TMJ

Question 1

What type of joint is the TMJ?

Answer 1

Bilateral synovial joint

Question 2

What surfaces articulate in the TMJ?

Answer 2

Mandibular condyle and glenoid fossa

Question 3

What does the TMJ play an essential role in?

Answer 3

Speaking and eating

Question 4

What is the mandibular glenoid fossa?

Answer 4

• Depression in the temporal bone in which the mandibular condyle sits in to form the TMJ.

Question 5

What is the articular eminence of the temporal bone?

Answer 5

Gentle slope of bone covered in cartilage.

Question 6

What type of bone is the Condyle?

Answer 6

Dense cortical bone covered in dense fibrous connective tissue.

Question 7

What are the bony landmarks of the TMJ?

Answer 7

Mandibular glenoid fossa
Articular eminence of temporal bone
Mandibular condyle

Question 8

What 3 ligaments give passive stability to the TMJ?

Answer 8

Temporomandibular lateral ligament
Stylomandibular ligament
Sphenomandibular ligament

Question 9

Non bony components of the TMJ?

Answer 9

Articular capsule
Synovial tissue
Articular disc
Ligaments

Question 10

What is the articular capsule?

Answer 10

Fibrous membrane surrounding the joint and attaches to; articular eminence, articular disc and neck of mandibular condyle

Question 11

What is the articular disc?

Answer 11

Fibrous extension of the capsule that runs between and articulates with the glenoid fossa and mandibular condyle

Question 12

What shape is the articular disc?

Answer 12

Biconcave disc shape; the condyle sits in the depression

Question 13

What are the functions of the ligaments involved with the TMJ?

Answer 13

Temporomandibular ligament limits extreme wide opening and lateral movements
Accessory ligaments limit border movements of mandible

Question 14

Where does the stylomandibular ligament run to and from?

Answer 14

Styloid process to angle of mandible

Question 15

Where does the sphenomandiblar ligament run to and from?

Answer 15

Spine of sphenoid bone to lingula of mandible.

Question 16

Where is the temporomandibular ligament located and what are the 2 parts?

Answer 16

Thickened lateral portion of capsule
Outer oblique and inner horizontal

Question 17

In which ways can the mandible move?

Answer 17

Depression and elevation
Lateral deviations
Protrusion and retrusion

Question 18

What are the 3 axis of rotation in the TMJ?

Answer 18

Horizontal
Frontal
Sagittal

Question 19

Which axis is used when the mandible moves up and down?

Answer 19

Horizontal

Question 20

What axis’ are involved in lateral movements of the mandible?

Answer 20

Frontal
Sagittal

Question 21

What happens during the first 20mm of jaw opening?

Answer 21

Mandible rotates on horizontal axis whilst the articular disc stays in place

Question 22

What happens if jaw opening exceeds 20mm?

Answer 22

The articular disc elongates and slides forward. The condyle is then able to glide over the articulating eminence to allow for full opening.

Question 23

What is the most common form of TMD?

Answer 23

Myofascial pain - discomfort/pain in muscles that control jaw function as well as neck and shoulder.

Question 24

What is degenerative joint disease in the TMJ?

Answer 24

Osteoarthritis or rheumatoid arthritis

Question 25

Three main categories of TMD?

Answer 25

Myofascial pain
Internal derangement
Degenerative joint

Question 26

What are the symptoms of TMJ disorders?

Answer 26

• Headaches, earaches and pressure behind eyes
• Clicking or popping sound on opening and closing
• Pain when opening mouth widely
• Lock jaw
• Trismus; limited opening

Question 27

What treatment options are available for TMJ disorders?

Answer 27

• Jaw exercises
• Hest compression
• Soft diet
• Pain relief/muscle relaxants
• Biteguard or splint if ongoing
• Botox
• Last resort; surgery

Question 28

How may dislocated jaw occur?

Answer 28

Trauma or yawning

Question 29

What are the symptoms of dislocated jaw?

Answer 29

• Pain in front of ear that gets worse with movement
• Bite feels ‘off’
• Problems talking
• Unable to close mouth causing drooling
• Lock jaw that protrudes forward

Question 30

What is trismus?

Answer 30

When an individual is unable to open their mouth more than 35mm

Question 31

What can trismus occur in a result of?

Answer 31

• Long dental appointments
• After ID block
• Trauma
• Oral surgery
• Infection
• Cancer
• Radiation treatment of head and neck

Question 32

Implications of trismus?

Answer 32

Difficult for;
- Patient to maintain oral hygiene
- Patient to eat
- Clinicians to treat

Question 33

Treatment options available for trismus?

Answer 33

• Stretching exercises
• Soft diet
• Time
• Threaded tapered screw appliance