Universitat Internacional de Catalunya - Barcelona

Masticatory System Dysfunction

• code 09244
• course 3
• term Semester 1
• type OB
• credits 3

Main language of instruction: Spanish

Other languages of instruction: Catalan, English

Head instructor

Dr. Jordi TOMÀS - jtomas@uic.es

Office hours

Prof. Responsable: Dra. Natalia Felipe   

Horarios de atención: Miércoles de  9  a 14  horas (Se recomienda pedir cita previa vía e-mail: nfelipe@uic.es )

Language of the course: Spanish / English

Coordinator: Dra. Felipe

Faculty: 

  Dr. Jordi Tomàs, Dra. Natalia Felipe, Gdo. Jaime Guinovart

Presentation

The dysfunction of the masticatory system and orofacial pain are very prevalent in the general population as these syndromes encompass a large number of pathologies (it can be said that practically 100% of the population will suffer from orofacial pain at some point during their life). This diversity of pathologies makes the differential diagnosis of orofacial pain extremely difficult, causing frequent frustration both in patients and in professionals dedicated to the treatment of these diseases. The dysfunction of the masticatory system is a broad subject, in which students have to progressively acquire a set of theoretical concepts, sufficient practical skill and experience to be able to diagnose and effectively treat clinical pictures of craniomandibular dysfunction and orofacial pain. Currently, the concept of dysfunction of the masticatory is integrated within the general context of the patient as a functional unit, which requires an integral treatment approach.

Requirements

Knowledge about anatomy of the stomatognathic system and neurophysiology of craniofacial pain.

Goals

-To teach dental students in order to achieve the basic, theoretical and practical knowledge in relation to the diagnosis of craneomandibular dysfunction and orofacial pain.

-To teach dental students the current knowledge about the different types of therapies for the treatment of craniomandibular dysfunction and orofacial pain.

-To promote among students the search of information regarding this subject.

Students after completing this course will be able to conduct the clinical study and diagnosis of patients with orofacial pain and disorders related to dysfunction of the orofacial area, both muscle and joint level. Know to differentiate the signs / symptoms of TMJ dysfunctional behavior and what treatment will be most beneficial for the patient.

• 33 - Knowing the morphology and function of the stomatognathic apparatus, including material on embriology, anatomy, histology and specific physiology
• 65 - Diagnosing, planning and undertaking, at a general level, multidisciplinary, sequential and integrated treatment of limited complexity for patients of all ages and conditions and patients with special needs (diabetes, hypertension, oncological diseases, transplants, immune-depression, anti-clotting, etc.) or disabilities. Specifically the dentist should be competent in establishing a diagnosis, a prognosis and developing a suitable treatment plan, particularly in terms of orofacial pain, temporo-mandibular disorders, bruxism and other parafunctions; dental and periapical pathology; oral and dental trauma; periodontal and peri-implanted tissue pathologies; pathology of the mandibular bone, of soft oral tissue and annex glands; states of partial or total edentation and planning rehabilitation treatment via dento-muco supported prostheses, or dental impants, dental malpositions or malocculusions and other anatomical or functional alterations of the face or the stomatognathic system and their potential orthodontic, orthopaedic or surgical corrections
• 67 - Creating diagnostic models, setting them up and taking inter-occlusal registrations
• 70 - Evaluating motor and sensory oral, mandibular and annex function
• 88 - To undertake non-surgical treatment for temporo-mandibular disorders and oro-facial pain
• 90 - To identify and correct oral habits that are susceptible to causing or exacerbating malocclusions

-Conceptualize the patient clearly dysfunctional. Being able to diagnose the patient with temporomandibular joint dysfunction.

-Know make a good medical history (anamnesis and exploration of masticatory system).

-Learn to make quick assessment screenings dysfunctional pathology of the masticatory system, after the student will implement the CUO and in their daily work as a dentist.

-Understand that in the dysfunction of the masticatory system are involved multifactorial etiologies and different specialists must be involved (knowing limitations and performance of each (dentist/doctor/therapist/psychologist/orthopedic/...Knowing that patients have to deal with the dentist and what should refer to other specialities.

-Differentiate the signs/symptoms associated with dysfunctional pathology and differential diagnosis with other pathologies that are sometimes confused or overlap.

-Knowing clinically explore the cranial nerves and his involevement with orofacial pain.

-Knowing explore and diagnose mucosal lesions involved in the pathology dysfunctional .

-Knowing explore and clinically palpable TMJ.

-Knowing clinically explore and feel the muscles of mastication.

-Assess whether there are problems associated with postural and his involvement with dysfunctional pathology of the TMJ.

-Differentiate between occlusal pathologies.

-Recognize what an abfraction clinically is, and erosion or atrition, and their consequences.

-Be able to evaluate different diagnostic screening tests to asses temporomandibular joint disorders. Diangosis by magnetic resonance imaging. Learn its interpretation. Know its indications and contraindications. 

-Knowing the different types of occlusal splints What splint is required for each pathology . Indications and contraindications.

-Knowing make an occlusalt splint. Learn the basics of preparation and use of repositoning/stabilizations splints.

-Differentatie the occlusal trauma from other pathologies. Ability to diagnose occlusal trauma primary/secundary.

-Learn how to take in the patient records. How to mount the models in the articulator. Finding centric relation.

-Know how to adjust a splint.

-Assess which cases need surgical tretaments. Indications of arthorscopy/arthrocentesis

-Introduce students to the field of research.

Lectures.

Seminars of preclinical practices (craniomandibular examination, ...).

Seminars of analysis of tests by the image.

Clinical Case Seminars.

Theoretical and practical exam.

Contents

 The final evaluation will be as follows:

Theoretical test:

The test will contain all the theoretical concepts taught throughout the whole semester. It will consist of 50 multiple-choice test questions. Every correct answer will be a point. The incorrect answers will subtract 0.25 points from the final score. To pass the test a minimum score of 30 points must be obtained. The theoretical test will represent 60% of the total grade of the subject.

Practice test:

The practice test will include the daily evaluation of the students (including punctuality), and a practical test. Attendance to the practice sessions is compulsory. The unjustified absence to any of the practical sessions will not pass the course. The practical test will represent 40% of the total grade of the subject.

It will be necessary to obtain a total score (theoretical test + practical test) of 6.5 / 10 to pass the subject. It will also be necessary to pass both exams individually (practical and theoretical) to approve the subject.

Exceptionally it will be valued with the professors of the subject and academic secretary the possibility of doing an oral examination of the subject if the individual situation requires it in particular.

Okeson JP. Tratamiento de oclusión y afecciones temporomandibulares. 7ª Ed. Elsevier, 2013.

Headache classification committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia. 2013; 33:629-808.

De Leeuw R, Klasser GD. ed. Orofacial Pain Guidelines for Assessment, Diagnosis and Management of the American Academy of Orofacial Pain. 5th Ed. Quintessence, 2013.

E: exam date | R: revision date | 1: first session | 2: second session:

• E1 09/01/2019 08:00h A02
• E1 09/01/2019 08:00h A01
• R1 30/01/2019 08:00h A05
• E2 26/06/2019 08:00h A01
• R2 03/07/2019 09:00h A01