TMJ Flashcards
Functional relationship between maxillary and mandibular teeth: BLOCKAGE
Occlusion
Grinding
Bruxism
Overactive masseter and
temporalis resulting in increased compressive force between teeth
Clenching
Space b/w occluding surfaces of teeth when the mandible is in physiologic resting position
Freeway space (FWS)
how big is freeway space
2-4 mm
- determined by the portion of the mandibular center incisor that is covered by the maxillary center incisor
when the mandible is in the maximally occluded position
*normal range: 1/3 of manibular center incisor
overbite
*vertical
determined by the horizontal distance between the
maxillary arch and the mandibular arch when the
mandible is in its maximally occluded position
overjet
normal range of overjet
3-6 mm
Mandibular teeth sit further anterior than maxillary teeth
under bite
an occlusal irregularity where the mandibular teeth and maxillary teeth are not in line with
the center incisors (i.e., either arch may shift to the
lateral side during occlusion). This type of occlusal
disharmony often may or may not affect the TMJ.
crossbite
The TMJ is a __ joint lined with ____
synovial lined with fibro cartilage
In full occlusion, molars are in approximation but front
teeth do not touch
open bite
*mm that has eccentric control of disc, only muscular attachement to disc
superior head of lateral pterygoid
___ cavity is relevant for anterior translation of the condyle
superior cavity
____ cavity is relevant for rotation
inferior cavity
The lateral pterygoids are very important because
superior portion attaches directly to the disc
switch between rotational movement and translatory movement in TMJ
TMJ ligament (then blends into capsule laterally)
___ branch of trigeminal nerve
mandibular branch (cranial nerve V3)
TMJ opening arthrokinematics
anterior roll (in first 20-25 mm of motion) with inferior/anterior slide
arthrokinematics of lateral deviation
ipsi rotation
contra condyle horizontal translation
___ mm is functional
35
normal ROM for opening
40-60 mm
intercusupation is also called
closing
lateral deviation norms
1/4 of opening, or about 10 mm
Protrusion/Retrusion norms
- 5-10 mm protrusion
- 3 mm retrusion
habits that lend to misuse overuse of TMJ
Clenching/grinding of teeth (Over-activation of
masticatory muscles)
* Gum chewing
* Other oral fixation
PARAFUNCTIONAL HABITS
HIGH PREVALENCE of ____ with TMJ, and also correlated with high disability
chronic pain (esp fibromyalgia)
difference between ADDwR and ADDwoR
-ADDwR: clicking/popping
-ADDwoR: no clicking, limitation with opening (blocking condylar head) OR disc is so anteriorly displaced that no limitation
Group 1 diagnostic classification of TMD
1a: normal opening
1b: limited opening
Group 2 diagnostic classification of TMD
2a: disc displacement with reduction
2b: disc disp. w/o reduction WITH limited opening
2c: disc disp. w/o reduction WITHOUT limited opening
Group 3 diagnostic classification of TMD
joint dysfunction
3a: arthraliga
3b: osteoarthritis
3c: osteoarthrosis
super important associated conditions with TMD!
HEADACHES
NECK PAIN
others:
-ear stuff
-dizziness
-swallowing/speech dis
-trigeminal neuralgia
-post herpetic neuralgia
-meniere’s disease
-
What is the cotton roll test?
if pain decreases: joint related
to confirm: test nonpainful side –> this will compress the painful side, will tell you PAIN = JOINT
more pain -> mm
mandibular neurodynamic testing sequence
capital cervical flexion
upper contralateral SB
lateral glide of mandible
MDNT used if you suspect neural origin of pain
what is a test to identify discal issues?
CRPT: centric relation provocation test
*if pain is recreated anterior to tragus, indicates structural pathology of disc complex
