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D117 > 3-1 tmd > Flashcards

3-1 tmd Flashcards

1
Q

Bony articular surfaces of TMJ

A

Superiorly: mandibular/glenoid fossa and articular tubercle/eminence of the temporal bone
Inferiorly: head of the condyle

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2
Q

tmj type of joint

A

ginglymoarthrodial joint

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3
Q

explain: TMJ is a synovial joint

A

it secretes fluid that serves as a lubricant

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4
Q

what separates the joint sapce into two compartments/joint spaces

A

articular disc

superior: gliding joint
inferior: hinge joint

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5
Q

what forms the gliding joint

A

articular eminence of the temporal bone and the superior surface of the articular disc

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6
Q

what forms the hinge joint

A

anterior surface of the condyle and the inferior surface of the articular disc

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7
Q

enumerate the 3 regions of the articular disc

A

Posterior band
intermediate zone
anterior band

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8
Q

thinnest portion of the articular disc which stays in contact w/ condyle when mandible moves

A

intermediate zone

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9
Q

what is the retrodiscal tissue

A

region of loose CT that is highly vascularized and innervated
tissue where articular disc is attached posteriorly
bordered by the superior retrodiscal lamina

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10
Q

differentiate inferior retrodiscal lamina from superior retrodiscal lamina

A

superior: contains many elastic fibers
inferior: chiefly collagenous fibers

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11
Q

define and purpose ligaments

A

elastic bands of tissues that support and confine the movement of the mandible
to protect muscles from being stretched beyond their capabilities

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12
Q

enumerate the ligaments of tmj

A 
capsular ligament/joint capsule
lateral ligament/temporomandibular ligament
collateral ligament
sphenomandibular ligament
stylomandibular ligament
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13
Q

describe capsular ligament/joint capsule

A

filled with synovial fluid
well-innervated
has proprioceptive functions (similar to periodontal ligaments)

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14
Q

describe lateral ligament/temporomandibular ligament

A

maintains the position of the condyle in the glenoid fossa by preventing lateral and posterior displacement of the mandible

consists of 2 fibers that run obliquely and transversely

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15
Q

which fiber limit the rotation of the condyles

A

oblique fibers of lateral ligament

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16
Q

constitutes the collateral ligament and their function

A

medial and lateral discal ligaments - stabilize the articular disc to the neck of the condyle

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17
Q

describe/attachment sphenomandibular ligament

A

connects spine of the sphenoid bone with the medial surface of the mandible

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18
Q

function of sphenomandibular ligament

A

gives some support to the mandible and may help limit maximum opening of the jaw

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19
Q

attachment of stylomandibular ligament

A

styloid process of temporal bone to posterior surface of the mandible (near the angle)

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20
Q

action of stylomandibular ligament

A

relaxed when mouth is closed but becomes tensed on extreme protrusion

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21
Q

Muscles of mastication

A
  1. masseter
  2. Temporalis muscle (3 heads)
  3. medial/internal pterygoid muscle (2 heads)
  4. lateral/external pterygoid muscle (2 heads)
22
Q

forms the sling (mom)

A

masseter and medial pterygoid muscle

23
Q

action of masseter

A

elevation; secondarily aids in protrusion of md

24
Q

only muscle that can be palpated intraorally… and why

A

temporalis muscle due to its connection to the coronoid process

25
Q

stabilizes the condyle during mastication

A

superior lateral pterygoid muscle

26
Q

one of the smalles muscle which aids in the protrusion, depression, and latero-medial movement of the mandible

A

inferior lateral pterygoid muscle

27
Q

maximum opening of the mouth

A

50-60mm

28
Q

during maximum opening what happens to the structures

A

retrodiscal tissue is stretched

articular disc is squeezed in between the articular eminence and the condyle

29
Q

at centric relation, position of structures?

A

top of condyle is over the posterior band of the articular disc

30
Q

types of TMD and differentiate

A
  1. myogenous tmd - muscle generated pain

2. Arthogenous tmd - jaw joint generated pain

31
Q

inflammation of the disc

A

capsulitis/synovitis

32
Q

symptoms of tmd

A
  1. pain/discomfort
  2. tmj noise
  3. locking of jaw
  4. limited opening of the mouth
  5. deviating jaw movements
  6. chewing difficulties
  7. headache
  8. abnormal jaw opening
33
Q

Epidemiology of TMD

A

women 2x more than men
3:1 to 9:1
non-px population: 40-75% possible TMD
10% of the population older than 18y/o

34
Q

characteristics of TMD

A

often remitting
self-limiting
fluctuate over time

35
Q

t/f pain severity is the same across all age groups

A

true

36
Q

t/f correlation between signs and symptoms of tmd is poor

A

true

37
Q

annual incidence rate of tmd

A

2%

38
Q

only __% of individuals are estimated to be in need of tx

A

3.6% to 7%

39
Q

T/F occlusal disorders cause TMD

A

false

40
Q

differentiate the different factors

A

predisposing factors - inc the risk of developing tmd
initiating factors - causes the onset of tmd
perpetuating factors - interferes w/ healing, enhances progression

41
Q

give 2 initiating factors

A

direct trauma to the jaw/joint

microtrauma from abnormal habits

42
Q

give 5 perpetuating factors

A 
Autoimmune disease
Systemic disease
Connective tissue breakdown
arthritis
Thinning of cortical plates
43
Q

other factors considered (in relation to malocclusion)

A
  1. loss of molar support = malocclusion; no
  2. change in VD = no recent studies
  3. extensive overbite = no
  4. extensive overjet = maybe/baka baliktad
  5. CR-ICP slides (centric relation to intercuspal position)
44
Q

differentiate screening from comprehensive evaluation

A

comprehensive eval - diagnosing px w/ symptoms

screening - diagnosing asymptomatic px

45
Q

TMD management

A
  1. appropriate diagnosis
  2. most conservative and reversible therapy
  3. relief of pain and dysfunction (First objective)
46
Q

non-surgical treatment

A
  1. self
  2. orthotic therapy (occlusal orthotics)
  3. stress management - relieve tmd symptoms
  4. physical therapy
  5. medications
  6. occlusal adjusment
47
Q

most prescribed management by dentists

A
  1. meds

2. splint therapy

48
Q

prescribed to a patient with limited jaw movements. what does it do?

A

TheraBite - slowly increase the bite or mouth opening of px

49
Q

what is a repositioning appliace

A

orthotic appliance with lingual ramp

50
Q

reduces anxiety, insomnia and muscle hyperactivity

A

anxiolytics

51
Q

types of medications

A

analgesics, Cox-2 inhibitors, muscle relaxtants etc

52
Q

T/F occlusal adjustment is part of the initial management

A

false

D117 (2 decks)

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