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Flashcards in LOL TMD Deck (91):
1

Inflammation of the capsule ligaments with Joint soreness and inflammation

Capsulitis

2

What is the most common TMD diagnosis?

Capsulitis

3

Irritation to the Synovial Fluid, similar to Capsulitis

Synovitis

4

Bone inflammation, wear and tear arthritis

Ostoearthritis

5

Osteoarthritis is the most common due to...

overuse

6

Clicking and Popping are due to...

Internal Derangement

7

Every Arthritis can be in the _____

2 most common systemic arthritis found there...

jaw joint

osteoarthritis/rheumatoid

8

Joint inflamed b/c of injury, auto accident, etc...

Should be evaluated for?

Traumatic arthritis

TMD

9

Type of pain that refers from one place to another (tender point to a distant site).

Myofascial pain

10

Myofascial pain is ______ and treated with what?

Referred

Stretching, heat, cold, rest, Muscle Relaxants

11

Localized pain, same area

Myalgia

12

Type of pain that is referred:

Type of pain that stays local:

Myofascial

Myalgia

13

Most common muscle pain is ______ and responds to ______

Myalgia

Stretching

14

Muscle inflamed from injury (or infection)

Myositis

15

Most common cause of Myositis for Dentists:

Do not...

Use what 3 Tx?

Wisdom tooth extraction

stretch

NSAIDS, steroids, rest

16

A Charlie Horse, forceful painful contraction, very rare (tetanus like)

Spasm

17

Spasms may be caused due to low ______ or other minerals/homones

could also be caused by a ____

K+

virus

18

Muscle tightens to protect joints or other muscles

*must find cause/what trying to protect

Protective Splinting

19

If body is Protective Splinting, what do?

Tx cause, use Muscle Relaxants

*also rest/stretching

20

Muscle that has undergone degenerative change that causes the contracted state to persist:

Usually due to _____

Calcified Contracture is _____

Can be ______

Stuck in a certain position _______

Myofibrotic Contracture

injury/infection

rare

hereditary

permanently

21

Anterior Temporalis refers to:

Middle Temporalis:

Posterior Temporalis:

Mx anteriors

Mx PM's

Mx Molars

22

Masseter refers to what 3 areas:

Ear

Lower molars

Above right eye

23

SCE refers to what 4 areas?

Ear

above eye (may be contralateral)

occiput

eye

24

Trapezius/Posterior Cervicalis refers to what 3 areas?

Temple

Ear

Eye

25

Lateral Pterygoid refers to what 3 areas?

TMJ

Eye

Zygoma

26

Differential Diagnosis important so Tx can be focused on joint or muscle

True

27

Jaw pain is usually _____

Joint or Muscle

28

Most TMD cases area a combo of both joint and muscle

True

29

Important to distinguish ADD w/o reduction early

True

30

When opening, if a jaw deflects to _______, required immediate attention

one side (locked)

31

What is the most common cause of TMD probs?

Multifactorial

32

List 6 contributing factors for TMD:

extrinsic trauma

hyper function of masticatory mm

hyperextension

occlusion

systemic disease

psychosocial

33

What is the most important thing when you screen a pt?

Hx

34

What treats Superior Capsulitis?

What does it use?

Unilateral Pivot

teeter/totter effect (pulls down one side of joint, lets heal)

35

What treats Posterior Capsulitis?

move Forward

*heals in anterior positioning device

36

What movement can aggravate lateral capsule?

Lateral

37

Mx Stabilization appliance stabilizes what?

eliminates:

reduces clenching force/joint loading by ___%

occlusion

fulcrums/interferences

70%

38

Mx Stabilization increases joint space

False

39

Mx Stabilization appliance should cover all teeth in what positions?

should have what kind of guidance?

CR, CO, MI

anterior/canine

40

Mn Stabilization has similar rules to Mx

True

41

(m, joint, both) Opening Pain:

Closing Pain:

Chewing Pain:

Moving the Head:

Sharp Pain:

Dull Pain:

Muscle or Joint

Joint

Muscle or Joint

Meck

Joint

Muscle

42

Pain associated with popping/clicking:

Side to side movement pain:

Limited opening w/o deviation

Limited opening with Deflection:

Joint

Joint

Muscle

Disc displaced/Joint

43

___% have at least 1 sign of joint dysfunction

___% has at least 1 symptom

____% of the population needs Tx

75%

33%

5-7%

44

Of the 5-7% of the population that need TMD Tx, % internal derangement?

arthritis:

masticatory muscle disorder?

31%

39%

30%

45

Females outnumber Males in TMD by what ratio?

4-5:1

46

___% of pts who come into your office have non-0tooth related pain, and we must identify these

40%

47

Rotation happens in what Joint Compartment?

Sliding/Displacement occurs where?

Inferior Joint compartment

Superior Joint compartment

48

The Jugular is in the TMJ

False

49

Lateral ROM:

Protrusion:

Opening:

10 - 12 mm

8 - 10 mm

over 40 mm

50

TMJ disc made of what?

Cartilage covering the condyle is what?

Why is this relevant?

Fibrous CT

Dense Fibrocartilage

healing

51

Primary Tx for TMD is what 3 things?

non-invasive

reversible

multidisciplinary

52

Tx for TMD includes dental specialist, primary care, neurologist, physical therapy, etc

True

53

Tx for TMD should never be what 2 interventions?

crowns/surgery

change bite location

54

Surgery/full mouth rehab is reserved for what in TMD?

second phase

*last option

55

Anterior reposition splint, aka

FARRAR

56

FARRAR (ant reposition splint) reduces load where?

temporarily recaptures what?

Use this device when?

Posterior attachment tissues

Anterior displaced disc

if disc too far forward

57

Anterior Reposition Splint should be used full time

False

*only at night

58

What is the goal of an Anterior Reposition Splint?

make a pseudo disc from healing

*never permanently reposition forward

59

TMD is always progressive

False

*heals better than other joints, most adaptable

60

Most common symptom of TMD is headache:

False

61

What is the most common symptom of TMD?

Jaw Pain

62

Most TMD cases are due to bad bite

False

63

Bad bite causes ___% of TMD

15%

64

Las Vegas Institute not evidence based

True

65

Use of x-rays are the only exception for machines/instruments to use to diagnose or Tx TMD

True

66

3 contraindications for TMD Tx

permanent bite changes

ortho appliance

full mouth rehab

67

TMD is usually not caused by malocclusion

True

68

6 symptoms of TMD

Jaw pain

Ear pain

Headaches

Ear stuffiness

Dizziness

Hearing loss

69

The Intracranial exam checks for function of what?

Cranial nerves

70

If you can't find pain in the tooth, look where?

same tooth in opposing arch

71

You can Tx sleep apnea, neuralgia, myalgia, movement disorders, dyskeniseas, and TMD

True

72

An IntraOral nightguard will prevent _____ but do nothing for ______

wear

pain

73

Nightguards and intraoral appliances look the same butthey differ how?

intraoral appliance is NOT an occlusal guard

*it is an Orthopedic appliance

***stabilization appliance

74

Any pain in the head can refer to anywhere else, this includes the neck down to where?

C5

75

If the pain is right below the TMJ, this could indicate...

neck/C1 problem

76

It is well documented that a removable orthotic works for TMD

True

77

The most common symptom of TMD is not headache, it is toothache

true

*although think different elsewhere

78

___% of the population has popping

50%

79

Bone to bone contact is very rare

True

80

Most common problem we see in TMD

muscle pain

81

Most common nerve causing pain to the TMD

Trigem

82

Masseter origin:

insertion:

innervation:

action:

zygomatic arch

lateral surface ramus/coronoid

masseteric branch V3

closes jaw/elevates Mn

83

Temporalis origin:

insertion:

innervation

Action:

tomporal fossa

coronoid process/ant Mn

V3 - deep temporal branches

elevates Mn (post fibers retract)

84

Lateral Pterygoid Origin:

Insertion:

Innvervation:

Action:

greater wing sphenoid (upper) lateral surface lateral pterygoid plate (Lower)

neck of condyle of Mn/articular disc/capsule TMJ

Branches of V3

opens mouth/protrusion/grinding

85

Medial Pterygoid Origin:

Insertion:

Innervation:

Action:

medial surface lateral pterygoid plate (sphenoid)/pyramidal process palatine/tuberosity Mn

lower part medial surface Mn/angle of Mn

Pterygoid branches V3

Elevates Mn/protrusion

86

Depression (3 mm.):

elevation (3 mm.):

Protrusion (1 mm.):

Retrusion (2 mm.):

Lateral:

suprahyoid, infrahyoid, gravity

temporal, masseter, medial pterygoid

lateral pterygoid

middle/posterior temporal, deep masseter

retractors same side/protruders opposite

87

TMJ is a modified...

Synovial Joint

88

Lateral temporomandibular ligament

stylomandibular ligament

sphenomandibular ligament

visualize

89

Intrinsic TMJ ligament:

2 Extrinsics:

TM-lateral ligmanet

Stylomandibular/sphenomandibular

90

Sylomandibular runs from where to where?

Sphenomandibular?

styloid process - angle mandible

spine of sphenoid - lingula of Mn

91

Opening pain can be _____

Closing pain...

muscle or joint

usually joint

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