As many of you know, I love learning about the TMJ and associated structures. But let’s be honest… it’s really hard. I’ve digested several books on TMJ, TMD, occlusal equilibration, and occlusal-muscle disorders and sometimes I still struggle to grasp all of the concepts. I collected my notes in my e-book, “The TMJ and Occlusal Adjustment” so I could polish up on practical TMJ knowledge when necessary.
But practical knowledge that can be used on a daily basis in our offices needs a solid foundation. I think the biggest obstacle to building that foundation is just being able to visualize how all of the associated TMJ structures fit together and function.
I recently had a chance to play around with a great 3D simulation called Anomalous Medical. This is the missing piece to building our foundation of TMJ knowledge.
Anomalous Medical allows us to control a detailed 3D model of head and neck anatomy. We can peel away layers of the “person” to isolate structures of interest. The rotate and zoom functions allow us to visualize those tough concepts, like origin and insertion of muscles, locations, and the like. There are apps available for download that can guide us through subjects like the muscles of mastication.
One of the most frustrating elements to visualize when we study the TMJ are those darn medial and lateral pterygoid muscles. Oh look, here’s the lateral pterygoid!
Hey there, lateral pterygoid. How are you today?
And I can rotate and zoom around to see our friend originate and insert from underneath and inside the mouth, like this:
Whooooah! This is blowing my mind.
We can run the app through normal chewing simulations to see how the muscles function. Then we can focus on the teeth and occlusion to see how they operate while the muscles do their thing. Cool stuff.
We can also manipulate the mandible into any position we wish while tracking the behavior of a structure of interest. Let’s take a right lateral excurison for example. What is the interocclusal relationship during this movement? What do the right and left condyle-disk assemblies look like? Which muscles are tensing and which are relaxing? We can test all of this and more.
Additional apps and features include MRI, CT and doppler samples of the TMJ. We can discover what all those pops, clicks, and crackles actually sound like and what they mean.
But this isn’t just an educational tool for us; it’s great for patients as well. We can customize and save specific anatomic details in a file for a particular patient. Everything from missing teeth to the height of the condyles can be tweaked so that we have an accurate 3D model of our patient. Imagine a consultation visit with this tool? Sweet.