Diagnositc Classifications Of TMDs, Signs And Symptoms Of TMDs Flashcards
3 categories signs and symptoms of masticatory dysfunction
Muscles
Temporomandibular joints
Dentition
Muscles
Most common in TMD complaint
Pain + dysfunction
Muscle pain
Fatigue + tightness
Severity = functional activity
Headache
Muscle dysfunction
Decrease range mand movement
Contraction or stretching increases pain
Inability open widely
Acute malocclusion
Muscle disorders
Protective co contraction *
Local myalgia *
Myofascial pain (trigger point) *
Myospasm
Chronic centrally mediated myalgia
Fibromyalgia
** Dental office
Protective co contraction *
Local myalgia *
Myofascial pain (trigger point) *
Myospasm
Chronic centrally mediated myalgia
Fibromyalgia
- Dental office
Protective co-contraction
Muscle splinting
Muscle function interrupted by event - muscle response occurs
Minor - resolves
Locally myalgia
Most common type of active muscle pain seen in the dental practice
Primary, non inflammatory, muscle pain disorder
Not resolved= changes in the muscle tissues may develop
Constant deep pain = affect CNS leading to certain muscle response
Myofascial pain - trigger pain
Regional muscle pain
Local areas of firm, hypersensitive bands of muscle tissues
Felt as taught bands when palpated = pain
Referred pain
Local provocation = helpful diagnostic
Most common clinical feature of Myofascial pain
Presence of local areas of firm, hypersensitive bands of muscle
Myospasm
Cns Induced tonic muscle contraction
Not common - usually have easily identified clinical characteristics
Muscle spasm fully contracted, major jaw positional changes result in acute malocclusion
Very firm muscles
Acute cramp
Chronic centrally mediated myalgia
Prolonged/constant period of muscle pain
Presence of constant, aching muscle pain
Pain = rest, increases with function
Muscles = tender to palpation + structural dysfunction
Most common clinical feature of chronic centrally mediated myalgia
Extended duration of the symptoms
Fibromyalgia
Widespread musculoskeletal pain
Tenderness = 11 or more of 18 specific tender point sites
Not a masticatory pain disorder
42% also have TMD like symptoms
What is the most common finding one observes when examining a patient for dysfunction
Functional disorders of temporomandibular joints
3 broad categories of functions disorders of TMJ
Derangements of condyle disc complex
Structural incompatibility of the articualr surfaces
Inflammatory joints disorders
2 major symptoms of functional disorders of TMJ
Pain
Dysfunction
Functional pain TMJ
Arthralgia
Originates from nociceptors in soft tissue around joint
Sharp sudden intense pain - joint movement
Dysfunction - functional disorders TMJ
Usually presents as disruption of normal condyle-disc movement, with the production of joint sounds
Click, popping, crepitation, jaw catching (locking)
Derangements of the condyle disc complex
Occur bc relationship b/w articualr disc and condyle changes
If morphology disc altered + distal ligaments =elongated, disc is permitted to slide (translate) across the articular surface of the condyle
Disc displacement with reduction
Single click = opening , very early stages of internal derangement
Morphological changes = of disc, where condyle rests - second click during later stages just prior to the closed joint = reciprocal click
Total disc displacement
No joint sounds
Lock occurs occasionally, person can resolve with no assistance, disc displacement with intervention locking
Pain or no pain
Disc displacement without reduction
Person unable to return disc to normal position on condyle
Mouth cannot be opened maximally bc position of disc does not allow full translation of condyle
Initial opening - 25-30 mm (max rotation)
Closed lock
Macrotrauma
Sudden force to join = structural alterations
Direct or indirect
Intubation procedures, TME, long appt
Whiplash
