LOL TMD Flashcards by Tim Agee

Inflammation of the capsule ligaments with Joint soreness and inflammation

Capsulitis

How well did you know this?

Not at all

Perfectly

What is the most common TMD diagnosis?

Capsulitis

How well did you know this?

Not at all

Perfectly

Irritation to the Synovial Fluid, similar to Capsulitis

Synovitis

How well did you know this?

Not at all

Perfectly

Bone inflammation, wear and tear arthritis

Ostoearthritis

How well did you know this?

Not at all

Perfectly

Osteoarthritis is the most common due to…

overuse

How well did you know this?

Not at all

Perfectly

Clicking and Popping are due to…

Internal Derangement

How well did you know this?

Not at all

Perfectly

Every Arthritis can be in the _____

2 most common systemic arthritis found there…

jaw joint

osteoarthritis/rheumatoid

How well did you know this?

Not at all

Perfectly

Joint inflamed b/c of injury, auto accident, etc…

Should be evaluated for?

Traumatic arthritis

TMD

How well did you know this?

Not at all

Perfectly

Type of pain that refers from one place to another (tender point to a distant site).

Myofascial pain

How well did you know this?

Not at all

Perfectly

Myofascial pain is ______ and treated with what?

Referred

Stretching, heat, cold, rest, Muscle Relaxants

How well did you know this?

Not at all

Perfectly

Localized pain, same area

Myalgia

How well did you know this?

Not at all

Perfectly

Type of pain that is referred:

Type of pain that stays local:

Myofascial

Myalgia

How well did you know this?

Not at all

Perfectly

Most common muscle pain is ______ and responds to ______

Myalgia

Stretching

How well did you know this?

Not at all

Perfectly

Muscle inflamed from injury (or infection)

Myositis

How well did you know this?

Not at all

Perfectly

Most common cause of Myositis for Dentists:

Do not…

Use what 3 Tx?

Wisdom tooth extraction

stretch

NSAIDS, steroids, rest

How well did you know this?

Not at all

Perfectly

A Charlie Horse, forceful painful contraction, very rare (tetanus like)

Spasm

How well did you know this?

Not at all

Perfectly

Spasms may be caused due to low ______ or other minerals/homones

could also be caused by a ____

K+

virus

How well did you know this?

Not at all

Perfectly

Muscle tightens to protect joints or other muscles

*must find cause/what trying to protect

Protective Splinting

How well did you know this?

Not at all

Perfectly

If body is Protective Splinting, what do?

Tx cause, use Muscle Relaxants

*also rest/stretching

How well did you know this?

Not at all

Perfectly

Muscle that has undergone degenerative change that causes the contracted state to persist:

Usually due to _____

Calcified Contracture is _____

Can be ______

Stuck in a certain position _______

Myofibrotic Contracture

injury/infection

rare

hereditary

permanently

How well did you know this?

Not at all

Perfectly

Anterior Temporalis refers to:

Middle Temporalis:

Posterior Temporalis:

Mx anteriors

Mx PM’s

Mx Molars

How well did you know this?

Not at all

Perfectly

Masseter refers to what 3 areas:

Ear

Lower molars

Above right eye

How well did you know this?

Not at all

Perfectly

SCE refers to what 4 areas?

Ear

above eye (may be contralateral)

occiput

eye

How well did you know this?

Not at all

Perfectly

Trapezius/Posterior Cervicalis refers to what 3 areas?

Temple

Ear

Eye

How well did you know this?

Not at all

Perfectly

Lateral Pterygoid refers to what 3 areas?

TMJ Eye Zygoma

Differential Diagnosis important so Tx can be focused on joint or muscle

True

Jaw pain is usually _____

Joint or Muscle

Most TMD cases area a combo of both joint and muscle

True

Important to distinguish ADD w/o reduction early

True

When opening, if a jaw deflects to _______, required immediate attention

one side (locked)

What is the most common cause of TMD probs?

Multifactorial

List 6 contributing factors for TMD:

extrinsic trauma hyper function of masticatory mm hyperextension occlusion systemic disease psychosocial

What is the most important thing when you screen a pt?

What treats Superior Capsulitis? What does it use?

Unilateral Pivot teeter/totter effect (pulls down one side of joint, lets heal)

What treats Posterior Capsulitis?

move Forward *heals in anterior positioning device

What movement can aggravate lateral capsule?

Lateral

Mx Stabilization appliance stabilizes what? eliminates: reduces clenching force/joint loading by ___%

occlusion fulcrums/interferences 70%

Mx Stabilization increases joint space

False

Mx Stabilization appliance should cover all teeth in what positions? should have what kind of guidance?

CR, CO, MI anterior/canine

Mn Stabilization has similar rules to Mx

True

(m, joint, both) Opening Pain: Closing Pain: Chewing Pain: Moving the Head: Sharp Pain: Dull Pain:

Muscle or Joint Joint Muscle or Joint Meck Joint Muscle

Pain associated with popping/clicking: Side to side movement pain: Limited opening w/o deviation Limited opening with Deflection:

Joint Joint Muscle Disc displaced/Joint

___% have at least 1 sign of joint dysfunction ___% has at least 1 symptom ____% of the population needs Tx

75% 33% 5-7%

Of the 5-7% of the population that need TMD Tx, % internal derangement? arthritis: masticatory muscle disorder?

31% 39% 30%

Females outnumber Males in TMD by what ratio?

4-5:1

___% of pts who come into your office have non-0tooth related pain, and we must identify these

40%

Rotation happens in what Joint Compartment? Sliding/Displacement occurs where?

Inferior Joint compartment Superior Joint compartment

The Jugular is in the TMJ

False

Lateral ROM: Protrusion: Opening:

10 - 12 mm 8 - 10 mm over 40 mm

TMJ disc made of what? Cartilage covering the condyle is what? Why is this relevant?

Fibrous CT Dense Fibrocartilage healing

Primary Tx for TMD is what 3 things?

non-invasive reversible multidisciplinary

Tx for TMD includes dental specialist, primary care, neurologist, physical therapy, etc

True

Tx for TMD should never be what 2 interventions?

crowns/surgery change bite location

Surgery/full mouth rehab is reserved for what in TMD?

second phase *last option

Anterior reposition splint, aka

FARRAR

FARRAR (ant reposition splint) reduces load where? temporarily recaptures what? Use this device when?

Posterior attachment tissues Anterior displaced disc if disc too far forward

Anterior Reposition Splint should be used full time

False *only at night

What is the goal of an Anterior Reposition Splint?

make a pseudo disc from healing *never permanently reposition forward

TMD is always progressive

False *heals better than other joints, most adaptable

Most common symptom of TMD is headache:

False

What is the most common symptom of TMD?

Jaw Pain

Most TMD cases are due to bad bite

False

Bad bite causes ___% of TMD

15%

Las Vegas Institute not evidence based

True

Use of x-rays are the only exception for machines/instruments to use to diagnose or Tx TMD

True

3 contraindications for TMD Tx

permanent bite changes ortho appliance full mouth rehab

TMD is usually not caused by malocclusion

True

6 symptoms of TMD

Jaw pain Ear pain Headaches Ear stuffiness Dizziness Hearing loss

The Intracranial exam checks for function of what?

Cranial nerves

If you can't find pain in the tooth, look where?

same tooth in opposing arch

You can Tx sleep apnea, neuralgia, myalgia, movement disorders, dyskeniseas, and TMD

True

An IntraOral nightguard will prevent _____ but do nothing for ______

wear pain

Nightguards and intraoral appliances look the same butthey differ how?

intraoral appliance is NOT an occlusal guard *it is an Orthopedic appliance ***stabilization appliance

Any pain in the head can refer to anywhere else, this includes the neck down to where?

If the pain is right below the TMJ, this could indicate...

neck/C1 problem

It is well documented that a removable orthotic works for TMD

True

The most common symptom of TMD is not headache, it is toothache

true *although think different elsewhere

___% of the population has popping

50%

Bone to bone contact is very rare

True

Most common problem we see in TMD

muscle pain

Most common nerve causing pain to the TMD

Trigem

Masseter origin: insertion: innervation: action:

zygomatic arch lateral surface ramus/coronoid masseteric branch V3 closes jaw/elevates Mn

Temporalis origin: insertion: innervation Action:

tomporal fossa coronoid process/ant Mn V3 - deep temporal branches elevates Mn (post fibers retract)

Lateral Pterygoid Origin: Insertion: Innvervation: Action:

greater wing sphenoid (upper) lateral surface lateral pterygoid plate (Lower) neck of condyle of Mn/articular disc/capsule TMJ Branches of V3 opens mouth/protrusion/grinding

Medial Pterygoid Origin: Insertion: Innervation: Action:

medial surface lateral pterygoid plate (sphenoid)/pyramidal process palatine/tuberosity Mn lower part medial surface Mn/angle of Mn Pterygoid branches V3 Elevates Mn/protrusion

Depression (3 mm.): elevation (3 mm.): Protrusion (1 mm.): Retrusion (2 mm.): Lateral:

suprahyoid, infrahyoid, gravity temporal, masseter, medial pterygoid lateral pterygoid middle/posterior temporal, deep masseter retractors same side/protruders opposite

TMJ is a modified...

Synovial Joint

Lateral temporomandibular ligament stylomandibular ligament sphenomandibular ligament

visualize

Intrinsic TMJ ligament: 2 Extrinsics:

TM-lateral ligmanet Stylomandibular/sphenomandibular

Sylomandibular runs from where to where? Sphenomandibular?

styloid process - angle mandible spine of sphenoid - lingula of Mn

Opening pain can be _____ Closing pain...

muscle or joint usually joint