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  4. > Temporomandibular Disorders (TMD) and Use of Oral Appliance for Obstructive Sleep Apnea Syndrome in the United States

An Extremely Misdiagnosed or Underdiagnosed Condition

Temporomandibular Disorder (TMD) is a complex condition that affects the temporomandibular joint (TMJ), the joint connecting the lower jaw to the skull. About 50% of the patient population receiving treatment for TMD complains of pain after 5 years of treatment, and about 20% of the population experiences long-term disability. Estimated annual healthcare cost associated with diagnosis, treatment (consultation), and device is about $4.00 billion. Slow but steady increase in awareness among patients—to get diagnosis and seek treatment—is driving the oral appliance market for treatment of TMD.

Definitions
Temporomandibular Disorders (TMD) is a complex condition that effects joint connecting lower jaw to the skull called temporomandibular joint (TMJ).
Electrosonography (ESG): Digital electrosonography is conducted by a pair of ultra-sensitive transducers placed over temporomandibular joints in the form of headsets. Vibrations from each TMD joint during the jaw movement are recorded and evaluated by the computer using spectral analysis. ESG is an important tool when used in combination with other diagnostic tools to diagnose and confirm TMD pathology.
Computerized Mandibular Scanning (CMS): It measures the rotational movement of the jaw in three dimensions of space and time to within 0.1 mm of accuracy, thus, leading to a thorough assessment of jaw function.
Electromyography (EMG): This measures the activity and dysfunction of the head, face, and neck muscles. EMG consists of a series of tests that more specifically identify and define the hypertonic musculature of the temporomandibular joint.
Hyperactivity of the face and jaw muscles are then recorded to determine whether or not the jaw is in a strained position.
Cephalometric analysis is the analysis of dental and skeletal relationships in the head. It is done by using a Cephalometer and it constitutes radiography.
Transcutaneous Electrical Nerve Stimulation (TENS): It is a physical, therapeutic equipment used to relax acute as well as chronic muscle contraction. The device when placed over the TMD joint stimulates the facial muscles, resulting in full muscle relaxation and increased blood and oxygen flow to the surrounding areas. Once the jaw is completely relaxed, jaw position can be determined accurately.
Oral Appliance (OA) therapy for Sleep Apnea involves selection, fitting and usage of specially designed oral appliance that maintains open and unobstructed airway while sleeping.
OA for TMD involves selection, fitting and usage of a specially designed oral appliance that maintains necessary gap between upper and lower mandibles so that the TMJ heals.

Table Of Contents

Temporomandibular Disorders (TMD) and Use of Oral Appliance for Obstructive Sleep Apnea Syndrome in the United States
Executive Summary
TMD—A Snapshot

Clinical Understanding of Temporomandibular Disorders (TMD)
TMD—Causes
TMD—Symptoms
TMD—Patient Flow
A Patient's 5-year Journey With TMD
TMD—Diagnosis
TMD—Treatment
TMD—Treatment (continued)
TMD—Treatment (continued)
TMD—Prognosis of Disease
Oral Appliance Devices Used (or marketed) for TMD

Oral Appliances Market in TMD—Drivers and Restraints
Market Drivers and Restraints
Market Drivers
Market Restraints

TMD and Sleep Apnea
Correlation Between TMD and Sleep Apnea
Case Study—Oral Appliance Treatment for Patients with TMD and Sleep Apnea
Oral Appliance Treatment Devices Used (or marketed) for TMD and Sleep Apnea
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