Functional Disorders of the TMJ Flashcards

1
Q

in the condyle-disc complex, the disc is ___ and ___ bound to the condyle by the ___ ligaments

A
  • laterally and medially

- discal collateral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

the only physiologic movement that can occur between the condyle and the articular disc is ___

A

rotation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

rotational movement of the condyle-disc complex is limited by what?

A

the length of the discal collateral ligaments, inferior retrodiscal lamina posteriorly, anterior capsular ligament anteriorly, morphology of the disc, degree of interarticular pressure, superior lateral pterygoid muscle, and superior retrodiscal lamina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

the only physiologic translatory movement occurs between the ___ and the ___

A

condyle-disc complex and the articular fossa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

describe the steps of normal opening movement

A
  1. mouth opens and condyle moves forward
  2. disc rotates posteriorly on the condyle
  3. superior retrodiscal lamina lengthens
  4. condyle-disc complex translates out of the fossa
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

during normal opening movement, once the condyle-disc complex translates out of the fossa, ___ maintains the condyle on the thinner intermediate zone of the articular disc and prevents the thicker anterior border from passing posteriorly through the discal space between the ___ and ___

A
  • interarticular pressure provided by the elevator muscles

- condyle and the articular surface of the eminence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

the ___ is the only structure that can retract the disc posteriorly

A

superior retrodiscal lamina

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what happens if the morphology of the disc is altered and the discal ligaments become elongated (internal derangement)? is this movement normal in a healthy joint? what is its degree determined by?

A

the disc is permitted to slide (translate) across the articular surfaces of the condyle. this type of movement is not present in the healthy joint. it’s degree is determined by changes that have occurred in the morphology of the disc and the degree of elongation of the discal ligaments.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what happens when the mouth closes during internal derangement?

A

when the mouth closes, the interarticular pressure is lower, so the disc can once again be displaced forward by tonicity of the superior lateral pterygoid muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

in the healthy joint, the surfaces of the condyle, disc, and articular fossa are ___, allowing ___ movement

A

slippery, allowing easy, frictionless movement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

describe reciprocal clicking

A
  1. during mandibular opening, a sound is heard when the condyle moves across the posterior border of the disc to its normal position on the intermediate zone.
  2. during closing, the normal disc position is maintained until the condyle returns to very near the closed joint position.
  3. as the closed joint position is approached, the posterior pull of the superior retrodiscal lamina is decreased.
  4. the combination of disc morphology and pull of the superior lateral pterygoid muscle allows the disc to slip back into the more anterior displaced position. this final movement of the condyle across the posterior border of the disc creates a second clicking sound (“reciprocal click”)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

___ describes actual dislocation of the articular surfaces

A

functional dislocation with reduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

T or F:
during functional dislocation with reduction, the patient is unable to maneuver the joint successfully to reduce the disc back to its functional position

A

false

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

is functional dislocation with reduction painful?

A

may or may not be painful depending on the severity and duration of the lock and the integrity of the structures in the joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what happens during functional dislocation with reduction of episodes of catching/locking become more frequent and chronic?

A

ligaments break down and innervation is lost. Pain becomes less associated with ligaments and more related to forces placed on the retrodiscal tissues.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

during ___, the patient is unable to return the dislocated disc to its normal position on the condyle, and the mouth cannot be opened maximally

A

functional disc dislocation without reduction

17
Q

during functional disc dislocation without reduction, deviation to the affected side occurs in maximum opening that is limited to ___mm. is the patient able to produce normal lateral ROM to the contralateral side?

A
  • 25-30mm

- pt is unable to produce normal lateral ROM to the contralateral side

18
Q

is pain present during functional disc dislocation without reduction?

A

not necessarily, unless force is applied, stretching the ligaments

19
Q

where does function occur during functional disc dislocation without reduction if pain is felt due to force applied that stretches the ligaments?

A
  • on the retrodiscal tissues
  • if sufficient force is applied to these tissues during function, tissue breakdown may occur leading to a perforation of these tissues
  • if moderate force is applied during functional movements, these tissues may develop a callous or pseudo disc
20
Q

___ is any sudden force to the joint that can result in structural alterations

A

macrotrauma

21
Q

___ is a blow to the chin or lateral portions of the mandible that may lead to dysfunctional changes that are irreversible

A

direct trauma

22
Q

___ trauma has greater risk to joint structures

A

open mouth

23
Q

___ trauma has stability from the intercuspal position of the teeth and protects the joint tissues to a greater degree (value of athletic mouth appliances)

A

closed mouth

24
Q

iatrogenic traumas, as in intubation procedures, third molar extractions, and long dental procedures create risk of ___

A

elongating the discal ligaments

25
Q

indirect trauma symptoms as in whiplash injuries can be explained as heterotropic symptoms associated with ___

A

deep pain input from the cervical spine

26
Q

___ is any small force that is repeatedly applied to the joint structures over a long period of time (bruxism and clenching)

A

microtrauma

27
Q

during microtrauma, if loading exceeds the functional limit of the tissue, ___ can result within the ___

A

irreversible changes or damage can result within the collagen network

28
Q

___ is softening of the articular surface

A

chondromalacia (example of microtrauma)

29
Q

the ___ theory involves free radicals associated with hyperalgesia

A

hypoxia/reperfusion theory (example of microtrauma)

30
Q

mandibular orthopedic instability resulting from occlusal disharmony is an example of ___

A

microtrauma

31
Q

an example of microtrauma is loss of ___ due to alterations in discal surface lubrication

A

frictionless movement

32
Q

T or F:
studies report that the incidence of TMD symptoms in a population of orthodontically treated patients is no greater than that in the untreated general population

A

true

33
Q

T or F:

orthodontic treatment is effective in preventing TMDs

A
  • false
  • the incidence of TMD symptoms in the orthodontically treated populations were found to be generally NO lower than that in the untreated population
34
Q

any dental procedure that produces an occlusal condition which is not in harmony with the musculoskeletally stable position of the joint can predispose patients to ___

A

TMDs

35
Q

T or F:
clinicians who provide dental care that will change the patient’s occlusion should follow the principles of orthopedic stability to minimize risk factors for TMDs

A

true