TMJ common conditions

Question 1

What are the categories within the joint disorder classification for TMD?

Answer 1

• arthralgia
• DDWR
• DDWOR
• capsular adhesion
• arthritis/osis

Question 2

What are the categories within the masticatory muscle disorder classification for TMD?

Answer 2

• masseter
• temporalis
• lateral pterygoid

Question 3

What is disc derangement w/ reduction?

Answer 3

• disc is dislocated then reduced back into place

Clinical presentation:
- deviation w/ opening
- opening click + closing click
- ROM grossly WNL
- history of hypermobility

disc rests in dislocated position

Question 4

What is disc derangement w/o reduction?

Answer 4

• disc remains dislocated in ant position

Clinical presentation:
- deflected mandible w/ opening
- no click, possible crepitus
- hypomobile stage
- 25-35mm opening
- decreased laterotrusion (lateral deviation)
- history of clicking but no longer clicking

Question 5

What is hypermobility/subluxation of the TMJ?

Answer 5

• slipping/excessive motion w/o dislocation

If there is unilateral issue (more prone to below) = deviation to the contralateral side:
- opening greater 50mm
- open locking

Question 6

What are some inflammatory conditions of the TMJ and what is the clinical presentation?

Answer 6

• capsulitis, retrodiscitis, arthritis

Clinical presentation:
- periarticular pain w/o referral elsewhere
- (+) TMJ loading (retrusive overpressure, contralateral pain w/ force biting)
- mandibular mobility normal to slightly limited
- no deflection or deviation

Question 7

What are myofascial disorders for the TMJ?

Answer 7

• masticatory musculature (as well as cervical)
• trigger points

Clinical presentation:
- (+) ipsilateral forced biting test
- deviations in mandibular movements
- mild limitation of joint mobility
- no clicking