Temporomandibular Joint Disorder Flashcards
what part of the joint feels pain
bilaminar zone which gets compressed by the condyle
what are the causes of TMD
myofascial pain
disc displacement
degenerative disease
chronic recurrent dislocation
ankylosis
hyperplasia
neoplasia
infection
what are the types of disc displacement
anterior with reduction
anterior without reduction
what is anterior with reduction disc displacement
it can slip back to its place
what is anterior without reduction disc displacement
it cannot slip back
what localised degenerative disease causes TMD
osteoarthritis
what generalised degenerative disease causes TMD
rheumatoid arthritis
how do you treat chronic recurrent dislocation
put thumbs on the buccal sulcus and push down and back
how can you tell if a patient has hyperplasia of the condyles
one grows more than the other and there will be facial asymmetry with the jaw pointing away from where it is happening
what is the pathogenesis of TMD
inflammation of muscles of mastication
trauma
stress
psychogenic
occlusal abnormalities
what are you looking for when examining the TMJ
clicks and crepitus
what does crepitus indicate
arthritic change
what is assessed intraorally
interincisal mouth opening
signs of parafunctional habit
MoM
what are the signs of parafunctional habit
cheek biting
linea alba
tongue scalloping
occlusal non-carious tooth surface loss
what radiographs can be used for TMD
OPT
CT
MRI
TRANSCRANIAL VIEW
NUCLEAR IMAGING
ARTHROGRAPHY
ULTRASOUND
what are the clinical features of TMD
female
18-30yrs
intermittent pain of months/years
muscle/joint/ear pain on wakening
trismus/locking
clicking/popping noises
headache
crepitus
what are the differential diagnoses for TMD
dental pain
sinusitis
ear pathology
salivary gland pathology
referred neck pain
headache
atypical facial pain
trigeminal neuralgia
angina
condylar feature
temporal arteritis
what patient education is given for TMD
counselling
avoid chewy foods, soft food diet, gum shields
electromyographic recording
jaw exercises
what medication can be given for TMD
NSAIDs
muscle relaxants
tricyclic antidepressants
botox
steroids
what counselling is given to the patient for TMD
reassurance
soft diet
masticate bilaterally
no wide opening
no chewing gum
dont incise food
cut food into small pieces
stop parafunctional habits
support mouth on opening
what physical therapy can given for TMD
physiotherapy
massage/heat
acupuncture
relaxation
ultrasound therapy
TENS
hypnotherapy
what splints can be given for TMD
wenvac splint
hard acrylic lower jaw splint
anterior repositioning splint
what are the functions of bite raising appliances
stabilise occlusion and improve function of masticatory muscles thereby decreasing abnormal activity
what irreversible treatment can be done for TMD
occlusal adjustment
TMJ surgery
