, closing the mouth.

TMJ arthritis

The condition of the bones and surrounding soft tissues of the joint can deteriorate over time in the presence of a condition known as arthritis. Arthritis can be caused by joint wear and tear or traumatic injury. Osteoarthritis is more common in older people. But the TMJ can also be involved in the systemic process in rheumatoid arthritis.

Intra-articular tissue can be damaged and painful when trying to move the jaw to talk or eat, and as a result, lead to jaw adhesion or blockage when trying to open the mouth.

Temporomandibular joint muscles

The chewing muscles attach your jaw to your skull. They provide movement of the jaw while talking, eating, etc.

Like other muscles, any of these can become sore or tense due to increased use. Sometimes the brain confuses these pain signals and you may feel pain elsewhere. This can lead to widespread jaw pain, neck pain, or headache.

Self-control of the disease shall include the following items:

  • try to avoid clenching your teeth during the day, the jaw is relaxed; at rest, the teeth of the upper and lower jaws should not close together

  • Avoid chewing on non-food items such as pens, pencils, toothpicks, or nails

  • Avoid playing musical instruments that strain the jaw or put pressure on the jaw

  • Limit jaw opening during chewing or yawning to two fingers wide

  • Allow jaw muscles to rest, avoid chewing gum, bagels, ice, hard meat or caramel

  • Use cold compresses or wet hot compresses

  • Massage painful muscles

  • Learn techniques and learn techniques for rest and relaxation

  • Do gentle jaw exercises as directed by your doctor or physiotherapist

  • Identify sleep problems and work with your doctor to improve your sleep

  • Record the characteristics of pain in your journal and anything that improves or worsens pain.

  • Write down treatments for the condition.

Treatment of dysfunction

Since there are so many possible causes of TMJ dysfunction, there is no one universal treatment. Symptoms of dysfunction can be temporary and not limited to serious consequences. Your doctor will work with you to help manage this condition. Most researchers recommend focusing on conservative and reversible therapy first.Research has shown that self-control and conservative treatments are most successful.

The goals of treatment are to reduce pain, increase jaw function, and limit the effects of TMJ dysfunction on daily life.

1. Self-control is one of the most successful ways to relieve pain.

Studies on the treatment and management of patients with stress have shown that reducing stress and anxiety can help reduce the severity of TMJ dysfunction symptoms.

Your doctor may recommend methods that you can use to manage stress, or they may refer you to other professionals for additional support.

2. Physiotherapy (exercise therapy).

Physical Therapists are trained professionals who assist patients in the rehabilitation of many injuries. Your health care provider will determine if exercise therapy can help reduce the manifestations of dysfunction.

3. Medicines.

Many medicines are helpful in the presence of any discomfort. Some are traditionally used to relieve pain, while others work in a different way. Your doctor will provide you with a specific treatment plan according to what needs to be done in your case.

4. Orthopedic aids.

A stabilizer tire or night stabilizer is known. The design will depend on your condition. It should only be used on the advice of a physician.Most orthotics work to protect teeth from each other, relieve pressure on the joints of the jaw, and help relax the jaw muscles.

5. Surgical intervention.

In cases of severe, persistent pain or loss of function, surgery may be necessary. Studies have shown that in about 5 out of 100 patients with TMJ dysfunction, conservative therapy is insufficient. These patients are referred for surgical treatment.

Temporomandibular joint exercises
90,000 Treatment of periodontitis quickly and efficiently in dentistry “Kedr”

Metal-free dental prosthetics is one of the methods of restoring the integrity of the dentition, in which all-ceramic crowns are used.Instead of metal, they use a base made of translucent zirconium oxide, so the finished copings are indistinguishable from the natural tooth tissue.

Treatment of periodontitis in the dental clinic “Kedr”
Periodontitis is an inflammation of the periodontal tissues with their gradual destruction. Most often, periodontitis develops against the background of untreated pulpitis, in which the infectious process passes from the root to the surrounding tissues.But the reasons for periodontitis may be different:

Tooth trauma.
Unsuccessful dental procedures.

Reaction to drugs (formalin, arsenic paste and others).
The gradual inflammatory process destroys the ligamentous apparatus responsible for keeping the tooth in the alveolus. This can lead to loosening of the dental unit, and in severe cases, its loss. Therefore, it is necessary to start treatment of periodontitis as early as possible.

Symptoms of the disease.
Periodontitis treatment begins after diagnosis. The main signs of pathological processes are:
Sharp or aching pain in the tooth, radiating to various parts of the jaw.
Fever (in the presence of a purulent focus).
Mobility of the unit in the alveolus.
General malaise and weakness.

The process tends to become chronic. In this case, the severity of the symptoms decreases.But the inflammation continues to gradually destroy the ligamentous apparatus. If periodontitis is not treated in time, the risk of complications, for example, the formation of cysts, increases.

How is periodontitis treated?
The method of therapy is selected by the dentist depending on the patient’s condition, his anamnesis. Usually, for the treatment of periodontitis, root canal enlargement is necessary, allowing the doctor to reach the infectious focus. Affected tissues are removed, antiseptic treatment is performed.

Then a temporary filling is applied, which will be replaced with a permanent crown after about 1 month, if the X-ray shows that the periodontitis treatment was successful. Also, the patient is often prescribed a course of antibiotics to suppress the pathogen.

You can restore your dental health in the Kedr Dental Clinic. Our specialists will select the best way to treat periodontitis. You can make an appointment by calling the contact phone number.

3D imaging software | Planmeca Romexis

3D imaging software | Planmeca Romexis

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Software Platform Planmeca Romexis® offers versatile and intuitive tools for dentists and clinicians in a variety of specialties, helping dental clinics of all types reach their full potential and provide the best possible level of care.The Romexis 3D software module supports all types of 3D images.

Software for all 3D images

The Romexis 3D software module is an excellent solution for all dental 3D imaging, as it allows users to manage CBCT images, surface models, 3D photographs and even 4D jaw movement records in one interface. The module is optimized for simplified and fast image viewing and provides the tools you need for advanced treatment plans and analyzes.

For all needs and areas of specialization

Romexis 3D provides users with all of these capabilities as it includes advanced 3D visualization tools specifically designed for various areas of dentistry such as orthodontics, prosthetics, implantology, endodontics, maxillofacial surgery and general dentistry.

Powerful 3D Diagnostic Tools

The Romexis 3D reconstruction view provides a direct view of the patient’s anatomy and is an excellent tool for patient education.This allows you to instantly view images from different projections or convert them to panoramic images and cross-sections. Software measurement and annotation tools, such as neural canal tracing, further support safe and accurate treatment planning.

Intelligent segmentation

Romexis provides an extensive set of tools for segmenting CBCT volume data. The entire volume can be converted to an STL model.Individual teeth, lower jaw and upper jaw, airways, sinuses and roots can be segmented, saved and exported from the program as STL files for further planning of orthodontic treatment or prosthetics and 3D printing.

Effective Airway Analysis


Romexis allows you to segment your airways with a couple of clicks. The software automatically calculates the volume and minimum area and marks the patient’s airway in vivid colors.Our Planmeca Ultra Low Dose ™ cone computed tomography protocol Planmeca is also the optimal choice for airway studies as it can significantly reduce patient dose without compromising diagnostic image quality.

3D photo

The Romexis 3D module enables the visualization and analysis of 3D photographs taken with the Planmeca ProFace® camera (available for all Planmeca Cone Beams) or imported from other sources in the standard OBJ file format.Photos can be matched to CBCT images and digital impressions in 3D virtual patient software – ideal for pre-post-procedure comparison, treatment simulation, and patient education.


Orthodontic diagnoses

CBCT scans are ideal for orthodontic diagnostics, and Romexis software makes it easy to analyze skeletal symmetry, identify unerupted and supercomplete teeth, and accurately identify root resorption and orientation.The software can also generate cephalometric and panoramic images from CBCT images that can be used for cephalometric analysis.

TMJ projections

Temporomandibular joint pain (TMJ) is experienced by a significant part of the population. Planmeca Romexis provides projections specifically designed for the exploration and analysis of temporomandibular joint problems. Both joints of the patient can be assessed simultaneously by means of the program with the determination of the exact dimensions.

CBCT overlay

The Planmeca Romexis 3D module allows two CBCT images to be overlaid. This makes it easier to compare before and after the procedure, and this function can also be used, for example, for subsequent orthognathic surgery or orthodontic treatment.

Endodontics instruments

All our 3D imaging devices have a special high resolution 75 μm voxel mode that has been specially designed for endodontic imaging.Combined with the superior imaging capabilities of the Romexis software, this mode is ideal for endodontic diagnosis and patient education. Root canals, trauma, root fractures and root resorption can be easily assessed, leading to accurate diagnosis and treatment plans.


Open platform with broad compatibility

Any type of 3D data in standard file format can be imported or exported from Romexis.The software also allows DICOM volumetric data to be converted to a surface model and exported to an STL file. You can export STL models (such as scans, crowns, abutments, airways and nerves) as a single file or separately. The 3D module also integrates with third-party software as well as lab portals and services to launch and export their data with a single click.

Simple exchange of results

Converting CBCT exams into multi-page printouts is quick and can also be used in conjunction with the free Planmeca Romexis® Viewer application for Windows and Mac.Cases can also be easily sent to mobile devices and viewed using the Planmeca mRomexis ™ imaging application for iOS and Android. In turn, sharing cases with partner clinics is very easy with the Planmeca Romexis® Cloud file transfer service.

Extending the existing 3D module

The Romexis 3D module can be easily converted into a complete treatment planning software with support for implant planning and orthognathic implant planning.The complete implantation workflow also allows the simulation of surgical templates for implant placement procedures and orthognathic splints.


Instructional Videos

Want to use Planmeca Romexis® software more efficiently? Watch our tutorial videos for tips and tricks.

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All On 6 implants | All on 6, Antalya, dentist, Turkey

Dental implantation “All on 6”

All On 6 (All on Six) implants; It is based on the procedure for installing 6 implants in the upper jaw and 6 implants in the lower jaw.When using an all-in-six implantation, a permanent fixed prosthesis can be placed on the lower jaw in at least 5 weeks, and on the upper jaw in at least 12 weeks. This method, which allows the denture to be fixed on the same day, is an advanced technology. It is a suitable method for our patients who experience bone loss, especially in the posterior region, for the use of fixed teeth.

All On Six Implants is a dental procedure used to restore the oral cavity of a person who has lost a significant number of teeth in one or both jaws.This procedure gives the person the opportunity to replace all of their teeth with six dental implants that look and feel natural. All On Six implants generally do not require bone grafts, so they are ideal for patients with low jaw bone density or volume.

Not everyone can be a candidate for all six dental implants. If you smoke or have diabetes, you may not be an ideal candidate for this procedure. The treatment is recommended for patients who have filled missing teeth or plan to remove the remaining teeth and replace them with implants.The All-on-6 procedure offers long-term and stable treatment as an alternative to traditional prostheses.

What is the procedure for the “All on Six” method?

All on Six implantation procedure; It is based on the placement of four or six dental implants in our edentulous patients. They are installed at a certain angle on the same day, and then the denture is fixed. If the patient is not asked or the doctor does not consider it necessary to remove them, there will be no change in the fixed teeth.This is a method of treatment for our patients who cannot use prostheses due to excessive bone loss. Implants can be used on the same day.

In order to avoid all the problems that may arise during treatment, a bone x-ray is performed before planning the treatment. At the same time, advanced technological systems are used. The treatment process is planned taking into account the thickness and height of the bone.

Who can use the “All On Six” technique?

Our patients who can receive All On Six implants; These are patients who do not have any obstacles to dental implantation surgery.Thus, this method can be applied to patients who do not have a systematic disease and have a sufficient amount of bone tissue. The situations requiring this treatment are as follows:

  • This method can be applied if our patients with fully edentulous jaw in the intermediate region of the molars have sufficient bone tissue and density.
  • This method can be used if after tooth extraction it is possible to thoroughly clean the sockets after tooth extraction.
  • It can be used if the patient’s teeth were extracted with adequate oral hygiene.
  • This technique is applicable if you have a laboratory equipped for a temporary fixed prosthesis.

What are the treatment steps of the All On Six technique?

When treating All On Six, we primarily conduct clinical and radiological examinations of our patients. We draw up suitable planning for our patients by taking measurements with computed tomography.Then, after installing four or six dental implants, we fix the dental prosthesis on the dental implants. Preparation of permanent teeth continues with special tests on average from 10 to 12 days. After about 3 months; we use permanent dentures for our patients.

What are the advantages of All on 6 implants?

  • shows rapid improvement.
  • makes you enjoy your food again and talk easily.
  • Gives a pearly white smile.
  • Removable dentures are not required.

While conventional removable dentures can effectively replace the entire component of lost or lost teeth, implants offer a stable and permanent method of restoring a complete set of teeth. All on 6 restores patients’ sense of ownership of their own teeth and offers an improved quality of life as they can eat and speak with confidence again. With All on 6 dental implants, you don’t need to have messy denture adhesive or remove dentures to clean and sterilize them.Replacement teeth are used in the same way as natural teeth.

How long will All On 6 implants last? The All On Implant Treatment Process 6

The entire procedure can be completed in just one day and usually takes 2-4 hours. Although the All On 6 procedure does not usually require a bone graft, it may be necessary depending on the density of the person’s bone. Everyone’s mouth is different, so it’s important for your dentist to carefully assess your mouth before starting the procedure. During the procedure, dental implants are placed in the jawbone under local anesthesia.The temporary prosthesis can then be attached to the implants while it heals.

Once the implants have healed, they are anchored to the implants with a permanent solution, eg removable over a bridge or prosthesis.

In the first 3 months after the procedure, the mouth heals, and the bone and gums change shape to adapt to the new device.

At this time, patients should carefully eat solid or heavily chewed food. Patients should expect some discomfort and swelling after the procedure.

For most patients, the discomfort goes away after a week. After the procedure, patients will need to have frequent check-ups with the dentist, especially in the first 3 months. To prevent any complications or infection, it is very important to see your dentist immediately if something is wrong. Once the dental implants have stabilized and the discomfort or pain disappears, the number of visits to the dentist is significantly reduced.

How are All On 6 implants used?

All On 6 implants look and work just like your natural teeth.All On 6 Dental Implants can replace all of your teeth with just six implants. The procedure itself is divided into two stages. The first is the installation of implants, and the second is dental prosthetics. Implants are made of titanium, All On 6 can be made of various materials such as dentures, porcelain and ceramics, the price of the procedure depends on your choice of dental solution and material. Implants replace the root of your teeth, which means that they will feel like your natural teeth, all 6 prosthetics procedures prevent bone loss in the future.Before starting cooperation with the clinic, you should check the equipment of the clinic and the professionalism of the staff.

What is sinus lift and bone insertion?

Sinus lift and bone insertion process; The upper jaw has anatomical cavities called the maxillary sinuses. In some of our patients, these gaps may increase due to dental transplantation. When the implant cannot be inserted due to this expansion; The sinus membrane is lifted up and materials are placed that allow bone formation.This is called a sinus lift. Materials used to insert the bone: It can be synthetic, animal or human.

Once the sinus lift procedure has been performed on our patients with very little bone, All On Six cannot be applied in one session. The application starts after a certain period of time. However, if there is sufficient bone tissue to support the implant; In this case, both the sinus lift procedure and the implant placement can be performed in one session.

Will there be pain at the end of using the six implant technique?

Pain is possible after All On Six implantation. However, this pain is very mild. Swelling is also possible. Our doctors prescribe pain relievers after the procedure to use when these pains are felt.

Since this is a procedure performed under local anesthesia, no pain is felt during the procedure. However, if our patients, who are afraid of surgery, seek help, the procedure can be performed under general anesthesia or general anesthesia.Thus, our patients who have anxiety problems or are afraid of surgery can go through this process painlessly.

What should be the nutrition for the All On Six method?

Following the “All On Six” procedure, there are some nutritional aspects to consider. Our doctors prescribe a diet for our patients after implantation “All On Six”. This diet should be followed for the 3-month period necessary for the implant and bone to heal. It is recommended not to eat solid food and to practice good hygiene.With the subsequent manufacture of a permanent prosthesis; You can eat without the need for any additional diet. However, if during this process there was a fracture of the prosthesis; You should visit our doctors and correct the loss of the implant.

Is it difficult to care for All On Six implants?

Caution should be exercised after All On Six implantation. In addition to daily brushing of your teeth; Oral showers, toothbrushes, and dental floss are recommended for cleaning and caring for your oral cavity.It is advisable to visit a stamotologist and undergo an examination every 6 months.

Can You Succeed With the All On Six Technique?

The success of the All On Six technique is quite high. Considering research; When evaluated over a long period of time, it is a very beneficial treatment method. What is the difference between the All On Six technique and a conventional implant system?

Looking at the difference between six implants and a conventional implant; All On Six implants are installed at a slightly higher angle to the jaw than conventional implants.This way they can get more support from the bone. Thus, they can carry the load, with 4 or 6 implants, up to 8 implants. It is also a method of treatment that can be used by maxillofacial surgeons or doctors with high medical skills. These are very durable implants. Other differences are shown below:

  • Traditional implants are more expensive. However, since fewer implants are used in the All on Six technique, this is reflected in their cost.
  • You can return to normal life in 3 months with the All on Six technique, while for traditional implants this period can be from 6 to 10 months.
  • Traditional implantation procedure requires major surgical intervention. However, the number of procedures performed on All on 6 implants is less.
  • No provisional prosthesis is used in conventional implants. However, on All on 6 implants, temporary dentures are installed immediately.
  • Bone graft is used for conventional implant placement. This procedure is not required on All on 6 implants.

What are the benefits of the “All on Six” technique?

All on Six Benefits:

  • Our patients who do not have any teeth can receive fixed dentures in one day in one surgical procedure.
  • No procedures such as sinus lift surgery or bone augmentation are performed during the procedure. Thus, it is a simple procedure that does not require complex surgical procedures.
  • Operation time is significantly less than with conventional dental implantation operations.
  • Compared to conventional dental implantation operations; Since the number of dental implants used is less, the cost is less.
  • Compared to conventional fixed dentures on implants; after the All on Six procedure, it is easier to maintain oral hygiene.
  • This is an application that provides aesthetic appearance, laugh line and smile aesthetics as it can be planned individually.
  • Suitable for patients who cannot use a removable denture due to the nausea reflex.
  • Since the All-on-six technique does not cover the patient’s palate, it is easier and more profitable for patients to get used to it faster.

Olga Karaban – The procedure for fixing braces is always very …

The procedure for fixing braces is always very exciting.

I will try to dispel all fears associated with this.

1. The whole procedure according to the standard takes about an hour.

2. It is absolutely (!) Painless, from the word at all)

3. A silicone limiter for lips and cheeks is installed – Optragate, which prevents saliva from getting on the teeth.

4. The surface of the teeth is treated with a brush and paste to remove plaque.

5. A special two-component material is applied to the tooth enamel to prepare it for fixation.

6. For fixation, the material of the company ZM is used (by the type of glue), which locally releases fluoride for another 3-4 months, thereby strengthening the tooth enamel.

7. The bracket and the material with which it is fixed are illuminated with a polymerization lamp.

8. An initial flexible nickel-titanium shape memory arch is inserted into the grooves of the braces and tied with rubber bands to the braces.

9. As a rule, the system is first installed on one jaw, on the second – after a couple of 4-6 weeks, sometimes after a couple of months.

10. 5-7 hours after fixation, certain biochemical processes begin to occur in the bone and painful sensations appear. The gradation is individual for everyone and depends on the threshold of sensitivity: someone just has itchy teeth, or there is a feeling of “goose bumps”, others are sitting on painkillers.

11. Salivation may increase for a while, the upper lip, when smiling or talking, may cling to the protrusions / hooks on the braces until the body is rebuilt.

Was it interesting? In the next post I will write recommendations on how to protect yourself from breakage / removal of the bracket and minimize discomfort after fixation 😉.

Photo by @ irena.os
Model- @sofiberidze
# fixing braces, # installing braces, # sapphire braces, # invisible braces, # dentist braces, # braces painless, # braces , #model, #probraces, #bracesrevocation, #orthodontists, #sofiberidze.

Dental Tribune Russian Edition

English Edition24 Aesthetic Dentistry Every aesthetic and reconstructive dentistry clinician is familiar with the challenges of predicting the treatment of multiple anterior teeth.Splints (deprogrammers) with an anterior bite pad are a useful treatment aid in all stages of treatment, from precise impressions to protecting temporary and final restorations. Studies show that in the absence of contact between the chewing teeth, the total load on the teeth can be reduced by 70%. This protective feedback mechanism is not only beneficial for the teeth, but it can also relieve unpleasant muscle pain caused by over-tension and spasms resulting from excessive contraction.For this reason, some dentists consider occlusive splints a first-line treatment for pain and dysfunction of the temporomandibular joint (TMJ). In most cases, the need for restoration of the frontal group teeth arises when their cutting edges and / or occlusal surfaces of the chewing teeth are worn out. This condition of the teeth is usually associated with nocturnal bruxism. Over time, this habit can lead to aesthetically unacceptable results associated with loss of anterior guidance, impaired occlusion harmony and general bite destabilization.Like many other diseases of the oral cavity, nocturnal bruxism is a painless condition, which, however, without treatment, can lead to increased tooth wear and TMJ pathology. In addition, according to studies, more than half of patients whose tooth wear is caused by parafunctional habits are unaware of them, which can interfere with effective treatment and even consent to it. Over time, nocturnal bruxism can lead to strengthening and enlargement of the chewing muscles.Enlarged masseter muscles pose additional problems in aesthetic treatment and often make it difficult to obtain an impression in the central relationship position using passive movements. In our clinic, deprogrammers have been successfully used for many years. These devices help to relax the overactive muscles. They allow the joints to be passively brought into the ideal anatomical position by opening the patient’s teeth. Occlusal splints are useful both as a diagnostic tool and as a first-line treatment or ancillary treatment.The TMJ QuickSplint is an immediate-use occlusal splint (deprogrammer) blank that requires a minimum investment of time and money, as well as the dentist’s experience. Although other methods exist, the author finds the TMJ QuickSplint a particularly useful device in the following two areas of aesthetic dentistry. Accurate Impression at Center Ratio A simple technique to accurately register occlusion involves the use of the TMJ QuickSplint at night for the week before the impression is taken.The design of the TMJ QuickSplint blank and the recommended way of adapting it make it easy and quick to produce a splint for the patient right during the visit to the dentist. As a deprogrammer, the TMJ QuickSplint relaxes the patient’s chewing muscles and helps to accurately register the center ratio. The TMJ Quick Splint can be used for both the upper and lower jaw, depending on the location of the maximum contacts, the stability of the occlusion, the preference of the dentist or patient.The procedure is simple. After 7-10 days of wearing the splint, the patient comes to take the impression. With the TMJ QuickSplint splint on the teeth, the patient needs to bite into its frontal plate, move the jaw back and forth several times and, at the moment of the greatest retrusion of the jaw, firmly bite the splint and squeeze the jaws to fix the position. The impression material is then inserted between the chewing teeth and allowed to polymerize. After that, the TMJ QuickSplint is removed from the oral cavity and the patient is asked to bite the newly formed sections of the impression material, which allows to ensure a stable position of the jaws at the moment when the impression material is introduced into the region of the anterior teeth; the result is an impression of the entire dental arch in the position of the central relation.Protecting temporary and permanent restorations Another common and serious problem is the preservation of temporary restorations before the final restorations are placed. The creation of a permanent splash guard for temporary restorations is impractical, and most systems on the market are made with hard acrylic, which can damage or dislocate the restorations. Temporary restorations are made in such a way that the patient can appreciate the future end result and receive some functional benefits.In fact, temporary restorations must be anchored firmly enough to allow restoration of dentition function, but the prepared teeth must remain intact when removed. Since the original cause of the patient’s teeth wear and tear persists, it often leads to breakage of temporary restorations. Failures or unforeseen complications in aesthetic treatments can negatively affect the patient experience, which is extremely important in terms of the clinic’s reputation.The TMJ QuickSplint is best made from Blu-Mousse (Parkell) or other similar fast-curing impression material, which allows the required procedures to be performed quickly, accurately and without damaging the restorations. The patient wears the TMJ QuickSplint overnight to prevent damage to the temporary restorations, which also reduce the overall load. After seating the final restorations, the TMJ QuickSplint is corrected. It can then be used before the manufacture of a personal protective mouthguard.In our clinic, patients are advised to keep the TMJ QuickSplint in case of symptomatic muscle tension or loss or damage of a protective splint. TMJ QuickSplint ™ is a registered trademark of Migratherapy LLC. Editorial Note originally published in Cosmetic Dentistry # 1, 2013. Improving Aesthetic Outcomes with the TMJ QuickSplint John F. Weston, USA Dr. John Weston is an accredited member of the American Academy of Aesthetic Dentistry.He lectures in the United States and abroad, publishes articles, conducts clinical research, and evaluates new and emerging technologies and products for major dental companies. Dr. Weston is the director and owner of the Scripps Center for Dental Care, a multidisciplinary dental clinic at Scripps Memorial Hospital in La Jolla, California.