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Sympsoiums yr2 > 24- Joints and TMJ > Flashcards

24- Joints and TMJ Flashcards

1
Q

What does the articulatory system consist of?

A
  1. The hinge (TMJ)
  2. The motors (Muscles)
  3. The contacts
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2
Q

What are the 3 zones of the fibrous disc?

A 
PB = posterior border
IZ= Intermediate border
AB = Anterior border
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3
Q

What are the three layers that lie behind the fibrous disc

A
  1. Superior retrodiscal lamina (elastic)
  2. Retrodiscal fat pad
  3. Inferior retrodiscal lamina (collagen)
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4
Q

What is the major muscle in TMD?

A

Lateral pterygoid as its superior portion is attached to the head of the condyle and the articular disc

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5
Q

Where is the temporalis origination and insertion?

A

Originates from the articular eminence and inserts onto the coronoid process of the mandible

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6
Q

Which muscle elevates and retracts the mandible?

A

Temporalis

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7
Q

Which muscle Elevates and protrudes the mandible?

A

Lateral pterygoid

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8
Q

Which muscles depress the mandible?

A

Gravity

  • digastric
  • geniohyoid
  • mylohyoid
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9
Q

What are the 3 different types of definitions of centric relation?

A
  1. anatomical
  2. geometrical
  3. physiological
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10
Q

What is the anatomical definition of centric relation?

A

position of the condylar head when fully seated in the glenoid fossa

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11
Q

What is the geometrical definition of centric relation?

A

by means of posselts envelope, anywhere between R and RCP, (mandible just rotating)

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12
Q

What is the physiological definition of centric relation?

A

Position where the muscles are doing the least amount of work

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13
Q

What does RCP stand for?

A

Retruded contact position

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14
Q

What does ICP stand for?

A

Intercuspal position

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15
Q

What does E stand for?

A

Edge to edge position of incisors

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16
Q

What does Pr stand for?

A

Maximum protrusion

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17
Q

What does T stand for?

A

Maximum translation of condylar head/maximum mandibular opening

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18
Q

What does R stand for?

A

Maximum mandibular opening with the condylar heads still in glenoid cavity

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19
Q

What type of things would you record on the occlusion record?

A
  • Skeletal base relationship
  • Angle relationship
  • First tooth that touches central relation
  • difference in RCP and ICP
  • canine guidance? group function?
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20
Q

What are the 3 main categories of temporomandibular disorders?

A
  1. Myalgia/myofascial pain
  2. Disc displacement
  3. Joint degeneration
21
Q

What is myalgia/myofascial pain?

A

Report of pain or ache in the jaw, temples, face, preauricular area or inside the ear. PLUS this pain can be felt on palpation of one of the major muscles of mastication

22
Q

What are the 2 types of disc displacement?

A
  1. With reduction

2. Without reduction

23
Q

What does disc displacement with reduction mean?

A
  • The disc is displaced anteriorly but reduces back into place making a clicking sound
24
Q

What does disc displacement without reduction mean?

A

Disc is displaced anteriorly but does not return back to normal

25
Q

What is joint degeneration?

A

Degenerative disorders of the join in which joint form and structure are abnormal e.g. arthrosis

26
Q

What type of model of illness is TMD described as?

A

Biopsychosocial model of illness

27
Q

What is bruxism

A

A parafunction which involves grinding/clenching of the teeth

28
Q

What are the 2 types of bruxism?

A

Wake bruxism

Sleep bruxism

29
Q

What is wake bruxism?

A

Habit in response to anxiety

30
Q

How do we identify sleep bruxism?

A
  • sleep study
  • third party witness
  • cheek ridging
  • tooth wear
  • tongue scalloping
  • ask patient questions
31
Q

What can we do about sleep bruxism?

A
  • stablisation
  • splint
  • CBT
  • Physiotherapy
  • warm compress
  • soft bite guard
  • ibuprofen
  • NTI device
  • Anterior repositioning splint
  • Arthrocentesis
32
Q

What are the 3 main splints to consider?

A
  1. stabilisation splint
  2. B splint
  3. Anterior repositioning splint
33
Q

What are some more mild splints?

A
  • soft splint

- local occlusal interference splint

34
Q

What does a stabalisation splint do?

A

help patients with masticatory muscle pain by reducing:
-pain intensity
-muscle tenderness
and allowing mouth opening to increase

35
Q

What are some key features of a stabilisation splint?

A
  • made in centric relation (when muscles doing least amount of work
  • created in ideal occlusion
  • made from hard acrylic (less likely to be chewed)
36
Q

What is needed to make a stabilisation splint?

A
  1. Alginate impression
  2. Centric relation jaw registration
  3. Facebow record
37
Q

What is a B-splint?

A

A smaller splint with localised pressure covering the anterior 6 teeth

38
Q

What splint covers only the anterior 6 teeth?

A

A B-splint

39
Q

What is an anterior repositioning splint?

A

A splint which creates more space in the joint capsule therefore allowing the disc to move and gradually moves back into place due to elastic fibres

40
Q

In what TMD is an anterior repositioning splint used?

A

Disc displacement WITH reduction

41
Q

How long does an anterior repositioning splint need to be worn for?

A

24/7 for 3 months

42
Q

What does CBT stand for?

A

Cognitive Behaviour Therapy

43
Q

What is CBT?

A

It is a way of talking about:

  • how you think about yourself, the world and other people
  • how what you do affects your thoughts
44
Q

How can CBT help

A

Helps “how you think” (COGNITIVE) and “what you do (BEHAVIOUR) and helps you focus on the here and now problems to improve your current state of mind

45
Q

What is Arthocentesis?

A

A clinical procedure of removing arthritic waste products from joint capsule to help disc move more smoothly (removing synovial fluid from synovial joint)

46
Q

What patients is arthrocentesis used on?

A

Patients with disc displacement WITHOUT reduction

47
Q

What treatment is given to patients with disc displacement with reduction?

A

Anterior repositioning splint

48
Q

What treatment is given to patients with disc displacement without reduction?

A

Arthrocentesis

Sympsoiums yr2 (27 decks)

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