TMD Flashcards
Typical age range?
20-40
T or F: More common in women?
True
What are the classifications of TMD?
Muscle disorders (45.3%), disc displacements (41.1%), Joint disorders (30.1%)
What are some of the causes of TMD?
poor occlusion, trauma, parafunction/bruxism, ligamentous hyperlaxity, posture, psychological stress
What are the four major components of the TMJ?
- TMJ disc
- Inferior joint space
- Superior joint space
- Retrodiscal pad
Articular disc attachments
posterior: temporal bone through a section of loose retrodiscal tissue
anterior: capsule and superior lateral pterygoid muscle
TMJ ligaments
Collateral ligs
stylomandibular ligament
sphenomandibular ligament
Suprahyoid muscles (3)
Digastric
Mylohyoid
Stylohyoid
Infrahyoid muscles (3)
Omohyoid
Thryrohyoid
sternohyoid
Is the TMJ a synovial joint?
Yes! and it follows the rules of a typical synovial joint
For every mm of lateral exursion you get how many mm of opening?
4 mm (same with 1 mm of protrusion= 4 mm of opening)
T or F: You should treat the C spine in a patient with TMD.
True
What kind of joint problem is present if the eye and mouth angle are elevated on the same side?
Craniovertebral problem
Craniomandibular if opposite eye and mouth angle are elevated
What are the MOST important muscles to palpate with TMD?
Masseter (intra and extra oral), Medial pterygoid, Temporalis, Superior pharyngeal constrictor (intra oral- pterygoid mandibular raphe with buccinator)
What are the important points of the pain map of Rocabado?
4 points of palpation: ant/post and sup/inf synovium
4 ligament joint stress test: TM lig, LCL, posterior lig, retrodisc insertion of post lig
What are the most important clinical signs and symptoms in TMD ?
muscle and joint pain, limitations in mandibular movt, and joint sounds
TMJ manual therapy
Long axis distraction
Lateral glides
myofascial mobilizations- deep head of the masseter, buccal wall/superior pharyngeal constrictor
What is the dosage for therEx for the TMJ exercises such as controlled opening or hyperboloid?
6x/day/6 reps each time
When instructing a patient in self mobs with the tubing for TMJ dysfunction, do you instruct them to move toward the side of pain or away?
Away- this may limit your TherEx options for pts with bilateral pain.
From the Wright’s article on TMD: when should you refer a pt with TMD pain to a dentist?
Nocturnal pain
Hot/cold sensitivity
Spontaneous throbbing pain
Throbbing pain that awakens during sleep
