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BDS 4 > TMD > Flashcards

TMD Flashcards

1
Q

What are TMD?

A

A cluster of musculoskeletal disorders of the masticatory system that share many common symptoms. Characterised by jaw and face pain, temporal headaches, referred ear symptoms, limited opening, TMJ clicking, crepitus and locking. Usually fluctuates with time.

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2
Q

What does TMD not include?

A
  1. Iatrogenic trauma or infective causes
  2. Neuropathic pain
  3. Neoplasia
  4. Non-parafunctional tooth wear
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3
Q

What are the different classification of TMDs?

A
  1. Joint pain
  2. Joint disorders
  3. Joint disease
  4. Fracture
  5. Congenital development disorders
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4
Q

What are different classification of masticatory muscle disorders?

A
  1. Muscle pain
  2. Contracture
  3. Hypertrophy
  4. Neoplasm
  5. Movement disorders
  6. Systemic related conditions
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5
Q

What is Dr. Wilkinsons classification of TMD?

A
  1. Masticatory muscle disorders (75% of all TMD)
  2. Hypertranslation (less than 10%)
  3. Synovitis (15%)
  4. Internal derangement (15%)
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6
Q

What are previously held believes about the cause of TMD?

A
  1. Occlsuion was the main factor - it is not, this is an old believe which has no merit

2.

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7
Q

What are some factors that may be associated/contributing with TMD to look out for?

A

Take these with a grain of salt because it is sort of the chicken or the egg question:

  1. Anterior open bite, overjet > 6-7 mm
  2. Unilateral maxillary lingual crossbite
  3. Missing posterior teeth > 5 or 6
  4. CO-CR slides > 2mm

In general, occlusion has minimal impact on TMD.

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8
Q

What some indications of TMD?

A

2 minute exam:

  1. Lateral pole terderness
  2. Limitations of opening
  3. Clicking
  4. Jaw muscle pain
  5. Active facets

If any of these two are positive findings, please schedule a thorough examination.

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9
Q

What should you ask when taking history of potential TMD?

A

PHECLFTPT

  1. Pain history
  2. Headaches
  3. Ear symptoms
  4. Clicking
  5. Limitation of opening
  6. Function
  7. Trauma history
  8. Parafunction
  9. Treatments
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10
Q

What are the parts of TMD examination?

A
  1. Range of movement examination
  2. Clicking assessment
  3. Palpation of TMJ, muscle of mastication, digastric, sternomastoid, coronoid process
  4. Occlusal assessment
  5. Appliances assessment
  6. Diagnostic images and tests
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11
Q

What are the symptoms of muscle issues only?

A
  1. Muscle and temporal pain
  2. Tired masticatory muscles
  3. temporalis headaches
  4. Sore teeth/gums
  5. Tooth soreness and wear
  6. Cheek/tongue biting
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12
Q

What are the symptoms of tmj hypertranslation?

A
  1. Click over eminence
  2. Open hesitation
  3. Open locking
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13
Q

What are the symptoms of synovitis?

A
  1. Lateral pole tenderness
  2. Limited opening
  3. Ear symptoms
  4. TMJ pain on function
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14
Q

What are the symptoms of TMJ form deviation?

A

A matched reciprocal clicking

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15
Q

What are the symptoms of degenerative joint disorders?

A
  1. TMJ crepitus
  2. Irregular TMJ radiograph
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16
Q

What is post-exercise muscle soreness?

A

It is acute muscle pain and stiffness that arises the day after unaccustomed exercise or acute overuse. Such as: excessive chewing, talking, bruxism, playing muscial instrument and long dental visits.

17
Q

What is myofacial pain?

A

It is a chronic muscle condition of unknown origin resulting in regional pain. It usually has trigger points.

18
Q

What are some of the diagnostic way we can diagnose sleep bruxism?

A
  1. PSG (polysanography) scoring using RMMA (rhythmic masticatory muscle activity) is gold standard
  2. Tooth wear with no other causes
  3. Soft tissue trauma
  4. Masseter hypertrophy
  5. Waking with transient pain, fatigue, limitation and headaches
19
Q

What factors are associated with bruxism?

A
  1. genetic factors
  2. Psychological factors
  3. Neurochemical factors - clonazepam/diazepam reduce bruxism
20
Q
A

BDS 4 (21 decks)

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