TMJ Flashcards
70% of TMJ disorder involve
mal positioning of the disc (internal derangement)
primary pathology of TMJ is
osteoarthritis/osteoarthosis
anatomy of TMJ
Modified ball and socket
Synovial joint
Temporal bone
Condyles of Mandible
Loosened capsule for movement
Disc (meniscus)
Attached more to mandible
what artery run behind TMJ
middle meningeal artery, supply dura
muscle of TMJ
Temporalis
Masseter
Pterygoid
Hyoid muscles
which muscle is powerful in biting
temporalis
which muscle is the main muscle involve in chewing
masseter
role of lateral pterygoid
– When both sides work together they push chin out and/or depress the chin. Unilaterally they produce side to side chin movements.
role of medial pterygoid
Helps to elevate and close the jaw. Working together they protrude the mandible, working unilaterally it produces a grinding motion.
TMJ biomechanics in opening and closing
Opening
Anterior roll and anterior glide of the condyle
Closing
Posterior roll and posterior glide
which joint doesn’t follow convex concave rule
TMJ
normal opening of the mouth and normal daily use
Normal opening is 35-55 mm ( 2 or 3 fingers in the mouth)
Normal daily use requires 25-35 mm
history question with TMJ
Grinding teeth
Clicking, locking, popping
Pain with functional movement of the jaw
Recent dental work
Surgeries
Medical conditions- lymph node swelling, tonsillitis, sinus infections
Hearing and balance issues
Headaches
profil of nose breather
alert eyes
jaw and cheekbone definition
higher CO2
parasympathic relaxation
deeper sleeper
spine support
good tongue posture
lower bp
alpaca whisperer
profil of mount breather
tired eyes
restless sleep/snoring
set back jaw
leaning forward
poor head posture
narrow palate
lower CO2/O2
higher blood pressure
stress activation
normal anatomical position of TMJ
: Normal anatomical position of articulating disc with respect to condyle and surfaces of articulation
ID-reducing of TMJ
Anteriorly displaced disc returning to normal anatomical position upon maximal opening (Wilkes Stage II-early Stage III).
ID-Non-reducing TMJ
Anteriorly displaced disc during closed and maximal opening positions with disc thickening present (Wilkes late Stage III-Stage IV).
Wilkes stage to classifying ID
Stage I- painless clicking in early opening and late closing with unrestricted motion
Stage II- occasional pain with clicking, intermittent locking, orofacial pain
Stage III- frequent orofacial pain, as locking becomes more frequent and mandibular becomes restricted
Stage IV- contours begin to change, chronic pain and restricted mandibular opening
Stage V- similar to stage 4 but with more severe symptoms (chronic pain, crepitus, significant ROM restrictions)
whaat is Bell’s palsy
Damage or inflammation of the CN VII (Fascial)
Sudden paralysis of one side of your face, causing it to droop
S/s of bell palsy
Drooling
Eye problems, such as excessive tearing or a dry eye
Loss of ability to taste
Pain in or behind your ear
Numbness in the affected side of your face
Increased sensitivity to sound
TMJ functionnal movement
Biting
Chewing
Swallowing
Coughing
Talking
what can restricted the opening of TMJ
muscle spasm, disc displacement
what does a click with opening mouth means
Click- condyle slips over the disc and then self reduces
Later then click in movement, better chance jaw may get locked
what does crepitus of TMJ means
Possible OA
Possible disc displacement
what is Chvostek sign
Used to help determine if there is a pathology of the 7th cranial nerve (facial)
Tap the parotid gland overlying the masseter muscle
Positive: facial muscles twitch
cervical spine effecting joint what can flexion and extension indicate
Flexion – posterior neck muscles tighten and mandible gets pulled up and forward
Extension – the mandible gets pulled down and backward
Can the patient go through full neck flexion and extension with the mouth closed?
