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Disease Affecting TMJ

name 3 disorders of TMJ joint myofascial pain+dysfunction (MOD) internal derangement syndrome osteoarthritis+rheumatoid arthritis *benign+malignant tumors can also affect TMJ
what is the TMJ articulation b/t condyle of mandible +glenoid fossa of temporal bone highly specialized
what divides the space into an upper and lower joint space? articular disk
what nourishes and lubricates avascular surfaces? synovial membrane lines joint and produces synovial fluid
what is the articular disk is attached? hint: 3 locations to lateral+medial aspects of condyle superior belly of lateral pterygoid muscle to joint capsule
(T/F) disk and bony surfaces are muscular? False. they are avascular
how are muscle spasms or dysfunctional muscle activity determined if they are occurring? palpation of mastication muscles
name the 6 muscles of mastication? masseter, temporalis, medial pterygoid, lateral pterygoid, anterior digastric, mylohyoid
what are the 3 elevator muscles? masseter, medial pterygoid, temporalis
where does the mandibular condyle rest during max. occlusal contact? glenoid fossa
where is the articular disk situated during max. occlusal contact? between the condyle, roof of glenoid fossa, articular eminence
what is the first phrase of opening characterized by? rotational (hinge) movement of condyle followed by anterior translation (sliding)
how does the disk move during translation? posteriorly
what are TMDs caused by? abnormalities in function of either joint or associated structures
who are TMD signs and symptoms mroe frequently and severly seen in? women, other adults
what percentage does TMD-related jaw pain, dysfunction or both affect? 5%
what could be the causes of dysfunction? disorders of muscles, mastication or internal derangements of components of joints
what are 3 parts to the evaluation? history, examination, imaging
what factor has been suggested to be the most likely cause of TMD? trauma
iatrogenic resulting from the action of a healthcare provider
iatrogenic causes indiscriminate use of corticosteriod injection into joint
what are the classification of trauma affecting TMJ? direct(assault), indirect(whiplash injury), secondary to parafunctional habits (clenching, Bruxism)
types of imaging used to determine condyle shape and if degenerate joint disease exists: panoramic, tanscranial, tomography, computed tomography, magnetic resonance imaging, arthrography
3 types of TMD myofasical pain+dysfunction internal derangements arthritis
what do popping and clicking most commonly reflect? disk displacement w/ reduction
comprehensive exam TMJ related includes: exam of joint, muscles of mastication, oral cavity, cervical spine
arthrogenous joint related
mnyogenous muscle related
why is tomography used? >accuracy in assessing condylar position_randge of mobility
why is computerized tomography used? most accurate for identifying bone abnormalities
why is magnetic resonance imaging used? mandatory for examining disk position, function, morphology, presence of joint effusions (inflammation changes)
why is arthrography used? utilizes radiopaque contrast agent injected into joint
myofascial pain and dysfunction 50% all TMD dysfunctional muscle hyperactivity w/ regional pain, tenderness in affected muscles+ variable amounts of reduced opening +complains of maloocclusion
disk displacement with reduction displaced anteriorly and returns to normal position when the mouth is opened or movement is away from affected side
disk displacement without reduction acts as obstacle to sliding condyle pt. complain: intermittent locking of jaw, lmtd mouth opening, assoc. w/ cessation of joint sounds, deflection of mandible, w/ midline correction upon opening+restricted lateral excursive movements away from affctd sit
3 parts of internal derangements displacements, ankylosis, hypermobility disorders
ankylosis immobility of condyle b/c fibrous/bony union b/t articulating surfaces classified: tissue (fibrous, bony) location (intra/extra-articular) extent of fusion (complete, incomp.) joint infect.after trauma=50%cases
hypermobility disorders- dislocation one or both of condyles translates anterior to articular eminence-->open lock, pt. can't reduce
hypermobility disorders- subluxation pt. can relocate mandible back into glenoid fossa
arthritis classifications osteoarthritis and rheumatoid arthritis
what is arthritis? inflammation of the joint
osteoarthritis *most common disease affecting TMJ degenerative changes of cartilage pt. pain symptoms worse in evening, lmtd opening, muscle splinting, crepitus
rhematoid arthritis 50-70% have TMJ involvement inflammatory, immunologic disorder of joints pt. pain symptoms worse in morning, lmtd opening, occlusal changes, preauricular edema+tenderness
Tx of TMD nonsurgical, surgical, multidisciplinary
nonsurgical Tx (phase 1) pharmalogic+physical therapy, moist heat, soft mechanical diet, streching pain meds., muscle relaxants, antianxiety (reduce musclehypertonicity) occlusal adj. may be preformed
goals of nonsurgical Tx improving function (range of motion) + reducing pain
nonsurgical Tx (phase 2) occlusal appliances, relax muscles, protect dentition+joint, biofeedback so pts aware of bruxing, relieving load of disk
surgical Tx for pt. w/ TMD other than MPD if they dont respond to nonsurgical therapy
surgical tx- arthrocentesis involves lavaging joint through needle
surgical tx-arthroscopy allows direct visualization and manipulation of joint
surgical tx-condylectomy involves surgical repositioning of needle
surgical tx-open joint surgery used to preform disk reconstruction w/ prosthetic device or autogenous graft
multidisciplinary management pt. may require referral to specialists (neurologist, otolaryngologist)
fact about osteogenic sarcoma one of the most commonly occurring malignant bone tumors
fact about synovial chondromatosis most common benign neoplasm of synovium
name 4 of the most common benign tumors osteochondroma, osteoblastoma, chondroblastoma, osteoma
Created by: 100000001783325
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