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Oral Med > TMJ > Flashcards

TMJ Flashcards

0
Q

What is para function?

A

Purposeless oro mandibular movements

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1
Q

What is the stomatoghnathic system?

A

TMJ
Muscle
Occlusion

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2
Q

What are examples of para function?

A

Bruxism,
Check biting
Nail biting

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3
Q

Bruxism can be…

A

Day or night

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4
Q

Most people brux during?

A

The day 30%

Night time 7-10%

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5
Q

What is the aetiology of bruxism?

A

Habit
Concentration
Stress
Sleep disorder

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6
Q

What are the TMJ disorders?

A 
Growth and development 
Trauma
Neoplasm
Arthritis
Degenerative
TMD
Dislocation 
Ankylosis 
Internal derangement
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7
Q

What is an example of a grower abnormality of TMJ?

A

Condylar hyperplasia
Condylar aplasia
Condylar Hypoplasia

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8
Q

What is an example of a traumatic injury to TMJ?

A

Fracture of condyles
Guards man
Fracture of body
Fracture of ramus

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9
Q

Why us an example of a condylar neoplasm?

A

Benign or malignant but are rare
Primary tumours of TMJ are less than 1% of head and neck tumours usually metasteses from 5B’s

Osteoma
Chondroma
Chondrosarcoma
Metastatic

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10
Q

Give an example of a degenerative diseases of TMJ

A

Osteoarthritis
RA
JA

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11
Q

Give an example of an inflammatory disease of TMJ

A

Inflammatory arthritis

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12
Q

What are the features of osteoarthitis? And symptoms

A

Beaking : oesophytes
Flattening: of condylar head
Cysts: subchondral Ely cysts

SSE
Sclerosis of glenoid fossa
Subchondral sclerosis (eburnatjkn)
Erosion of articular surface of condylar head

Chronic pain, crepitus, difficulty in chewing

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13
Q

How does RA of TMJ present?

A 
Flattening of condylar head
Erosion and destruction of condylar surface
Occasional oesophytes 
Hollowing of gelonoid fossa
Reduced range of movement 
Usually bilateral and symmetrical
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14
Q

What is TMD?

A

A narrow spectrum of relatively non specific disorders that affect the TMJ and or MOM

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15
Q

What are the primary symptoms of TMJ?

A 
Pain and muscle or joing
Click
Limitation
Grinding
Pain from joint capsule, restrodiscsl tissues muscles 
Locking
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16
Q

What are the secondary symptoms of TMJ?

A

Otalgia
Vertigo
Headache
Low grade tinnitus

17
Q

What is the prevalence of TMD?

A

Affects all ages
M and f same
Most commonly in young adults peak 20-40
20-75%of people have symptoms but only 2-4% have treatment

18
Q

What is the aetiology of TMD?

A 
Trauma
Bruxism
Occlusion
Stress
Idiopathic

BIOPSYCHOSOCIAL: biological, psycho and social

19
Q

What is the diff diagnosis of TMD?

A 
Related structure pathology eg teeth, patoid ENT
Neuralgia
Intra cranial lesions
Cervical pain
Vascular eg temporal arterits 
Somatic presentation of psychiatric 
Diseases of salivary gland 
Headaches
20
Q

What is the treatment for TMD?

A

Physical: massage, heat compress, yoga, homeopathy, US, acupuncture
Drugs: NSAIDS, anxiolytics, muscle relaxants, anti depressant
Occlusal splint
Psychological
Surgery
Acupuncture
Placebo

21
Q

What should the normal painless Maximal opening be?

A

40-55mm

22
Q

What can happen in patients with TMJ when they open their mouth?

A

Deviation p

23
Q

What is internal derangement?

A

Localised mechanical fault innTMJ which interferes with its smooth action

24
Q

What sign may indicate risk of internal dereangemtn?

A

Clicking

This is because the disk may become abnormally shaped and displaced and may act as a door stop

25
Q

What are the symptoms of ineffective arthritis?

A 
Pyrexia
Systemic upset
Swelling 
Erythema
Suppuration
Very restricted mouth opening
26
Q

What is ankylosis ?

A

Abnormal,al union across a joint space

27
Q

What type of tissue may form the union in ankylosis?

A

Fibrous or bony

28
Q

What are the two groups of ankylosis ?

A

Extracapsular and intra capsular

29
Q

What are the causes of extra capsular ankylosis?

A
  1. Trauma eg laceration leading to peri articular fibrosis
  2. Chronic interested infection next to the joint
  3. Tumours fibro sarcoma and chondrosarclma
  4. Peri articular fibrosis: irradiation or prolonged immobilisation of the jaw
30
Q

Why are the causes of intrscapsular ankylosis ?

A

Trauma: intra capsular, condylar fracture, penetrating wound and forceps delivery at birth
Infection: otitis media, mastoiditis, osteomyelitis, pyogenic arthritis
Tumour: osteoma, chondroma, osteosarcoma, sarcoma, fibro sarcoma, synovial sarcoma,
Misc: synovial chondromatosis

31
Q

What are the surgical options for TMJ ?

A

Arthroscopy and arthocentesis
High condylar shave
Eminectomy
Joint replacement

32
Q

What is arthocentesis?

A

Lavage of the joint

33
Q

What is an eminectomy?

A

Cut of: to enable joint to slide freely

Build up: stops translational movement

34
Q

What are the signs which would make you suspicious of a tumour?

A 
New signs of TMD in patient more than 60
Lymph involvemtn 
Cranial nerve dysfunction
Trismus
Anosmia
Objective ipsilateral hearing loss
35
Q

What are the imagine options for TMJ?

A 
DPT
PA
CT
MRI
NM
36
Q

When would we do a DPT?

A

Patient present with trimsus and take open and closed view

37
Q

When would we take a PA jaws?

A 
Fracture 
Cysts 
Tumour
Mandib hypo and hyperplasia 
Maxillofackal deformations
38
Q

When would we do a CT?

A

Looks at hard and soft tissue
Shape and condition of condyle, fossa and articular eminence
Position shape and integrity of disk
Nature of condylar head disease

39
Q

When would we do an MRI?

A

Assessment of soft tisse
Good when looking at position and from of disk in open and closed views and when diagnosis of internal dereangemtn possible and pre op before disc sugery

41
Q

When would we take a radiosotope ?

A

Use technetium 99mTc and will get into areas of active bone growth as well as salivary glands, thyroid, blood liver, lung and heart,

42
Q

WHere does the manidble deviate towards the side of when there is a problem?

A

it will deviate towards the side of derangment eg the side that has the problem

Oral Med (31 decks)

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