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Dr Stephen J Davies
BDS , M.D.Sc., D.G.D.P.(UK)
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Case studies

The temporomandibular joint

Case studies

Wrong diagnosis, wrong treatment

This patient was suffering from bilateral facial pain and over an 18 month period saw a GMP, an ENT consultant, a neurologist, a clinical psychologist, a psychiatrist, a restorative dentist and his GDP. During this time the attempted treatment included the removal of 3 third molars, 2 apicectomies and 4 root treatments. His symptoms remained unchanged. As a last resort he was sent to the temporomandibular disorder clinic, where he was diagnosed with pain dysfunction syndrome which was successfully corrected with a stabilisation splint. At no point before arriving at the clinic had his articulatory system been examined fully.

Right diagnosis, wrong treatment

In this case the diagnosis was correct but a variety of major treatment including a supra-occluding inlay, a supra-occluding bonded crown and root fillings were ineffective. And irreversible! When there is no guarantee of success, reversible or non-invasive methods should be attempted first. In this case splint therapy should have been tried to determine whether the alteration of the patient's occlusion may have proved successful.



Treatment carried out over the course of 18 months


Right diagnosis, wrong treatment