H&N, OCSE, TMJ Flashcards
How do you evaluate the clinical joint surfacs of the TMJ?
1) active protrusion followed by opening - fist with fingers over condyle, then a dynamic compression test with fingers under angle of mandible
2) if dynamic compression provokes crepitus, continue with dynamic translations
Bumann & Lotzmann - TMJ Disorders and Orofacial Pain (textbook)
What does crepitus in the TMJ indicate?
osteoarthrotic changes in the functional joint surfaces
1) crepitus during protrusion – osteoarthrotic changes in the temporal joint surface
2) crepitus during opening – changes in the condylar surface
crepitus with pain = arthritis
crepitus without pain = arthrosis
Bumann & Lotzmann - TMJ Disorders and Orofacial Pain (textbook)
What does clicking in the TMJ indicate?
most commonly disk displacement (usually anteromedial)
causes:
- disk hypermobility
- partial or total disk displacement
- disk displacement with adhesion
- disk displacement with terminal repositioning
- lateral ligament impingement
- hypertrophic cartilage
- condyle hypermobility
Bumann & Lotzmann - TMJ Disorders and Orofacial Pain (textbook)
What is the cause of a TMJ click at the end of active protrusion or jaw opening?
condyle hypermobility or
disk displacement with terminal repositioning
Bumann & Lotzmann - TMJ Disorders and Orofacial Pain (textbook)
What is the average maximum force one can generate on their anterior teeth?
140-200N (about 1/3 of the posterior bite force)
What is the average maximum force one can generate on their posterior teeth?
600-750N
Hagberg
The initial 20mm of rotation/opening is in the (upper/lower) compartment of the TMJ and the remainder is in the (upper/lower) compartment.
lower
upper
Average jaw opening (range in mm)
49-56mm
Average laterotrusion (range in mm)
10-11mm
Average protrusion (range in mm)
10-11mm
What is the endfeel of a healthy TMJ?
What is indicated if the endfeel is too soft or too hard?
hard ligamentary: healthy
soft: muscle contracture
too hard: capsule shrinkage
rebounding: nonreducing disk displacement
bony: hyperplasia of the coronoid process or ankylosis
What is the difference between a relaxation splint and a stabilization splint?
relaxation: normalize muscle tone by distributing forces equally (in CR)
stabilization: secure the max-mand relationship established by therapy and test the Tx results for 4-6 weeks; occlusal indentations are deeper than relaxation splint
What is a decompression splint?
design is like relaxation splint with ant guidance
purpose: Tx compromised TMJ in which constriction of capsule, muscles, and ligaments interferes with relief of articular structures that would be provided by occlusion
