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TMD > MC book Qs > Flashcards

MC book Qs Flashcards

1
Q

Up to ___ of the population has at least one sign or symptoms of TMD.

A

75%

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2
Q

A healthy joint is a prerequisite for successful restorative work ( true or false)

A

true

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3
Q

true or false… the TMJ is the most complex joint in the body

A

true

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4
Q

The TMJ provides for ___ movements

A

hinging and sliding

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5
Q

the TMJ is classified as a compound joint, requiring the presence of ___

A

at least three bones

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6
Q

The articular disc is composed of ___

A

dense fibrous connective tissue

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7
Q

From an anterior view, the articular disc is thicker ___

A

medially

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8
Q

When the mandible opens, the inferior joint space ____

A

opens more posteriorly

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9
Q

The precise shape of the articular disc depends upon the morphology of ____

A

the mandibular fossa and the condyle

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10
Q

The retrodiscal tissue is…

A

located posterior to the articular disc

highly innervated

highly vascular

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11
Q

true or false… The articular surfaces of the condyle and mandibular fossa are lined with hyaline cartilage.

A

False

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12
Q

compared to fibrous CT, hyaline cartilage…

A

is more susceptible to the effects of aging

is more liable to break down

has less ability to repair

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13
Q

true or false… Synovial fluid in the TMJ acts as a medium providing metabolic requirements to the surrounding tissues.

A

true

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14
Q

the synovial fluid ____

A

acts as a lubricant

helps to minimize friction

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15
Q

No barrier exists between the synovium and the fluids present in the joint spaces because….

A

there is no epithelium or basement membrane

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16
Q

GAGs can produce a cushion to compressive loads by ___

A

causing the cartilage to imbibe extracellular water.

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17
Q

Requirements for healthy cartilage include…

A

plenty of water

proteoglycans

a collagenous mass

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18
Q

The functional ligaments that support the TMJ are ___

A

the collateral ligaments

the capsular ligament

the temporomandibular ligament

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19
Q

The accessory ligaments for the TMJ are ____

A

(A and B)

stylomandibular

sphenomandibular

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20
Q

The muscles of mastication include the….

A

(all of the above)

temporalis and masseter

lateral and medial pterygoid

anterior and posterior digastric

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21
Q

Temporomandibular disorders result from….

A

(A and B)

macrotrauma

microtrauma

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22
Q

Microtauma occurs as a result of…

A

(A and C)

sustained adverse loading

repetitive adverse loading

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23
Q

Inflammation of the joint space can be the result of…

A

(A and B)

unresolved ligamentous insertion injuries due to traumas

unresolved tendinous insertion injuries due to trumas

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24
Q

Capsulitis and synovitis may be associated with ….

A

(all of the above)

a disc displacement

hypermobility

dislocation

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25
Q

If a disc is reduced….

A

it can be recaptured

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26
Q

In cases with disc displacement without reduction, ____

A

the posterior lateral ligaments have been severely stretched

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27
Q

Mast cells release ____ as part of the inflammatory response

A

seratonin

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28
Q

Disc surface cracks can occur as a result of ___

A

compression

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29
Q

Bradykinin and substance P are ___

A

inflammatory neuropeptides

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30
Q

Abnormal rotation of the ilium can cause…

A

anterior rotation of the mandible

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31
Q

A comprehensive examination to determine if a patient has TMD must include ___

A

(all of the above)

a health history and review of chief complaints

a clinical examination

tests and imaging

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32
Q

true or false… when taking a patients medical history it is important to obtain information on pharmaceutical medications as well as homeopathic medicines and vitamins

A

true

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33
Q

the initial examination performed by the assistant should include….

A

(all of the above)

measurement of maximum jaw opening

measurement of degree of protrusion

measurement of CEJ to CEJ distance and lateral movement

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34
Q

The normal range for opening for a patient with a dolichofacial type is ___

A

42mm

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35
Q

The cervial range of motion is measured using ___

A

an arthroidal protractor

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36
Q

the articular disc is composed of ___

A

dense fibrous connective tissue

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37
Q

the joint vibration analysis works on the ___

A

principle of motion and friction

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38
Q

The temporals muscle should be palpated….

A

(B and C)

at rest

after the patient has clenched

(not with the patient clenching)

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39
Q

The superficial master muscle is palpated ____

A

(a and b)

While the muscle is contracting

with the patient clenching

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40
Q

true or false… the anterior digrastic muscle is palpated underneath the chin with the patients mandible in a protruded position

A

true

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41
Q

Morning headaches are a sign of ____

A

(a and b)

OSA

TMJ dysfunction

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42
Q

Initial X-rays taken will include…

A

(all of the above)

a pano

a sub-mental vertex raiograph

sagittal tomograms

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43
Q

The neck muscles that must be palpated include….

A

(all of the above)

the trapezius

the splenius capitus

the sternocleidomastoid

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44
Q

The ___ originates from the styloid process.

A

(all of the above)

styloglossus muscle

stylopharyngeal muscle

stylomandibular and stylohyoid ligaments

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45
Q

Muscles must be palpated….

A

(all of the above)

one at a time

one side at a time

bilaterally

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46
Q

The lateral TMJ is is palpated…

A

with the mouth closed

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47
Q

The corrected sagittal tomogram is ____

A

inherently more accurate than the trans cranial projection

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48
Q

The TMJ should not ____

A

(all of the above)

click

pop

produce a grating noise

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49
Q

The Epworth Sleepiness Scale ___

A

(all of the above)

is self-administered by the patient

assesses the amount and restfulness of sleep

assess the sleeping pattern

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50
Q

Following a full evaluation of patients, ___ should take place

A

(a and b)

a diagnosis

triage

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51
Q

One of the more common symptoms a TMD is ___

A

headaches

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52
Q

true or false… An injury to the TMJ has a more significant impact on the nervous system than a knee injury

A

true

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53
Q

___ involves the transmission of a noxious stimulus from a site in the body to the brain.

A

nociception

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54
Q

TMJ tissue damage results in the release of ___

A

inflammatory neuropeptides

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55
Q

Pain from a tooth travels ___ before ascending to the brain.

A

down into the patient’s neck

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56
Q

All noxious stimuli go through ___

A

the thalamus

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57
Q

Intra-capsular derangements of the TMJ can result from ___

A

(a and b)

macrotauma

microtrauma

58
Q

An intra-capsular derangement is ___

A

(all of the above)

disc dislocation with reduction

disc displacement

disc dislocation without reduction

59
Q

true or false… Extra-capsular pathology results in mandibular deflection on protrusion.

A

false

60
Q

true or false… capsulitis and synovitis have the same clinical presentation

A

true

61
Q

degenerative joint disease in the early stages will result in ___

A

a scratchy noise (crepitus)

62
Q

Local inflammation of the outer fibrous layer is ___

A

capsulitis

63
Q

Local inflammation of the inner synovial longing is ___

A

synovitis

64
Q

in some cases, ___ is the only way to diagnose chronic disc dislocation

A

MRI

65
Q

A patient with normal opening that is painful and that has had this problem for less than two weeks should….

A

receive oral appliance therapy

66
Q

A patient with a primary headache should ___

A

be considered for oral appliance therapy

67
Q

Temporal headaches may be due to ___

A

(a and b)

clenching

grinding

68
Q

Disc displacements results in ____

A

(all of the above)

clicking of the TMJ during opening

clicking of the TMJ during closing

a normal range of movement

69
Q

true or false… the cold spray technique is used as a diagnostic aid in patients with limited opening

A

true

70
Q

true or false… intra-capsular pathology results in the patient being able to open wider with mild passive force

A

false

71
Q

The ADA has adopted ___ AAOP guidelines for the evaluation and treatment of TMD

A

Okeson’s

72
Q

Approximately ___ of patients can tolerate the mandible retruded to its most superior position

A

15%

73
Q

Coincidence between centric relation and centric occlusion occurs in __ of the population

A

15%

74
Q

It is currently agreed that the normal position is to have the condyles positioned ___

A

superanteriorly

75
Q

bite registration methods include…

A

(all of the above)

the TENs bite

the swallow bite

the phonetic “S” bite

76
Q

The disadvantage of the TENs bite is that the bite is taken ___

A

with decreased muscle tonus

77
Q

The “S” sound…

A

(a and b)

produces a patent airway

corrects the mediolateral occlusal cant

78
Q

taken properly, the neuromuscular bite results in….

A

substantial vertical change in the maxillomandibular relationship

79
Q

Correcting the cant of the plane of occlusion is ____

A

essential in restoring equal muscle length

80
Q

The swallow bite is ___

A

(a and b)

affected by inflammation

more of a vertical correction than AP correction

(it is NOT highly reliable)

81
Q

a poetic “S” bite registration…

A

(all of the above)

gives the limit of AP movement

has the mandible forward of the habitual bite

has the mandible level

82
Q

An Aqualizer is used to…

A

reduce nociceptive input

83
Q

The phonetic “S” bite….

A

(all of the above)

it not subject to the patients will

results in higher freeway space than after swallowing with the mandible in a relaxed position

is reproducible

84
Q

A phonetic “S” bite is best taken with…

A

reduced novicpetive input to the brain

85
Q

during the phonetic “S” bite registration, the patient counts from ____

A

66-77

86
Q

When applying bite registration material for a phonetic “S” bite, it should be ___

A

first applied to the anterior teeth

87
Q

Depending upon the space, ___ can be used as a separating device during bite registration.

a microbrush

a disposable three-way syringe

a disposable saliva ejector

one of the above

A

one of the above

88
Q

Prior to taking the patient’s bite, ___

A

(a and b)

The CEJ to CEJ distance should be measured

the overbite should be measured

89
Q

true or false… all bite registrations record a static position

A

true

90
Q

true or false… when making an AP correction, it is important to understand the limit for this without increasing muscle tonus.

A

true

91
Q

True or false… All patients complaining of sleep disorders or pain disorders should be treated with appliances.

A

false

92
Q

True or false… all patients with TMDs and headaches can be treated with oral appliances

A

false

93
Q

Long-term stabilization can be achieved using

a - overlay partial dentures

b - orthodontics

c - fixed prosthodontics

d - combinations of a, b, and c

A

d - Combinations of a, b, and c

94
Q

Day positioned appliances are intended for ___

A

therapeutic appliance therapy

95
Q

An orthotic appliance is ____

A

(all of the above)

used to restore function

used to reduce symptoms

used to restore all injured components back to their original dimensions

96
Q

The goals of orthotic appliance therapy for patients with disc displacement are….

A

(all of the above)

to provide the best possible condyle-fossa relationship at the time of treatment

to decompress the capsular inflammation

to restore proper muscle length bilaterally

97
Q

A splint is…

A

(all of the above)

rigid or flexible

used to maintain a displaced or mobile part in position

used to keep an injured part in place or protected

98
Q

Wearing orthotic appliances for long periods of time (long-term)….

A

can lead to changes in the position of the teeth

99
Q

true or false.. Anterior bite planes spread the force of the elevator muscles over a larger area than other anterior programmers.

A

true

100
Q

The goal of the OD 1 is….

A

(all of the above)

to create proper spacing between the condyle and fossa

to enable room for tissue movement and disc repositioning

to change the ligamentous relationships

101
Q

True or false.. the objective of the OD 1 is to recapture all discs

A

false

102
Q

true or false… compact and labial bow OD 1s may increase patient comfort

A

true

103
Q

The Olmos Day Positioned orthotic is indicated for….

A

(a and b)

chronic dysfunction of intra-capsular origin (disc displacement)

skeletal and muscular asymmetry

104
Q

Patients must be instructed…

A

(all of the above)

that the OD 1 is a functional appliance

that the appliance must be worn during all waking hours

how to clean the appliance

105
Q

True or false… the use of an anterior bite plane may result in the development of undesired dental and osseous changes

A

true

106
Q

Swallowing without wearing functional daytime appliances will ___

A

produce symptoms

107
Q

An OD3 appliance is indicated instead of an OD 1 appliance if…

A

(all of the above)

the patient is allergic to metals

the arch form is very narrow

there is less than 1.5mm of space inter-occlusally

108
Q

If an appliance does not fit, it may be due to…

A

(b and c)

poor impression or distorted models

improper or inadequate adjustments upon delivery

109
Q

For a day orthotic intended to have only centric contacts…

A

(a and b)

all protrusive interferences must be removed

all non-working interferences must be removed

110
Q

true or false… centric tomograms should be taken after placement of an orthotic to check positioning.

A

true

111
Q

If the position was correctt but the patient complains that he or she is only hitting on one side…

A

the side where the patient is not hitting should be relined

112
Q

the ON 4 appliance is ___

A

all of the above

113
Q

True or false… perter and Gross found the repositioning therapy would reduce trauma to the distal ligament

A

true

114
Q

The benefit of condyle-fossa positioning is…

A

(all of the above)

relief of joint pain

relief from tinnitus

correction of dysfunctional. posture

115
Q

True or false… CT scans can be used to view condyle positioning

A

true

116
Q

Indications for night orthotics include…

A

(all of the above)

clenching or grinding at night

sleep interrupted by temporal headaches

episodes of bruxism

117
Q

The anterior deprogrammer (ON 1) is designed to ____

A

(all of the above)

reduce nocturnal clenching and grinding

change the fulcrum of the elevator muscles

reduce the patients ability to forcefully close

118
Q

The Olmos Night Positioner is indicated for ____

A

(all of the above)

patients who lock in the supine position

stretched capsular and distal ligaments

to augment a day orthotic appliance

119
Q

The ON 3 orthotic appliance ….

A

(all of the above)

holds the mandible forward by using a circular ramp

has a round hole that lets air pass to the oropharyngeal airway

improves the airway

120
Q

The ON 3 orthotic appliance can be used in patients with…

a - inflammation of the joint capsule

b - airway obstruction

c - clench or grind their teeth

A

any combination of the above

121
Q

About ___ Americans suffer from a sleep problem.

A

70 million

122
Q

___ of men with moderate to severe obstructive sleep apnea have not been clinically diagnosed.

A

82 percent

123
Q

Sleep-disorder breathing can be categorized as ___.

A

(all of the above)

snoring

upper airway resistance syndrome

OSA

124
Q

A person is considered to have OSA if…

A

a complete cessation of breathing occurs at least 30 times during 7 hours of sleep

125
Q

Cardiovascular symptoms associated with OSA are…

A

(all of the above)

systemic hypertension

coronary and ischemic heart disease

stroke

126
Q

true or false… sleep bruxism may occur as a result of OSA

A

true

127
Q

Sleep bruxism is defined as…

A

An oromotor movement disorder

128
Q

Risk factors for obstructive sleep apnea include ___

A

(all of the above)

obesity

anatomic abnormalities of the upper airway

male gender

129
Q

A general measure that can help if a patient is suffering from OSA is ___

A

(all of the above)

to lose weight

to sleep on your side

to avoid alcohol two or three hours prior to sleeping

130
Q

Oral appliance therapy is recommended for patients with ____

A

(a and b)

Mild OSA

moderate OSA

131
Q

Success rates using oral appliance therapy to treat OSA are as high as ___

A

76%

132
Q

true or false… Boil-and-bite appliances specifically address the occlusal and TMJ relationship.

A

false

133
Q

Guessing which patients may benefit from airway dilator therapy ____

A

is dangerous and can result in over-titration

134
Q

The position for optimal airway patency can be determined ___

A

(a and b)

using a pharyngometer

using a rhinometer

135
Q

The TAP2 T-TL appliance…

A

(all of the above)

allows for 25mm of lateral freedom

can be adjusted AP

can produce disc dislocation

136
Q

The Silencer ____

A

(a and b)

allows for vertical adjustments

allows for AP adjustments

137
Q

true or false… Appliance therapy is always a complete alternative to CPAP.

A

false

138
Q

The OASYS Oral Airway System…

A

(all of the above)

Consists of a lower appliance

consists of an upper splint

is a mandibular repositioned and nasal dilator

139
Q

Non-adjustable appliances…

A

(a and b)

hold the mandible in a fixed position

are non-adjustable

140
Q

The key to success in oral appliance therapy is….

A

(all of the above)

appropriate patient selection

appropriate appliance selection

diligent case management

TMD (2 decks)

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