TMD Flashcards
TMJ VS TMD
tmj - the joint; everyone has
tmd- the dysfunction; not everyone has
orofacial pain
pain in face and jaw/mouth region
Orofacial pain classifications
- primary headache/non cervicogenic headache
- TMJ dysfunction
- Masticatory Muscle Disorder
- Cervicogenic headache
The TMJ has two joint compartments… explain the movement for each compartment
superior - slides/translation
inferior - rolls/rotates
what are the ROM norms for TMJ
what muscles perform TMJ movements
what category of tmj issues has a reciprocal click
disc derangement with reduction
what category of tmj issues has no clicking (two noted issues)
disc derangement without reduction
myofascial disorder
what category of tmj issues has a history of hypermobility?
disc derangement with reduction
what category of tmj issues is the “hypomobile stage”
disc derangement without reduction
which category of tmj issues has opening to 25-35mm? what about >50 mm
25-35 = disc derangement without reduction
> 50 = hypermobile/sublux
what category of tmj issues is positive for CONTRALATERAL pain with forced biting?
inflammatory conditions
what category of tmj issues is positive for IPSILATERAL pain with forced biting?
myofascial disorder
what category of tmj issues has a loud clunk/popping sound, the feeling of it being out of place, and open locking?
Hypermobility/Sublux
explain overbite vs overjet
overbite: how far overlapping the front teeth are over bottom teeth; frontal plane 1/3 mandible incisor
overjet: how far anterior top teeth sit over bottom (3-6mm) ; transverse/sagittal plane
what is a quick way to test functional opening?
3 knuckles test- you should be able to fit 3 knuckles in mouth
opening to lateral excursion rhythm
4:1
TMJ “rhythm”
first 11mm condylar rotation
Deviations & Deflection
C- curve: hypomobility; reduction of disc
S - curve: muscle imbalance
Deflection: deviates towards less mobile side
T or F: measuring opening is the only measurement to discriminate between those with and without TMD
TRUE
forced biting provocation test (cotton roll test) and interpretation
looking for increased symptoms
ipsilateral pain = muscle/tendon irritation
contralateral pain = joint
can modalities be used in isolation for TMD ?
no, they are complementary for symptom relief
How fat apart should teeth be in resting position
2-3 mm
what should you avoid with TMD ?
- uncontrolled yawning
- gum chewing
- nail biting
- resting chin in hands
- stomach sleeping
how much sleep should you get?
7-8 hours
what should be strengthened and what should be lengthened in everyone for better posture?
strengthen - DCF, cervical extensors, scapular retractors
lengthen - scalenes, pecs, SCM, suboccipitals
treatment for joint mobility
mobs
PROM / AROM w caution
treatment for joint inflammation
protection , ice, ionto
- parafunctions
- chewing
- ROM
treatment for disc or articular dysfunction
address impairments of joint pain and reduced ROM
CONSERVATIVE TX WONT SIGNIFICANTLY HELP
DDwoR - educate patient abt remodeling phase, noise and motion should normalize over time
treatment for TMD pain
exercise
diaphragmatic breathing
stress reduction technique
relacation of mandibular mm
Rocabado 6x6 Exercises
- Nasal Breathing - 6 breaths
- Controlled Opening
- Mandibular Rhythmic Stabilization
- Upper Cervical Distraction: OA nodding
- Axial Ext of Cervical Spine (chin tuck)
- Shoulder Girdle Retraction (w thor ext)
Theory of Condylar Remodeling
normalize forces between disc and musculature
- co-contraction enhances stabilization
wheh youre laterally deviating, it will gap and glide the condyle anteriorly while the disc remains in place
