Flashcards in LOL TMD Deck (91):
Inflammation of the capsule ligaments with Joint soreness and inflammation
What is the most common TMD diagnosis?
Irritation to the Synovial Fluid, similar to Capsulitis
Bone inflammation, wear and tear arthritis
Osteoarthritis is the most common due to...
Clicking and Popping are due to...
Every Arthritis can be in the _____
2 most common systemic arthritis found there...
Joint inflamed b/c of injury, auto accident, etc...
Should be evaluated for?
Type of pain that refers from one place to another (tender point to a distant site).
Myofascial pain is ______ and treated with what?
Stretching, heat, cold, rest, Muscle Relaxants
Localized pain, same area
Type of pain that is referred:
Type of pain that stays local:
Most common muscle pain is ______ and responds to ______
Muscle inflamed from injury (or infection)
Most common cause of Myositis for Dentists:
Use what 3 Tx?
Wisdom tooth extraction
NSAIDS, steroids, rest
A Charlie Horse, forceful painful contraction, very rare (tetanus like)
Spasms may be caused due to low ______ or other minerals/homones
could also be caused by a ____
Muscle tightens to protect joints or other muscles
*must find cause/what trying to protect
If body is Protective Splinting, what do?
Tx cause, use Muscle Relaxants
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 _______
Anterior Temporalis refers to:
Masseter refers to what 3 areas:
Above right eye
SCE refers to what 4 areas?
above eye (may be contralateral)
Trapezius/Posterior Cervicalis refers to what 3 areas?
Lateral Pterygoid refers to what 3 areas?
Differential Diagnosis important so Tx can be focused on joint or muscle
Jaw pain is usually _____
Joint or Muscle
Most TMD cases area a combo of both joint and muscle
Important to distinguish ADD w/o reduction early
When opening, if a jaw deflects to _______, required immediate attention
one side (locked)
What is the most common cause of TMD probs?
List 6 contributing factors for TMD:
hyper function of masticatory mm
What is the most important thing when you screen a pt?
What treats Superior Capsulitis?
What does it use?
teeter/totter effect (pulls down one side of joint, lets heal)
What treats Posterior Capsulitis?
*heals in anterior positioning device
What movement can aggravate lateral capsule?
Mx Stabilization appliance stabilizes what?
reduces clenching force/joint loading by ___%
Mx Stabilization increases joint space
Mx Stabilization appliance should cover all teeth in what positions?
should have what kind of guidance?
CR, CO, MI
Mn Stabilization has similar rules to Mx
(m, joint, both) Opening Pain:
Moving the Head:
Muscle or Joint
Muscle or Joint
Pain associated with popping/clicking:
Side to side movement pain:
Limited opening w/o deviation
Limited opening with Deflection:
___% have at least 1 sign of joint dysfunction
___% has at least 1 symptom
____% of the population needs Tx
Of the 5-7% of the population that need TMD Tx, % internal derangement?
masticatory muscle disorder?
Females outnumber Males in TMD by what ratio?
___% of pts who come into your office have non-0tooth related pain, and we must identify these
Rotation happens in what Joint Compartment?
Sliding/Displacement occurs where?
Inferior Joint compartment
Superior Joint compartment
The Jugular is in the TMJ
10 - 12 mm
8 - 10 mm
over 40 mm
TMJ disc made of what?
Cartilage covering the condyle is what?
Why is this relevant?
Primary Tx for TMD is what 3 things?
Tx for TMD includes dental specialist, primary care, neurologist, physical therapy, etc
Tx for TMD should never be what 2 interventions?
change bite location
Surgery/full mouth rehab is reserved for what in TMD?
Anterior reposition splint, aka
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
Anterior Reposition Splint should be used full time
*only at night
What is the goal of an Anterior Reposition Splint?
make a pseudo disc from healing
*never permanently reposition forward
TMD is always progressive
*heals better than other joints, most adaptable
Most common symptom of TMD is headache:
What is the most common symptom of TMD?
Most TMD cases are due to bad bite
Bad bite causes ___% of TMD
Las Vegas Institute not evidence based
Use of x-rays are the only exception for machines/instruments to use to diagnose or Tx TMD
3 contraindications for TMD Tx
permanent bite changes
full mouth rehab
TMD is usually not caused by malocclusion
6 symptoms of TMD
The Intracranial exam checks for function of what?
If you can't find pain in the tooth, look where?
same tooth in opposing arch
You can Tx sleep apnea, neuralgia, myalgia, movement disorders, dyskeniseas, and TMD
An IntraOral nightguard will prevent _____ but do nothing for ______
Nightguards and intraoral appliances look the same butthey differ how?
intraoral appliance is NOT an occlusal guard
*it is an Orthopedic appliance
Any pain in the head can refer to anywhere else, this includes the neck down to where?
If the pain is right below the TMJ, this could indicate...
It is well documented that a removable orthotic works for TMD
The most common symptom of TMD is not headache, it is toothache
*although think different elsewhere
___% of the population has popping
Bone to bone contact is very rare
Most common problem we see in TMD
Most common nerve causing pain to the TMD
lateral surface ramus/coronoid
masseteric branch V3
closes jaw/elevates Mn
coronoid process/ant Mn
V3 - deep temporal branches
elevates Mn (post fibers retract)
Lateral Pterygoid Origin:
greater wing sphenoid (upper) lateral surface lateral pterygoid plate (Lower)
neck of condyle of Mn/articular disc/capsule TMJ
Branches of V3
Medial Pterygoid Origin:
medial surface lateral pterygoid plate (sphenoid)/pyramidal process palatine/tuberosity Mn
lower part medial surface Mn/angle of Mn
Pterygoid branches V3
Depression (3 mm.):
elevation (3 mm.):
Protrusion (1 mm.):
Retrusion (2 mm.):
suprahyoid, infrahyoid, gravity
temporal, masseter, medial pterygoid
middle/posterior temporal, deep masseter
retractors same side/protruders opposite
TMJ is a modified...
Lateral temporomandibular ligament
Intrinsic TMJ ligament:
Sylomandibular runs from where to where?
styloid process - angle mandible
spine of sphenoid - lingula of Mn