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4 - oral surgery > tmd > Flashcards

tmd Flashcards

1
Q

What are some different names for TMD?

A

Temporomandibular dysfunction
Myofascial pain dysfunction
Pain dysfunction syndrome
Facial arthromyalgia
Costen’s syndrome
TMJ

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2
Q

Name the suprahyoid muscles

A

Digastric
Mylohyoid
Geniohyoid
Stylohyoid

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3
Q

Name the common causes of TMD

A

Myofascial pain
Anterior disc displacement with reduction
Anterior disc displacement without reduction
Localised degenerative disease
Generalised degenerative disease

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4
Q

What are some problems that may manifest as TMD?

A

Chronic recurrent dislocation
Ankylosis
Hyperplasia
Neoplasia
Infection

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5
Q

What factors can lead to the pathogenesis of myofascial pain as TMD.

A

Inflammation of muscles of mastication or TMJ secondary to parafunctional habits
Trauma
Stress
Psychogenic factors

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6
Q

Name the infrahyoid muscles

A

Omohyoid
Thyrohyoid
Stylohyoid
Sternohyoid

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7
Q

What steps are involved in the assessment of TMD?

A

Complaint
HPC
PH
PMH
PDH
SH
Examination

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8
Q

What aspects are examined during the extra-oral assessment for TMD?

A

Muscles of mastication
Joints (for clicking or crepitus)
Jaw movements
Facial asymmetry

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9
Q

What aspects are examined during the intra-oral assessment for TMD?

A

Inter incisal mouth opening
Signs of parafunctional habits
Muscles of mastication

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10
Q

What special investigations can be considered for TMD when pathology is suspected?

A

OPT
CT/CBCT
MRI
Nuclear imaging
Arthography
Ultrasound

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11
Q

What are some common clinical features of TMD?

A

Affects females more than males
Affects ages 18-30 most commonly
Intermittent pain of several months or years duration, Muscle/joint/ear pain
Trismus/locking
Clicking/popping noises
Headaches
Crepitus

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12
Q

Name 4 conditions that should be considered in the differential diagnosis of TMD?

A

Dental pain
Sinusitis
Ear pathology
Salivary gland pathology
Referred neck pain
Headache
Atypical facial pain
Trigeminal neuralgia
Angina
Temporal arteritis

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13
Q

What are the treatment options for reversible TMD?

A

Patient education
Counseling
Jaw exercises
Physiotherapy
Medications (NSAIDs, muscle relaxants, tricyclic antidepressants, Botox, steroids)
Physical therapy (massage/heat, acupuncture, ultrasound therapy, hypnotherapy)
Splints (Bite raising appliances, anterior repositioning splint)

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14
Q

What is the purpose of bite raising appliances in TMD treatment, and how do they work?

A

Bite raising appliances stabilize the occlusion, improve masticatory muscle function, and protect teeth from grinding.
The exact mechanism is unknown, and there’s limited scientific evidence to support their use.

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15
Q

What does counseling for TMD involve?

A

Reassurance
Soft diet
Masticate bilaterally
Avoid wide opening
Avoid chewing gum
Refrain from incising foods
Cut food into small pieces
Stop parafunctional habits (e.g - nail biting, grinding)
Support the mouth during opening (e.g - yawning)

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16
Q

What treatment options are available for irreversible TMD?

A

Occlusal adjustment (rarely done)
TMJ surgery

17
Q

Name the different types of TMJ surgery

A

Arthrocentesis
Arthroscopy
Disc-repositioning surgery
Disc repair/removal
High condylar shave
Total joint replacement

18
Q

What is anterior disc displacement with reduction in TMD, and what are the signs and symptoms?

A

The most common cause of TMJ clicking
The disc is initially displaced anteriorly during opening but reduces
Signs/symptoms include jaw tightness, locking, and the mandible may deviate to the affected side before returning at opening

19
Q

What can cause trismus in TMD, and how is it managed?

A

Trismus can result from trauma such as IDB, prolonged dental treatment, or infection
Management may involve physiotherapy, Therabite, or a jaw screw if it doesn’t resolve spontaneously

20
Q

What is a common manifestation of disc displacement in TMD

A

Painful clicking

21
Q

Describe the cause of joint clicking in the TMJ

A

Lack of coordinated movement between the condyle and articular disc in the TMJ

22
Q

What are the different classifications of TMJ clicks?

A

Early
Middle
Late

23
Q

How is anterior disc displacement with reduction in the TMJ treated?

A

Counselling
Limiting mouth opening
Using a bite raising appliance
Surgery may be required in severe cases

24
Q

Name 3 causes of trismus from trauma in the TMJ?

A

IDB
Prolonged dental treatment
Infection

4 - oral surgery (19 decks)

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