TMJ

Question 1

TMJ ROM

Answer 1

Full opening: 40-60mmLateral deviation: 8-12mmProtrusion: 3-6mm

Question 2

To which surface of the joint is the disc more attached to?

Answer 2

Convex surface of the mandibular condyle

Question 3

What are the disc’s medial/lateral attachments?

Answer 3

Medial collateral ligaments and lateral collateral ligaments connect the disc to the medial and lateral poles of the condyle

Question 4

What are the disc’s posterior attachments?

Answer 4

The disc is continuous with the posterior attachment

Question 5

What are the disc’s anterior attachments?

Answer 5

The disc is attached to the joint capsule and the superior lateral pterygoid

Question 6

What type of joint is the TMJ and what motions does it do?

Answer 6

Modified hinge; Anterior gliding and hinge-like rotation

Question 7

What are the two phases of mouth opening?

Answer 7

Phase 1: First 10-15mm, rotation occurs in this phase.Phase 2: After 15mm, the head of the mandible and the articular disc glide anteriorly.

Question 8

What is functional opening?

Answer 8

About 40mm

Question 9

What muscles contribute to mouth closing?

Answer 9

TemporalisMasseterMedial pterygoid

Question 10

What muscles contribute to protrusion?

Answer 10

Medial pterygoidLateral pterygoid

Question 11

What muscles contribute to retrusion?

Answer 11

Posterior fibers of temporalis

Question 12

What muscles contribute to mouth opening?

Answer 12

Lateral ptyergoid
Digastric
Stylohyoid
However, gravity does most of the work here.

Question 13

TMJ joint noises and what they might mean

Answer 13

Clicking: disc dysfunction and/or hyper mobility
Grinding: arthritis

Question 14

3 diagnostic categories

Answer 14

Joint abnormalities
Congenital structure abnormalities
Idiopathic loss of functional mobility

Question 15

Synovitis and capsulitis s/sx

Answer 15

Pain in the pre auricular area
Unable to close back teeth together
Openning

Question 16

TMJ hypermobility s/sx

Answer 16

“my jaw feels like it’s going out of place”
Joint noises
Joint catching while in the open position
Mandibular depression >40mm and deviation toward the noninvolved side
Palpable irregularities with closing

Question 17

Disc displacement with reduction s/sx

Answer 17

Popping and clicking with mouth opening and closing

Reciprocal click

Question 18

Disc displacement without reduction s/sx

Answer 18

Intermittent locking w/o joint noises
Opening limited to 20-25mm with deflection toward involved side
Limited lateral excursion toward the contralateral side

Question 19

Treatments for TMJ dysfunction

Answer 19

Postural reeducation
Modalities for pain
Inflammation reduction
Biofeedback
Joint mobs
AROM and muscle strengthening
Edu re: eating soft foods, decreasing habits that stress the TMJ, maintaining the rest position of the tongue