TMD

Question 1

TMJ VS TMD

Answer 1

tmj - the joint; everyone has
tmd- the dysfunction; not everyone has

Question 2

orofacial pain

Answer 2

pain in face and jaw/mouth region

Question 3

Orofacial pain classifications

Answer 3

1. primary headache/non cervicogenic headache
2. TMJ dysfunction
3. Masticatory Muscle Disorder
4. Cervicogenic headache

Question 4

The TMJ has two joint compartments… explain the movement for each compartment

Answer 4

superior - slides/translation

inferior - rolls/rotates

Question 5

what are the ROM norms for TMJ

Question 6

what muscles perform TMJ movements

Question 7

what category of tmj issues has a reciprocal click

Answer 7

disc derangement with reduction

Question 8

what category of tmj issues has no clicking (two noted issues)

Answer 8

disc derangement without reduction

myofascial disorder

Question 9

what category of tmj issues has a history of hypermobility?

Answer 9

disc derangement with reduction

Question 10

what category of tmj issues is the “hypomobile stage”

Answer 10

disc derangement without reduction

Question 11

which category of tmj issues has opening to 25-35mm? what about >50 mm

Answer 11

25-35 = disc derangement without reduction

> 50 = hypermobile/sublux

Question 12

what category of tmj issues is positive for CONTRALATERAL pain with forced biting?

Answer 12

inflammatory conditions

Question 13

what category of tmj issues is positive for IPSILATERAL pain with forced biting?

Answer 13

myofascial disorder

Question 14

what category of tmj issues has a loud clunk/popping sound, the feeling of it being out of place, and open locking?

Answer 14

Hypermobility/Sublux

Question 15

explain overbite vs overjet

Answer 15

overbite: how far overlapping the front teeth are over bottom teeth; frontal plane 1/3 mandible incisor

overjet: how far anterior top teeth sit over bottom (3-6mm) ; transverse/sagittal plane

Question 16

what is a quick way to test functional opening?

Answer 16

3 knuckles test- you should be able to fit 3 knuckles in mouth

Question 17

opening to lateral excursion rhythm

Answer 17

4:1

Question 18

TMJ “rhythm”

Answer 18

first 11mm condylar rotation

Question 19

Deviations & Deflection

Answer 19

C- curve: hypomobility; reduction of disc

S - curve: muscle imbalance

Deflection: deviates towards less mobile side

Question 20

T or F: measuring opening is the only measurement to discriminate between those with and without TMD

Answer 20

TRUE

Question 21

forced biting provocation test (cotton roll test) and interpretation

Answer 21

looking for increased symptoms

ipsilateral pain = muscle/tendon irritation

contralateral pain = joint

Question 22

can modalities be used in isolation for TMD ?

Answer 22

no, they are complementary for symptom relief

Question 23

How fat apart should teeth be in resting position

Answer 23

2-3 mm

Question 24

what should you avoid with TMD ?

Answer 24

• uncontrolled yawning
• gum chewing
• nail biting
• resting chin in hands
• stomach sleeping

Question 25

how much sleep should you get?

Answer 25

7-8 hours

Question 26

what should be strengthened and what should be lengthened in everyone for better posture?

Answer 26

strengthen - DCF, cervical extensors, scapular retractors lengthen - scalenes, pecs, SCM, suboccipitals

Question 27

treatment for joint mobility

Answer 27

mobs PROM / AROM w caution

Question 28

treatment for joint inflammation

Answer 28

protection , ice, ionto - parafunctions - chewing - ROM

Question 29

treatment for disc or articular dysfunction

Answer 29

address impairments of joint pain and reduced ROM CONSERVATIVE TX WONT SIGNIFICANTLY HELP DDwoR - educate patient abt remodeling phase, noise and motion should normalize over time

Question 30

treatment for TMD pain

Answer 30

exercise diaphragmatic breathing stress reduction technique relacation of mandibular mm

Question 31

Rocabado 6x6 Exercises

Answer 31

1. Nasal Breathing - 6 breaths 2. Controlled Opening 3. Mandibular Rhythmic Stabilization 4. Upper Cervical Distraction: OA nodding 5. Axial Ext of Cervical Spine (chin tuck) 6. Shoulder Girdle Retraction (w thor ext)

Question 32

Theory of Condylar Remodeling

Answer 32

normalize forces between disc and musculature - co-contraction enhances stabilization wheh youre laterally deviating, it will gap and glide the condyle anteriorly while the disc remains in place