Manual of Temporomandibular Disorders / Edition 2

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Manual of Temporomandibular Disorders, Second Edition is a four-color, softcover handbook of information on temporomandibular disorders, an array of medical and dental conditions that affect the temporomandibular joint (TMJ), masticatory muscles, and contiguous structures. The book provides evidence-based, clinically practical information that allows dentists to diagnose TMD accurately, rule out disorders that mimic TMD (that is, make a differential diagnosis), and provide effective therapy for most patients. This book offers comprehensive coverage in a compact package. The book's tone is conversational, with a focus on solving TMD problems at chairside. The author's crisp, engaging writing style allows the clinician to find precise answers quickly, without wading through a morass of detail.

Features include:

  • Includes Frequently Asked Questions
  • Features Quick Consults, Technical Tips and Focal Points
  • Covers disorders that mimic TMD and identifies factors which warrant referral
  • Extensive color photographs and line drawings
  • A CD accompanying the book contains
    • Recommended patient questionnaire and educational handouts (editable with Microsoft Word)
    • A 635-slide TMD course presentation (editable with PowerPoint) and accompanying student manual (editable with Microsoft Word)
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Editorial Reviews

From the Publisher
"This updated text is essential for any GDP or hospital practitioner. . . it contains insightful coverage, with both text and figures easily absorbed and at incredible value for money". (British Dental Journal, 25 September 2010)

"The strength of this book is in the clinical detail presented in its discussion of differential diagnosis, occlusal appliance therapy and the multidisciplinary treatment approach. The personal way in which this book was written gives the interested clinician a bird's eye view of the thinking of an experienced orofacial pain practitioner in making diagnoses and constructing reasonable treatment plans. The review of the many different types of appliances including configurations, materials, techniques and lab instructions is as comprehensive a clinical discussion as I have seen in one place. Part 4, the discussion of multidisciplinary treatment also provides lots of practical information for the clinician and really frames the discussion in an easy to understand clinical way without getting lost in the description of clinical trials and research. Dr. Wright's use of case reports in section 5 helps cement the points he makes in earlier chapters. His inclusion of appendices with diagrams, forms, and instructions and the editable files on the CD gives the clinician a windfall of material from which to draw from to create printed documents and PowerPoint presentations for patient education and for potential referring doctors. To my knowledge, it is unprecedented for an author to provide his personal lecture slides (in an editable format no less) with the purchase of the book."
(AAOP E-News, Summer 2010)

"Dr. Wright's Manual of Temporomandiblar Disorders will be a valuable addition to the library of those who treat TMD patients and institutional libraries as well." (Oral Surg Oral Med Oral Pathol Oral Radiol Endod, August 2010)

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Product Details

  • ISBN-13: 9780813813240
  • Publisher: Wiley, John & Sons, Incorporated
  • Publication date: 11/10/2009
  • Edition description: Older Edition
  • Edition number: 2
  • Pages: 432
  • Product dimensions: 7.40 (w) x 9.60 (h) x 1.00 (d)

Meet the Author

Edward F. Wright, DDS, MS, MAGD, is an associate professor at the University of Texas Health Science Center-San Antonio (UTHSCSA). He completed a one-year general dentistry residency and the University of Minnesota's two-year TMJ and Craniofacial Pain Fellowship. He taught TMD diagnosis and treatment to more than 100 U.S. Air Force residents in general dentistry, orthodontics, periodontics, and prosthodontics. Upon retiring from the Armed Forces, he completed a two-year research fellowship in TMD diagnosis and treatment at the South Texas Veterans Health Care System and taught TMD diagnosis and treatment to their general dentistry residents. He is now UTHSCSA's Course Director for their predoctoral dental students' TMD Course and Dental Anatomy and Occlusion Course, and Module Director for their stabilization appliance rotation. Dr. Wright is the primary author of over 25 journal articles.

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Table of Contents



Part I. Initial Evaluation

Chapter 1. Patient Interview

Chapter 2. Review of the “Initial Patient Questionnaire”

Chapter 3. Clinical Examination

Range of Motion

TMJ Noise

TMD Palpations

Intraoral Examination

Occlusal Changes

TMD Pain Caused by a Tooth

Tooth Pain without Local Pathology

Additional Evaluations

Chapter 4. Imaging

Plain Radiographs

Panoramic Radiograph

Axially Corrected Sagittal Tomography

Computed Tomography

Cone Beam Computed Tomography

Magnetic Resonance Imaging


High-Resolution Ultrasound

Imaging Strategies

Imaging Recommendations

Chapter 5. TMD Diagnostic Categories

TMJ Articular Disorders

Disc Displacement Disorders

Dislocation (Also Known as Subluxation)

Inflammatory Disorders




Congenital or Developmental Disorders

Masticatory Muscle Disorders

Myofascial Pain



Myofibrotic Contracture

Centrally Mediated Myalgia

Local Myalgia


Chapter 6. Contributing Factors

Part II. Common Acute TMD Conditions and Treatments

Chapter 7. TMD Secondary to Trauma

Chapter 8. TMD Secondary to Dental Treatment

Preventing Aggravation from Dental Treatment

Medial Pterygoid Muscle Pain

Inability to Close into Maximum Intercuspation

Occlusal Interference Sequelae

Obstructive Sleep Apnea Appliances

Chapter 9. Lateral Pterygoid Myospasm

Chapter 10. Acute TMJ Disc Displacement without Reduction

Chapter 11. TMJ Dislocation

Part III. Occlusal Appliance Therapy

Chapter 12. Stabilization Appliance

Mandibular Positions and Interocclusal Record

Physical Variables

Full or Partial Coverage

Maxillary or Mandibular

Hard, Intermediate, or Soft Material

Thick or Thin

Appliance or Wire Retention

Summary of Physical Variables

Appliance Adjustments

Internal Adjustments

Internal Reline

External Adjustments

External Reline

Appliance Repair

Appliance Examples

Pressure-Cured Mandibular Acrylic Stabilization Appliance

Maxillary Acrylic Stabilization Appliance

Hard Thermoplastic Stabilization Appliance

Impak Stabilization Appliance

Dual Laminate Thermoplastic Stabilization Appliance

Soft Thermoplastic Stabilization Appliance

Appliance Management

Chapter 13. Anterior Positioning Appliance

Mandibular Position and Interocclusal Record

Design and Adjustments

Appliance Management

Part IV. Multidisciplinary Treatment Approach

Chapter 14. Self-Management Therapy

Self-Management Instructions

Closure Muscle-Stretching Exercise

Lateral Pterygoid Muscle-Stretching Exercise

Posture Exercises

Breaking Daytime Habits

Chapter 15. Physical Medicine

Muscle Massage


Trigger-Point Compression

Trigger-Point Injection

Physical Therapy



Magnetic Therapy

Chapter 16. Cognitive-Behavioral Intervention

Breaking Daytime Habits




Stress Management

Chapter 17. Pharmacological Management


Anti-inflammatory Medications

Nonsteroidal Anti-inflammatory Drugs (Ingested Form)

Steroidal Anti-inflammatory Drugs

Muscle Relaxants

Tricyclic Antidepressants

Topical Medications

Nutritional Supplements

Chapter 18. Other Dental Procedures

Occlusal Equilibration

Orthodontic-Orthognathic Therapy

Prosthodontic Therapy

TMJ Surgery and TMJ Implants

Chapter 19. Integrating Multidisciplinary Therapies

Treatment Summaries and Clinical Implications

Occlusal Appliances

Self-Management Therapy

Lateral Pterygoid Muscle-Stretching Exercise

Closure Muscle-Stretching Exercise

Posture Exercises

Massage and Trigger-Point Compression


Trigger-Point Injections

Physical Therapy



Magnetic Therapy

Breaking Daytime Parafunctional, Muscle-Tightening, or Fatiguing Habits



Biofeedback with Relaxation

Stress Management

Pharmacological Management

Occlusal Therapy

TMJ Surgery

Integrating Conservative Therapies

TMD Refractory to Initial Therapy

Long-Term Management

Part V. Case Scenarios

Case 1: Pulpal Pathosis Mimicking TMD Symptoms

Case 2: Chronic Sinusitis

Case 3: Chronic Forehead Pain Referred from the Neck

Case 4: Myofascial Pain Secondary to Nocturnal Parafunctional Habits

Case 5: Tooth Attrition—No Pain

Case 6: Myofascial Pain Secondary to Daytime Parafunctional Habits

Case 7: Medial Pterygoid Myospasm

Case 8: Tense, Depressed, and Poor Sleep as Contributing Factors

Case 9: Fibromyalgia as a Contributing Factor

Case 10: TMJ Disc Displacements and When to Treat It—No Pain

Case 11: TMJ Inflammation

Case 12: Intermittent Acute TMJ Disc Displacement without Reduction

Case 13: Acute TMJ Disc Displacement without Reduction—Unlocked

Case 14: Acute TMJ Disc Displacement without Reduction—Not Unlocked

Case 15: Osteitis Causing Inability to Open Wide

Case 16: Lateral Pterygoid Myospasm

Case 17: Acute Exacerbation of TMD

Case 18: Multiple Forms of Head and Neck Pain after Crown Insertion

Case 19: Appliance that Positioned Condyles into Their “Proper Position,”

Part VI. Fundamentals of Clinical Studies

Designs of and Advice for Performing Clinical Studies

Literature Review

Study Population

Institutional Review Board (IRB) Approval

Developing Study’s Parameters

Strengthening Study

Writing and Submitting Manuscript

Practice-Based Research

Prominent Clinical Study Designs

Case Report

Case Series Study

Cross-Sectional Study

Case-Control Study

Cohort Study

Nonrandomized Clinical Trial

Randomized Controlled Trial

Parallel-Group Randomized Clinical Trials

Cross-Over Randomized Clinical Trials

Other Types of Publications You May Want to Consider

Literature Reviews


Systematic Reviews

Considerations in Assessing Clinical Trials



1. Referral Criteria for Hygienists

2. Initial Patient Questionnaire

3. TMJ Disc Displacements

4. TMD Self-Management Therapies

5. Occlusal Appliance Care Instructions

6. Closure Muscle-Stretching Exercise

7. Posture Improvement Exercises

8. Laboratory Occlusal Appliance Instructions

9. Example of Dental Record Entries

10. Examples of Physical Therapy Consultations

11. Examples of Psychology Consultations

12. Working with Insurance Companies

13. Sources for Additional TMD Information



Files on Accompanying CD


Referral Criteria for Hygienists.doc

Initial Patient Questionnaire.doc

TMJ Disc Displacements.doc

TMD Self-Management Therapies.doc

Occlusal Appliance Care Instructions.doc

Closure Muscle-Stretching Exercise.doc

Posture Improvement Exercises.doc

Laboratory Occlusal Appliance Instructions.doc

Example of Dental Record Entries.doc

Examples of Physical Therapy Consultations.doc

Examples of Psychology Consultations.doc

Working with Insurance Companies.doc

Sources for Additional TMD Information.doc

Appendices in Spanish

Appendix 2 in Spanish.doc (Initial Patient Questionnaire)

Appendix 4 in Spanish.doc (TMD Self-Management Therapies)

Appendix 5 in Spanish.doc (Occlusal Appliance Care Instructions)

Appendix 6 in Spanish.doc (Closure Muscle-Stretching Exercise)

TMD Course Material

Part I.ppt

Part II.ppt

Part III.ppt

Part IV.ppt

Part V.ppt

TMD Course Manual.doc

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