Articulating Paper is Lying To Us - Measuring the Occlusion Digitally with Force and Time - PDP109

[@CarlosSanchez-dp9xb]

I highly recommend the T-Scan!!! A must if you care about occlusion!!!

[@NinoMaluri]

Thanks for making this video. I had a crown put in about a week ago, and it caused me crazy headaches and earaches. I have about 10 crowns in my mouth already, and it never did this. From my reading, this can happen if the crown is too high and is touching the opposing tooth too strongly or not correctly. Then I researched and found out about T-Scan, and that articulating paper simply can't tell you what a T-Scan can. Then I looked around, and no dentist in my city has a t-scan (or at least not listed on their websites and on google), but I found a dentist in the capital city of my country that has it. The capital city is years ahead of my city in every way. So but I still wanted to learn more about this. And this video is really spot on. So thank you :)

[@Shadow1986]

Far out. You're an intelligent philosophic patient

[@NinoMaluri]

@@Shadow1986 Not really. The problem with that crown I mentioned has now turned to a full blown disc displacement in my right TMJ, and I'm probably gonna have arthroscopic surgery to reposition the disc. I did an MRI, the radiologist missed the displacement. The TMJ specialist said it's anterior displacement when my mouth is closed based on his misreading of the MRI. What I have is a lateral displacement, which is slowly turning into a postero-lateral displacement. I diagnosed this myself based on a KZbin video of a doctor who showed various TMJ issues on a CBCT and an MRI. He showed a lateral disc displacement, and I looked at my MRI photo, and it was right there. It was hard to see, because it was small then, but it's there. The radiologist should have seen it, the MRI specialist should have seen it, but they didn't, and I lost the period where my disc could maybe have been recaptured with a splint or something. Additionally, some 15 doctors I've seen about this, where not a single one was interested in HOW my jaw clicks, any of them could have had a good idea of what my displacement is simply by my symptoms, but they didn't care, and they don't know anything! I've worn 2 splints in the meantime. Both caused an increase in pain and worsening of symptoms, permanently. In the end, I have horrible tension and significant pain in both my TMJs 24 hours per day every day, but mostly on the right one. I have horrible clicking in my right TMJ, and my left one is very fragile now too. I have tinnitus. I have swollen lymph nodes around my right ear and on my neck on the right, as well as my right tonsil is swollen. And my neck clicks a little bit and has some crepitus. If I was an intelligent and philosophic patient, I wouldn't be in this mess. But the doctors are useless, and I for me research the TMJ topic from head to toe took too long. And now it's too late for any conservative solutions, because I just don't see how they would be effective permanently. What is the point of even trying to recapture a disc with an uncomfortable splint, because what's gonna keep the disc in place once it recaptures? If the disc is displaced because of stretched and/or torn ligaments, the disc will not stay in place even if you recapture it. Unless maybe if you wear a splint every day for the rest of your life, but I'd rather die than live like that. I believe the crown and bite changes i mentioned in my opening comment forced my right condyle to go higher in the socket every time i closed my teeth together or bit something with my front teeth, and at an angle (towards the ear). About 3 months of constantly hitting my articular disc on the side, eventually the articular disc moved laterally. There is a collateral lateral ligament which holds the articular disc from moving laterally. I believe my collateral lateral ligament got stretched or cut in half/detached from my articular disc. So my disc moved laterally, but not all the way at first. But over the months as I was wasting time with doctors, my disc moved more and more laterally. At this point my condyle is either hitting bone on bone or hitting the collateral lateral ligament, causing pain. But unfortunately I think I have bone on bone, due to the nature of my pain. I'm getting another MRI in 3 weeks, so we'll see what we get. But at this point I think the only solution is an arthroscopy to reposition the disc, and to reattach the ligament if it's cut, or to shorten the ligament if it's stretched. This would save my left TMJ from collapsing too in due time (unless it's already too late), and it will give me a normal right TMJ and give me my life back again. Of course, anything could go wrong. The surgery could fail. I could get an infection and die, or lose half my face. They could cut nerves or whatever during the procedure and I could lose feeling in half of my face, lose the ability to move my face as I do, lose the ability to blink on one eye, or any number of a hundred things. Lastly, even the arthroscopy could fail, because they can only reposition the disc if the disc hasn't been severely deformed. If the disc is severely deformed, then they have to remove it, and I guess put a silicone disc instead. This will almost surely fail, but it's the last and only thing that can be attempted. And if this fails, immediately or in due time, next step is total joint replacement surgery. So, I was an intelligent philosophic patient, I wouldn't be in this mess. My life is over.

[@Emily-xl2cr]

@@Shadow1986 Why do dentists like you doubt patients this way?? Where in other professions does this happen?? Why are patients not allowed to advocate for themselves without being labelled as crazy? What's up with dentists honestly.

[@Emily-xl2cr]

@@NinoMaluri I'm so sorry for what you've been put through :( Are things any better?

[@NinoMaluri]

@@Emily-xl2cr Not really. My pain is reduced, so I guess that's a bit of an improvement. Other than that, I've sort of given up. I just stay home and suffer every day. Not sure where this goes, but probably nowhere good. I've been to many doctors, but nobody wants to listen, nobody looks at imaging, nobody takes anything seriously. And they give stupid advice, like reduce stress, go on a vacation, find a girlfriend, get married. They must be kidding me, I don't know. And they're all specialists, which means nobody can help with anything. I need one doctor for the ear and eustachian tube, one doctor for the teeth, one doctor for the jaw, one doctor for the neck, one doctor for the heart. You just run in circles chasing your own tail. Most doctors just can't wait to send you to a different specialist, or to be done with you as fast as possible. I can't explain to them what happened, my symptoms. If I could, they could connect the dots perhaps. But it's impossible. And nobody really knows anything about TMJ, not really. I thought I would get some certainty regarding the situation in my jaw joints with CBCT and MRI, but I didn't. But even if I did, there isn't really anything they can do for damage in the joint. Splints, pharmaceuticals, arthrocentesis, none of it will reconnect a torn ligament, or tighten a stretched ligament, or regenerate a perforated disc. A splint does make sense in some respect, in that it decompresses your joints and maybe they can heal. But every splint I've put in my mouth skyrocketed my pain levels, and in increased my dysfunction, fast! Then when I stop wearing a splint, the pain levels go back to pre-splint after a few weeks or months. But the dysfunction (clicking, skipping) remains increased forever it seems. I had a repositioning splint, a flat splint, an anterior deprogrammator, and even a few little splints i made myself using polymorph. My body hates splints. They destroy me. So yeah, I guess the only hope that remains is the future. Artificial intelligence, stem cells, improved imaging, new discoveries. There are surgeries like arthroscopy and arthroplasty. But they're expensive, they have bad long-term success rates, and they come with some real risks to your head, and life. But at some point I'll get tired of existing and suffering every day, and I'll probably look for an arthroscopic TMJ surgeon to go in there and STOP THE FUCKING CLICKING!!! I can't even close my mouth straight anymore without my right TMJ clicking or running into a block. I don't know if it's my disc, or maybe adhesions, I don't know. And lastly, we have regenerative medicine, like prolotherapy and PRP and stem cells. If my condition remains how it is or deteriorates further, and I decide life isn't worth living like this anymore, I'll probably go do RPP first, then Prolotherapy, then stem cells (if i can find anyone to do that, and if i can afford it). And lastly, surgery, and may god help me...

[@bryambriceno.]

Great Jaz!!! You defenitely interviewed a legend in occlusion!! More than 35 years of solid research in computirized occlusal analysis !!!

[@DrEMoulton]

Wow, excellent on both parts!! Jaz very engaging, Dr. K very remarkable what you have done. Thank you both for your contributions!

[@protrusive]

very kind thank you!

[@dnadnadna743]

Easier to fix a new filling, there was no pain before- so its the high point of the filling.. if the high point it at one extreme end there is more force to cause pain...

[@ZACY1234]

I heard a lecture from Dr. Melkers and he also mentioned putting some vaseline on the articulating paper. He said it’s because, the Vaseline is hydrophobic and so “pushes away” the hydrophilic saliva and so it can mark better. But now that I am thinking about it, how an arti paper leaves marks on a tooth without having to use Vaseline and on glazed ceramic not?? 🤔🤔

[@protrusive]

Hi Dem! I was always taught (and read) that the petroleum jelly just helps to release the dye from the articulating paper. Ink just rubs off the articulating paper at areas of contact - works better when dry for sure!

[@bryambriceno.]

Jaz! Do you have the name of tmd sistematic research done with T scan researches dr Robert Mentioned?

[@protrusive]

Hi Byram - sorry for the delay! If it helps, Dr Kerstein sent me a ton of papers and they are available here: www.protrusive.co.uk/evidence

[@bryambriceno.]

@@protrusive thanks for the response Jaz! I checked them out, amazin by the way. Even bought his research handbook afterwards on Amazon to find more data and I am waiting for ir to arrive at my country Costa Rica. Nevertheless, I have not been able to find the name or author of the the sistematic research about TMD that included tons of T Scan researches. The one he mentioned in the podcast . Thanks!!!