TMD

Question 1

Blood supply to the TMJ

Answer 1

deep auricular atery - branch of 1st maxillary arterty

Question 2

Nerve supply of TMD

Answer 2

auricotemporal, massentericc, posterior (deep) temporal nerve

Question 3

What zone in the TMD feels pain

Answer 3

the bilaminar zone - prevents complete detachement, brings condyle back, overtime starts to lose collagen fibres

Question 4

Causes of TMD

Answer 4

degernative diseases - osteoarthritis, RA
myofasical pain
disc displacement - anterior +/- reduction
ankylosis
hyperplasia - one condyle grows more than other
neoplasia
infection

Question 5

Anterior dislocation with reduction

Answer 5

when pt brings jaw back they can hear a click

Question 6

Anterior dislocation without reduction

Answer 6

if bilaminar stops working, there is no reduction and pt cannot open widely as dislocated anterior

Question 7

signs of parafuction

Answer 7

cheek biting
tongue scalloping
occusal NCTSL
linea alba (white lines on cheek)

Question 8

What is normal mouth opening

Answer 8

42-55mm

Question 9

Tx for TMD

Answer 9

advise soft diet
avoid stressors
no chewing gum
no wide opeing
no biting fingernails
cut food into small pieces
support mouth on opeing
jaw exercises (physio)
massage
heat and cold
ultrasound
TENS
Drugs - gabapentin, amitriyptaline
Bite raising appliance
TMJ surgery

Question 10

Functions of a bite appliance

Answer 10

eliminates occusal interference
reduces loading on TMJ
prevents jaw head from rotating so far posteriorly in glenoid fossa

Question 11

What are the splint types

Answer 11

Soft acylic splint
Hard acrylic splint - difficult to wear and can get caught in undercuts
(please construct upper/lower soft occulsal splint, full coverage as prevents overuption of 7’s)

Question 12

Where is botox for TMD injected into to

Answer 12

Masster muscle

Question 13

What are the symptoms of TMD

Answer 13

jaw and face pain
earache
headache
jaw locking
limited mouth opeing
pain radiating along cheek or down neck
jaw joint noise