Treating the triad

  • G. Cozzani
UK: Quintessence price £225.00; pp 408 ISBN 9788874921522 | ISBN: 978-8-8749-2152-2

Most of us find TMD, as a group of disorders, difficult to understand and treat. There is much diagnostic discussion but few definitive clinical solutions out there in the literature. Dr Cozzani presents in this text a systematic approach for the treatment of this group of disorders. The cases he presents range from simple cases to the most complex.

The text splits treatment into two phases. Phase 1, musculo-articular therapy, aims to recapture disc position/formation of the pseudo disc as best as possible with an anterior repositioning splint worn always. Axial alignment is thus restored with improvement in muscle tension and thus relief of pain.

Phase 2 is orthodontic occlusal finishing which aims to rearrange the dentition with orthodontic appliances while maintaining the splint. This should in theory and in practice allow a long-term stable functional efficiency between teeth, muscles and TMJ.

Dr Cozzani presents many complete case reports of step-by-step procedures used to treat patients suffering from TMD. The author describes the various splints used in treatment with clear indications of their use. He also includes descriptions of splint fabrication which I found interesting. These splints include the six-point splint, stabilisation splint, michigan plate, various forms of anterior repositioning splints, maintenance splint and distractor.

The 408 pages are divided into 6 chapters. These include basic concepts, diagnosis, musculo-articular therapy, orthodontic occlusal finishing, children and temporomandibular disorders and innovative orthodontic treatment of teeth, muscles, and temporomandibular disorders. Along with orthodontic treatment of TMD, the prosthetic and surgical treatments are also considered.

The excellent text is accompanied by illustrations, diagrams, MRI scans and clinical photos of a very high standard which aided my understanding and enjoyment of this text.

The author himself admits that while this book 'may meet disagreement and criticism, it is hoped that it may provide food for thought and discussion, without which no progress is ever made'.

I would deem this book to be an essential text for any orthodontist with a special interest in treating TMD.