Editor's Letter
BiteTech
FROM THE GUEST EDITOR
Paul Belvedere, DDS
Dear Readers,
In 1961, I had a sound reason to become involved with
the understanding and treatment modalities of a
TMD (temporomandibular dysfunction). I was the
patient!
A doctor gains additional understanding of a disease or
illness when the patient is oneself. The associated physiologic
manifestations brought about by temporomandibular
joint (TMJ) problems are difficult to understand. How can the articulation
of two bones cause such problems? While localized joint pain makes intuitive sense, associated anatomic pain away from the
joint space and violent bouts of vertigo are
harder to rationalize. I desperately needed to engage
in a commonsense self-evaluation and splint design to solve my problem.
That is why over 40 years ago I began the lifelong process of understanding mandibular positioning through occlusal interception.
My journey began with a three-unit gold onlay bridge
replacing tooth No. 19. The bridge fit the teeth but the occlusion caused problems, and my
TMD started then. I sought the advice of
dentists and medical doctors, but no one could give me relief. In their defense, they were working
with TMJ treatment modalities that were in
their genesis back then. Many different mandibular positioning devices were created for my problem, including
upper and lower appliances of all shapes and sizes. Some were made from
acrylic and others from cast metal. Every
conceivable functioning design was fabricated
until the condylar pressure that led to inflammation and pain in the joint,
surrounding tissues, and structures could be eliminated.
The knowledge gained from personal evaluation of
mandibular repositioning devices led to the
creation of what is today known as “the reverse wedge”—a simple yet effective device through which a predictable
increase in the distal portion of the posterior
teeth and a lesser dimension in the premolar area
positions the mandible to bring the head of the condyle slightly out of the fossa. By relieving abnormal and/or over-pressures in
the TMJ, I became pain-free.
I could not predict 40 years ago that my suffering
would lead to performance-enhancing mouth wear.
I invite you to enjoy this very special supplement to Compendium of Continuing Education
in Dentistry introducing this new field of dentistry.
Respectfully,
Paul Belvedere, DDS
Private Practice
Minneapolis, Minnesota
