Physical Exercises for Temporomandibular Disorders

"Coordination training for lateral movement of the mandible (spatula exercise):~1. A wooden spatula is loosely placed between the teeth of the upper and lower jaw; the head must be aligned with the body axis; the exercise should be performed in front of a mirror.~2. The lower jaw moves to the left and back to the center with little contact to the spatula~3. The lower jaw moves to the right and back to the center under contact with the spatula~Training of the left lateral pterygoid muscle:~1. The left palm is placed on the left temple region~2. Right hand forms a fist and is placed on the tip of the right chin~3. Both arms are aligned parallel to the surface of the floor~4. The lower jaw is moved to the right against a moderate resistance of the fist = concentric muscle work~5. With measured force of the fist, the lower jaw is brought back to the center = eccentric muscle work (Right lateral pterygoid muscle training with opposite hands.)"

"Upper and lower jaw impressions are registered by using an intraoral scanner. The arbitrary hinge axis position is determined using a face bow.~The stabilization appliance with anterior canine guidance is manufactured in the Lexmann laboratory in Dresden.~The stabilization appliance is incorporated by the dentist and the static and dynamic occlusion is checked. A tension-free fit of the appliance on the lower jaw is necessary. Additionally, equal contacts in the side teeth area and incisors guidance in the case of mandibular protrusion are checked visually and by using occlusion foil. During mandibular lateral movement only the canine guidance takes place and is also registered optically and by using occlusion foil.Interference contacts should be adjusted.~The patient is instructed to wear the stabilization appliance while sleeping. The wearing rhythm is described as intermittent. (three nights - wearing the appliance, one night - not wearing the appliance)."