Lingual nerve damage during third molar removal.
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Biomedical subjects
Publications and source records attributed to H Ogus.
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Mandibular joint disorders have always aroused a great deal of controversy as to their nature, aetiology and treatment. Over the last decade, with the advent of sophisticated techniques for functional investigation, a measure of agreement has been reached among researchers and clinicians dealing with the problem. However there seems to have been an unfortunate spin-off in that there may be a tendency to overinvestigate, overcomplicate and overtreat the situation. Perhaps it is possible to regard the common disorders (pain-dysfunction, derangement, osteoarthrosis) as a single pathological entity, a traumatic condition, with associated degenerative factors. Arguments and evidence supporting this view are presented. It is suggested that there may be a common factor that explains the many and varied management regimes, and that is internal rearrangement of the mandibular joint.
The majority of cases of temporomandibular joint pain that are referred to the consultant dental surgeon are diagnosed as pain-dysfunction syndrome, a term first suggested by Schwartz (1959) and now probably the most widely accepted. Another relatively common problem is degenerative disease or osteoarthrosis, and although this generally affects an older age group than pain-dysfunction syndrome, its occurance in the younger patient is by no means a rarity and is further evidence that the two conditions are expressions of the same problem, that is repetitive overloading of the joint. It is proposed that this should be termed mandibular stress syndrome.
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An investigation into the involvement of the temporomandibular joint in rheumatoid arthritis is described. There is evidence to show that is is affected in two-thirds of all cases of the disease, and this figure agrees broadly with other recent studies. The clinical and radiographic presentation is discussed and its relationship to degenerative disease (osteoarthosis) of the temporomandibular joint is shown. The clinical course of this manifestation of rheumatoid arthritis is proposed and a line of treatment is suggested.
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