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BDS4 ORAL SURGERY > TMJ Disorder > Flashcards

TMJ Disorder Flashcards

1
Q

what are some different names for TMJ dysfunction?

A
  • TMJ dysfunction
  • Myofascial pain dysfunction
  • Pain dysfunction syndrome
  • Facial arthromyalgia
  • Costen’s syndrome
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2
Q

what is the blood supply of the TMJ?

A

deep auricular artery (branch of 1st part of maxillary artery)

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3
Q

what nerves supply the TMJ?

A
  • auriculotemporal
  • masseteric
  • posterior (deep) temporal nerve
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4
Q

what part of the articular disc of TMJ is innervated?

A

area in the bilaminar zone

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5
Q

What are examples of degenerative diseases that cause TMD?

A
  • osteoarthritis (localised)
  • rheumatoid arthritis (generalised/systemic)
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6
Q

What are causes of TMD?

A
  • myofascial pain
  • disc displacement
  • degenerative diseases
  • chronic recurrent dislocation
  • ankylosis
  • hyperplasia
  • neoplasia
  • infection
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7
Q

What are the types of disc displacement that can cause TMD?

A
  • anterior with reduction (disc returns to original place)
  • anterior without reduction (disc does not return to original place, stuck in front of condyle permanently)
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8
Q

what are examples of neoplasia that can cause TMD?

A
  • osteochondroma
  • osteoma
  • sarcoma
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9
Q

what is ankylosis of TMJ?

A

TMJ is totally fused to base of skull, no jaw movements

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10
Q

how does hyperplasia of TMJ present?

A

One condyle grows more than the other
- patients have a facial asymmetry

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11
Q

What is the pathogenesis of TMD?

A
  • inflammation of MOM
  • trauma of joint
  • stress
  • psychogenic
  • occlusal abnormalities
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12
Q

Why might the muscles of mastication be inflamed?

A

parafunctional habits

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13
Q

What areas of social history may contribute to TMD?

A
  • occupation
  • stress
  • home circumstances
  • sleeping pattern
  • relationships
  • habits
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14
Q

what are some intra-oral signs of parafunctional habits?

A
  • cheek biting
  • linea alba
  • tongue scalloping
  • occlusal NCTSL
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15
Q

what are common clinical features of TMD?

A
  • females > males
  • age 18-30y/o
  • intermittent pain of several months or years
  • muscle / joint/ ear pain
  • trismus/locking
  • clicking popping joint noises
  • headaches
  • crepitus
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16
Q

what does crepitus indicatr?

A

late degenerative changes

17
Q

what conditions are sometimes confused as being TMD?

A
  • dental pain (third molars)
  • sinusitis
  • ear pathology
  • salivary gland pathology
  • referred neck pain
  • headache
18
Q

what reversible treatment is involved in treating TMD?

A
  • patient education
  • physical therapy
  • medication
  • splints
19
Q

what medications are used to treat TMD?

A
  • NSAIDs
  • muscle relaxants
  • tricyclic antidepressants
  • masseter botox
  • steroids
20
Q

What advice would you give to a patient with TMD to help improve their condition?

A
  • reassurance
  • soft diet
  • masticate bilaterally
  • no wide opening
  • no chewing gum
  • don’t incise foods
  • cut food into small pieces
  • stop parafunctional habits
  • support mouth on opening (e.g yawning)
21
Q

what are some examples of physical therapy that may be used to help treat TMD?

A
  • physiotherapy
  • massage/heat
  • acupuncture
  • relaxation
  • TENS
  • hypnotherapy
22
Q

what types of splints may be used to treat TMD?

A
  • bite raising appliances
  • anterior repositioning splints
23
Q

what is a specific name of splint that can help TMD by raising the bite?

A

Wenvac splint

24
Q

what irreversible treatment is sometimes involved in treating TMD?

A
  • occlusal adjustment (rare!)
  • TMJ surgery
25
Q

what different types of TMJ surgery are there?

A
  • arthrocentesis
  • arthroscopy
  • disc-repositioning surgery
  • disc repair/removal
  • high condylar shave
  • total joint replacement
26
Q

How might patients with internal derangement of the TMJ present?

A

painful clicking of TMJ

27
Q

what is the most common cause of TMJ clicking?

A

anterior disc displacement with reduction

28
Q

Explain the movement involved in anterior disc displacement with reduction?

A
  • disc initially displaced anteriorly to the condyle during opening
  • as jaw opens, condyle slides down but is blocked by this disc
  • patients will hear a loud pop (painful usually) and this is the disc slipping back behind condyle
  • jaw now free to move normally
29
Q

what are the signs/symptoms of anterior disc displacement with reduction?

A
  • jaw tightness/locking
  • mandible may initially deviate to affected side before returning to midline
30
Q

What can happen if anterior disc displacement with reduction is left untreated?

A

it can eventually progress to osteoarthritis

31
Q
A

BDS4 ORAL SURGERY (16 decks)

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