Temporomandibular Disorders – 13% 7Q Flashcards
A TMJ problem after debanding may indicate
CR / CO discrepancy
Name the 3 types of condylar movements
rotation/hinge
translation
In Posselt’s envelope, what is the last closing movement ?
Hinge
describe the disc position of the TMJ in a patient with closed lock
anterior disc displacement without reduction
limited opening (~23mm)
describe the disc position of the TMJ when the patient is in open lock
the condyle is entrapped in front of the lagging disc and cannot slide back under the fossa
the mandible can only be dislocated (posteriorly/anteriorly)
anteriorly
Normal maximum opening is ___ - ___ mm
50 - 60mm
You can induce _________ due to anterior disc displacement after 30 min of reduction (opening)
clicking
anterior disc displacement (is/is not) a common symptom of TMD
is not
during anterior disc displacement, the posterior border of the disc will thin and the inferior restrodiscal lamina is elongated resulting in the condyle articulating on the _____________ border of the disc instead of the _______________ zone.
posterior
intermediate
referred TMD pain travels toward the _________ and can cause what symptom?
head (cehpalad direction)
headache
Innervation of the TMJ include two branches on cranial nerve ___. Also name the 2 branches.
V3
Auriculo-temporal, masseteric
what type of joint is the TMJ? clue: it is bi-arthrodal
ginglymoarthroidial
TMJ is a __________ joint where the articular surface is lined by a thin ___________ membrane
synovial
synovial
The articulating surface of the condyle is covered with _______________, which may be associated with chondrocytes
dense fibrous CT
The superior joint compartment of the TMJ provides _______________ movement
translational
The inferior joint compartment of the TMJ provides ____________ movement
rotational
the glenoid fossa is lined with ?
hyaline cartilage / fibrocartilage
does the glenoid fossa undergo remodeling?
yes, and this can affect the position of the chin
what happens to the glenoid fossa with age?
it gets deeper
what is the major area of adaptation and compensation of the Mn?
Ramus
The degenerative joint disease osteoarthritis will present clinically as: (3)
sudden change in occlusion
open bite
pain
what is the most important cardinal symptom of TMD?
limited opening
What are the subjective cardinal symptoms of TMD?
Pain – does not cross midline (psychogenic)
Limited opening *most important
Noise
What are the objective cardinal symptoms of TMD?
ADD
locking
condylar dislocation
what is a symptom?
something a patient notices. Are subjective and open to individual interpretation
what is a clinical sign?
an abnormality a health care professional notes during an examination. More subjective and usually confirm symptoms the patient describes
what 3 things are myofacial pain dysfunction related to?
occlusion
trauma
physiologic factors
what is the primary etiology of TMD?
parafunctional habits
unlike other joint discs, the TMJ disc is made of
fibrous CT
others are hyaline
the the condyle is 2x larger in the _________ dimension than in the _____________ dimension
transverse
AP
moving dentition from CR → CO will ( inc / dec ) the VDO
increase
who has more prevalence of TMD: general population or orthodontic population? whose study?
they are the same
Sadowsky and BeGole
TMD affects which sex more?
females
IF TMD is stress related, patients are also likely to present with
trismus and muscle spasms
anatomically, TMD is due to
pathology or derangements
Treatment for TMD consists of: (3)
Flat appliance for muscle relaxation (guards)
Stress management
Physical therapy
the Pancherz Herbst study showed that TMD
increased for 3 months then returned to normal
Joint sounds found in ___% of the population
25%
Smith and Freer studied TMD in Ext vs Non-Ext patients and found:
no significance in rate of soft clicks
T/F: Larsson and Ronnerman said that ortho can be preformed without fear of creating TMD
True
Gianelli found no difference in condylar position in ext vs non-ext groups but Dibbets and VanDerWeele found increased clicking in:
4Bi ext group
mandible will deviate to (affected / non-affected) side upon opening
affected
what condition of a large salivary gland can mimic TMJ?
Parotitis
