Neuromusuclar Pain Diagnostic Xrays
Tomogram and Transcranial x-rays are used to see the position of the jaw bone in respect to the skull bone. If the jaw bone is out of alignment with the skull then pain sets in. Normally, these x-rays are used to pinpoint the space between the top of the jaw bone (condyle) and underside of the skull bone (glenoid fossa). This is the space where the fibrocartilage disc is located. This protective disc (pseudo-ligament) cushions the head of the condyle like a shock absorber and protects the skull and brain tissue from unnecessary pounding of the jaw. If the spacing between the head of the condyle and the skull bone is less than 3 mm. then there is proof that the protective disc is either thinning down or dislocated. Most migraine patients have less than 1 mm. of space! These same patients present with no clinical symptoms of any joint problems…only the x-rays can pick up the disturbance.
Panorex is one of the most common x-rays used by dentists and oral surgeons in every day practice. Alone, it cannot detect any jaw or joint problems. Too many dentists and surgeons use this x-ray to try to diagnose TMJ and headache problems. A Panorex is mainly used to look at the structures of the jaws, neck, and head. It is a screening tool that we use to make sure that there are no abnormalities. We also use this x-ray to help determine if the Coronoid Process is enlarged. This is the bone in the middle of the jaw that extends up into the middle of the face. In many headache patients, especially the ones who grind their teeth, we notice an enlarged coronoid. Abnormal growth or enlargement of this bone causes sharp pain into the face region due to the fact that this bone starts to "knife" through the muscles.
Head/Skull x-rays are used to gauge the alignment of the jaws, skull, and neck bones. These help us to determine where the imbalance lies. They are also used to perform computerized analysis of the relationship between the skull and jaws. These results allow us to pinpoint the causes of the pain problem and help us to dictate the future protocol for treatment.