Disorders and prblems Flashcards
Ankylosis of TMJ
is a pathologic condition where the mandible is fused to the fossa by bony or fibrotic tissues.
Arthritis of TMJ
affects the cartilage, subchondral bone, synovial membrane, and other hard and soft tissues causing changes such as TMJ remodeling, articular cartilage abrasion and deterioration
Internal derangement of temporomandibular joint
are conditions in which the articular disc has become displaced from its original position the condylar head.
Myofascial pain of TMJ
It is caused by muscle tension, fatigue, or (rarely) spasm in the masticatory muscles.
Reiter syndrome
Reactive arthritis is a type of arthritis caused by an infection. It may be caused by Chlamydia trachomatis, salmonella, or another infection. The condition may cause arthritis symptoms, such as joint pain and inflammation.
What TMJ joint disorder could be present (no crepitus) following trauma?
Ankylosis
Arthrocentesis
is a procedure performed to collect synovial fluid from joint spaces for the identification of a disease process or the relief of painful or bothersome symptoms.
What social habit is NOT associated with aphthous ulcers and why?
Smoking - causes hyperkeratosis (the opposite of aphthous ulcers.
How many people are affected by TMDs?
10-15%
Is there a gender bias in those effected by TMDs?
Females more common
Taking a TMD history: assessing pain (3)
- Character (dull, acute etc)
- Site (jaw, ear, etc)
- Affected by (i.e. jaw movement, function etc)
CSA
Taking a TMD history: Assessing noises
Clicking, snapping, popping, crepitus (grinding, crunching etc).
Taking a TMD history: assessing movement (4)
- Restricted opening
- Interfering with ability to eat
- Locking - intermittent/persistent; closed; open; able to release with manoeuvre?
- Deviation
R.I.L.D
Taking a TMD history: Habits
Clenching, grinding, chewing or biting habits etc
Taking a TMD history: key consideration to ask about
past history of trauma
First area to palpate on TMJ examination
Lateral pole
What should you observe when palpating lateral pole of TMJ?
Repetition movements (opening, closing, lateral, protrusive movements):
Does palpating elicit the patient’s familiar pain?
Any noises palpable?
Any noises audible to the patient?
What muscles should be palpated during TMJ examination?
Temporalis (when teeth clenched, above the ear and forwards above the eye) and masseter (bimanual - one hand inside the mouth, one outside)
Examining TMJ: mouth opening?
Deviation on opening
Extent of opening
What findings might you see intra-orally with someone with a TMD?
Ridging buccal mucosa at level of occlusal plane (cheek biting)
Scalloping of borders of tongue (wavy edges of tongue)
Tooth wear (grinding?)
What further investigations could you do for a TMD?
• Plain radiographs not normally indicated
• Cone Beam Computed Tomography (CBCT)
• Magnetic Resonance Imaging (MRI)
Which TMD?
- pain muscle origin
- temple and jaw
Myalgia (local, pain, pain with referral)
Which TMD?
Painful joint
seen when palpating lateral pole
Arthralgia
Which TMD?
- History of noise during movement
- Clicking popping (opening and closing, opening OR closing, lateral/protrusive movements)
Disc displacement with reduction
What TMD?
- jaw locked
- limitation in jaw opening significant with ability to eat
Disc displacement without reduction with limited opening (disc does not reduce with opening, persistent limited mandibular movement)
Which TMD?
- History or examination noise on jaw movement
- Crepitus detected with palpation
Degenerative joint disease
(TMJ osteoarthritis affects the cartilage, subchondral bone, synovial membrane, and other hard and soft tissues causing changes such as TMJ remodeling, articular cartilage abrasion and deterioration)
Which TMD?
- jaw locking in an open mouth position
- need a manipulative manoeuver to close the mouth
Subluxation (open lock)
When should you refer on a patient with a TMD?
- Chronic TMD lasting over 3 months
- Symptoms worsening
- Psychological distress
- Uncertain diagnosis
