TMD

Question 1

What are the Rocabado 6x6?

Answer 1

the 6 fundamental components of activity for TMD treatment
1. Tongue clucking
2. Controlled TMJ rotation on opening
3. Mandibular rhythmic stab/isometrics
4. Upper Cervical distraction
5. axial extension of the cervical spine aka chin tucks
6. Shoulder retractions

Question 2

How it TMD caused?

Answer 2

Caused by overstretching of the posterior ligaments, which allows progressive anterior posi5oning of the ar5cular disc

Question 3

Explain the biomechanics of TMJ opening

Answer 3

2 parts, rotation and translation

1. initial opening is caused by posterior rotation of the condyle on the articular disc
2. Then, the mandibular condyle and the disc translate on the mandibular fossa, anteriorly via the lateral pterygoid

Question 4

Explain the biomechanics of closing.

Answer 4

Posterior translation of the condyle and disc followed by rotation

eccentric contraction of the lateral pterygoid and relaxation of the disc tissue help cause this.

Question 5

Name is this muscle opens or closes the TMJ: Temporalis

Answer 5

Closes

Question 6

Name is this muscle opens or closes the TMJ: Digastric

Answer 6

Opens

Question 7

Name is this muscle opens or closes the TMJ: Masseter

Answer 7

Closes

Question 8

Name is this muscle opens or closes the TMJ: Medial pterygoid

Answer 8

closes

Question 9

Name is this muscle opens or closes the TMJ: inferior lateral pterygoid

Answer 9

Opens

Question 10

Name is this muscle opens or closes the TMJ: Hyoids - stylohyoid, geniohyoid & mylohyoid

Answer 10

Opens

Question 11

Name the muscles that close the TMJ

Answer 11

Temporalis, Masseter, Medial Pterygoid

Question 12

Name the muscles that open the TMJ

Answer 12

Gravity
Diagastric, lateral pterygoid, hyoids (stylohyoid, geniohyoid, mylohyoid)

Question 13

what muscles are involved in lateral deviation?

Answer 13

Ipsilateral temporalis and contralateral pterygoids (medial and lateral)

Question 14

what muscles protrude the TMJ?

Answer 14

masseter, pterygoids

Question 15

WHat muscles are involved in retrusion of the TMJ?

Answer 15

Temporalis, digastric, suprahyoids - stylo, genio, mylo

Question 16

Explain the pathophysiology of Disc displacement with reduction.

Answer 16

When the ar5cular disc is displaced enough to cause joint dysfunc5on, the mandibular condyle has to slide over the disc to open crea5ng joint sounds, causing pain and restric5ng mo5on.

In early‐stage displacement this cracking or clicking sound will occur early during mouth opening and (poten5ally) late in mouth closing. The disc isn’t as far anterior as it can be in later stages so the joint sound is earlier. This is referred to also as ‘Anterior Disc displacement with reloca5on’ – because the mandible is ‘reloca5ng’ on opening or ‘disloca5ng’ on closing in rela5on to the disc.

In late‐stage displacement this cracking or clicking sound will occur late during mouth opening and (poten5ally) early in mouth closing. The disc is further anterior as than it was in the early stage so the joint
sound is later in the mo5on. This is referred to also as ‘Anterior Disc displacement with reloca5on’ – because the mandible is ‘reloca5ng’ on opening or ‘disloca5ng’ on closing in rela5on to the disc