5] Examination Of TMJ Flashcards
Strongest muscle in the body
Masseter
Headache or facial pain associated with
disorder of the cranium, neck, eyes, ears,
nose, sinuses, teeth, mouth, or other facial structures
TMD
Disc attaches to the condyle how?
Via medial and lateral collateral ligs
Joint structure of the capsule
Highly innervated and vascularized
3 ligaments
Temporomandibular
Sphenomandib
Stylomandib
Innervation
Trigeminal nerve
Trigeminal-cervical complex
Action of temporalis
Elevation
Ipsi deviation
Action of masseter
Elevation
Action of medial pterygoid
Elevation
Contra deviation
Protrusion
Action of lateral pterygoid
Depression
Protrusion
Contra deviation
Action of supra hyoids
Depression and swallowing
Action of infrahyoids
Swallowing
How much mandible depression is normal?
40-50 mm
How much mandibular depression is functional?
30 mm
2 phases of mandibular depression
Anterior rotation of the condyle accounts for the first 11-25mm of opening
• Translation of the disc/condyle complex accounts for the remainder of opening
Controlled by the digastrics, inferior head of the lateral pterygoid, and gravity
Mandibular depression (opening)
Controlled by the temporalis, masseter, medial pterygoid, and superior head of the lateral
pterygoid muscle
Mandibular elevation (closing)
Superior/posterior translation of upper joint
followed by rotation of the condyle below the disc in the lower joint
Mandibular elevation (closing)
How much protrusion is normal
5-10 mm
Protrusion is controlled by
bilateral action of the masseter,
medial pterygoid, and lateral pterygoid muscles
Retrusion is done by
deep masseter, posterior
temporalis, diagstric & suprahyoid muscles
How much lateral deviation is normal?
8-12 mm
Lateral deviation is done by
lateral pterygoids and ipsilateral temporalis
What type of joint is TMJ
Synovial
Reduction is when there is
Clicking
What is resting occlusion
The manner in which the upper and lower teeth come together
• Jaw clenching/grinding is linked to increased
masticatory muscle activation & pain,
increased cervical and trunk muscle activation
Bruxism
Explain active disc reposition technique
Movement:
- Lateral deviation to contralateral to side of displacement
- Maximal mandibular depression
- Mandibular elevation while maintaining lateral deviation
- Slow return to resting occlusion
Rocobado 6 x 6
- Mandibular rest position
- Controlled mandibular rotation
- Rhythmic stabilization
- Cervical joint liberation
- Axial extension
- Shoulder girdle retraction
Normal mandibular opening
35-50 mm
25-35 functional
