TMJ Flashcards
Intra-articular hydraulic manipulation of the temporomandibular joint is indicated for patients with: (A) internal derangement. (B) disc perforation. (C) fibrous ankylosis. (D) chronic subluxation.
A
A 40 year-old female presents with 18 month history of right preauricular pain, opening click at approximately 20 mm of opening, slight deviation of the mandible to the right with maximal interincisal opening of 32 mm. Success of arthroscopic surgery in this setting is: (A) 35-45%. (B) 55-65%. (C) 75-85%. (D) 95%-100%.
C
Pharmacological management of chronic myofascial pain dysfunction involving the facial musculature could include:
(A) 30 mg of amitriptyline every evening.
(B) 50 mg of dopamine twice daily.
(C) 30 mg of carbamazepine every evening.
(D) 50 mg of gabapentin twice daily.
A
The most important principle in total TMJ alloplastic reconstruction is:
(A) three weeks of mandibular immobilization to prevent micromotion.
(B) removing the coronoid process for improved range of motion.
(C) maintaining occlusal relationships.
(D) primary stability of the device to the native bone.
D
Which of the following is accurate pertaining to the use of a customized alloplastic total temporomandibular joint in a patient with a failed proplast teflon implant?
(A) (B) (C) (D)
Contraindicated due to foreign body giant cell reactions Provides best option for anatomic reconstruction
Not predictive for long-term functional stability Predictable in relieving pain and restoring function
B
Lasting reduction in temporomandibular disc displacement:
(A) has not been convincingly demonstrated long-term.
(B) is benefitted significantly by lower joint space lavage.
(C) depends significantly on altering synovial viscosity.
(D) varies in accord with the degree of osteoarthritis.
A
The most common long-term complication of discectomy for the treatment of TMJ internal derangement is: (A) ankylosis. (B) facial nerve injury. (C) condylar remodeling. (D) chronic pain.
C
Internal derangement of the TMJ which presents as a chronic closed lock is most effectively managed by what surgical procedure?
(A) Arthrocentesis
(B) Arthroscopic lysis and lavage
(C) Arthrotomy with disc repositioning
(D) Discectomy and disc replacement with cartilage
B
The major advantage of the modified condylotomy procedure over open arthrotomy in treating internal derangements of the TMJ is that:
(A) the condylotomy procedure is more likely to reduce the disc.
(B) the condylotomy procedure is performed outside the capsule.
(C) open arthrotomy procedures require more frequent re-operation.
(D) the modified condylotomy produces a more rapid return to normal function.
B
An 18 year-old patient presents with the development of a sudden, severe limitation of opening to only 18 mm. If medications and bite splint therapy fail to alleviate the symptoms the next step to consider is: (A) arthrocentesis. (B) open arthrotomy. (C) alloplastic joint replacement. (D) physical therapy.
A
The pain of trigeminal (V) neuralgia:
(A) has been duplicated by lesioning V ganglia of experimental animals.
(B) is associated with complaints of numbness and deep sensory loss.
(C) is triggered by non-noxious stimuli, and pain outlasts the stimulus.
(D) is characterized by throbbing pulsations and contralateral spread.
C
The generally accepted surgical treatment for temporomandibular joint osseous ankylosis is:
(A) narrow gap arthroplasty with aggressive manipulation.
(B) high condylectomy.
(C) wide gap arthroplasty with interpositional grafting.
(D) osteotomy at the angle level.
C
The most common indication for use of a total TMJ prosthesis is in patients suffering from:
(A) ankylosis.
(B) multiple previous surgeries.
(C) the effects of temporomandibular joint trauma.
(D) temporomandibular joint tumors.
B
Molecular level research suggests which of the following as possibly useful in the early management of temporomandibular joint dysfunction? (A) Disc repositioning (B) Discectomy (C) Condylotomy (D) Arthrocentesis/arthroscopic lavage
D
Interleukins and cytokines are intra-articular agents thought to affect temporomandibular joint function through: (A) encouraging ligamentous healing. (B) producing joint pain. (C) counteracting deleterious agents. (D) inciting osteolysis.
B
