TMJ

Question 1

What is the TMJ?

Answer 1

The articulation between the mandible , the articular disc and temporal bone
The disc divides the joint into an upper and lower joint
The upper joint is a gliding joint
The lower joint is a hinge
Motion can occur in all 3 axis
Can get arthritis here (the articulating disc) if they chew on one side because of dental issues or pain (routine and habit)

Question 2

Resting position

Answer 2

Teeth are slightly separated
Freeway space
If not space: Could be orthodontic
Problem or Psychosocial issue (clenching mouth or grinding)

Question 3

Motions of the TMJ

Answer 3

Depression –mouth opening
Mandibular elevation-mouth closing
Centric occlusion-the state of maximal contact of the teeth in mouth closing
Protrusion-anterior translation
Retrusion-posterior translation
Lateral excursion-right and left

Question 4

Reinforcement of the TMJ

Answer 4

Temporomandibular ligament
Restricts mouth opening
Posterior ligament: open is slacked and when closed is tight
Anterior ligament: restrict mouth opening (snakes don’t have this)
These two ligaments give us problems!!!!

Question 5

Testing mandible depression and protrusion

Answer 5

Mouth opening
Place cervical spine in neutral
Head should be stable
Ask patient to open mouth
Should be pain free
Watch for deviations
Measure
Use millimeter or centimeter
Edge of incisors (front teeth) from top and bottom
Usually only one side (rarely bilateral)
Looking for symmetry
IF there isn’t symmetry: muscle, ligament, disc, or deformity on one side OR hypermobility of the other side

Answer 6

Right and keft
Place cervical spine in neutral
Head should be stable
Ask patient to open mouth
Should be pain free
Watch for deviations
Measure
Use millimeter or centimeter
Center of upper incisors to center of lower incisor
Boney deformity (birth problem) (surgery)
Tendinitis or synovitis
Modification of diet (easy to eat)
Lose body due to a fracture (surgery)
Mechanics of chewing