1 / 32

TEMPROMANDIBULAR JOINT

TEMPROMANDIBULAR JOINT. TMJ: is a bilateral joints permits the mandible to move as a unit with two functional patterns: Hinge (inferior portion) Translation (superior portion) (ginglymoarthroidal joint) (compound joint) it has four anatomical parts: 1- condyle

channery-wong
Télécharger la présentation

TEMPROMANDIBULAR JOINT

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. TEMPROMANDIBULAR JOINT

  2. TMJ: is a bilateral joints permits the mandible to move as a unit with two functional patterns: • Hinge (inferior portion) • Translation (superior portion) (ginglymoarthroidal joint) (compound joint) it has four anatomical parts: 1- condyle 2- articular fossa 3- articular disc 4- articular capsule

  3. The Synovial fluid: Consist of small amounts of a clear, straw-colored viscus fluid. It is an infiltrate of the blood diffused out from the rich capillary network of the synovial membrane. Function: 1- lubrication by two mechanisms: boundry lubrication weeping lubrication 2- nutrition. 3- clear the tissue debris.

  4. Ligaments : 1-collateral(discal) 2-capsular 3-tempromandibular 4-sphenomandibular 5-stylomandibular

  5. Muscles of mastication: 1- masseter: superficial & deep 2- temporalis 3- medial pterygoid 4- lateral pterygoid: superior & inferior - Digastric muscles is not a muscle of mastication but it play an important role in mandibular function.

  6. Nerve supply: the mandibular division of the trigeminal nerve. Vascular supply: superficial temporal artery--- post middle meningeal artery--- ant internal max.artery---- inf deep auricular Anterior tympanic Ascending pharengeal arteries

  7. Control of TMJ movements: -Vertical jaw reflexes: 1-jaw jerk 2-jaw opening 3-jaw unloading -horizontal jaw reflexes

  8. Age changes of theTMJ: 1- Flattened condyle 2- osteoporosis of the condyle bone. 3- Thickning of the fibrous covering of the condyle. 4- Thinning of the cartilagenous zone of condyle. 5- Thinning of the disc 6- Fibrotic synovial folds 7- Thickening of the b.v. walls 8- Decrease the number of nerves

  9. These age changes lead to: -Decrease in the synovial fluid formation -Impairment of motion due to decrease in the disc and capsule extensibility -Decrease the resilience during mastication due to chondroid changes into collagenous elements -Dysfunction in older people

  10. Disorders of TMJ

  11. Disorders of the TMJ: 1- limitation of movement: - temporary - permanent 2- dislocation 3- pain 4- hyperplasia 5- neoplasm 6- loose bodies in the TMJ

  12. 1-limitation of mandibular movement: due to: a-intracapsular causes: Infective arthritis Juvenile arthritis Traumatic arthritis Intracapsular condyle fracture b-pericapsular causes: Irradiation Dislocation Condylar neck fracture Infection of adjacent tissues

  13. c-muscular: Tmj dysfunction syndrome Myalgia due bruxism Haematoma from ID block Tetanus d-Others: Oral submucous fibrosis Systemic sclerosis Zygomatic & maxillary fracture Drugs Craniofacial anomalies involving the joint

  14. Limitation of TMJ movements: Temporary persistent (trismus) (ankylosis)

  15. 1-Temporary (trismus):due to: • infection & inflammation in or near the joint • Injuries • tetanus & tetany • TMJ dysfunction syndrome • drugs • hysterical

  16. 2-persistent (Ankylosis)

  17. 2-Dislocation: due to: -blow on the jaw -forceful extraction -while yawning -epileptic pt recurrent dislocation is a typical feature of ehler-danlos & marfan’s syndrome or there may be no systemic disorder.

  18. Types of displacement: 1-anterior disc displacement with reduction: Joint noise, pain, clicking and full range of movements 2-acute anterior disc displacement without reduction: Acute onset of limitation of opening with pain & deviation to the affected side, history of clicking 3-chronic anterior disc displacement without reduction: Limitation of opening for variable period,history of clicking

  19. 3-Pain in or around the joint:due to: • injury • infection & inflammation • vascular disease e.g: cranial arteritis • muscle spasm e.g: pain dysfunction syndrome • rheumatoid & other arthritis • salivary gland disease e.g: parotid neoplasm • ear disease e.g: otitis media, externa

  20. 4-Hyperplasia: Is rare unilateral overgrowth of the condyle. It causes: facial asymmetry, deviation of the jaw to the unaffected side on opening and crossbite. Treated by: -If it is stabilized at the end of puberty --- corrective osteotomies to restore occlusion & facial asymmetry -If it is still active --- intracapsular condylectomy

  21. 5-Neoplasms:(rare): • osteochondroma • osteoma • chondroma

  22. 6-Loose bodies in the TMJ: (rare): • osteochondritis disssecans: due to trauma • synovial chodromatosis benign neoplasm

  23. Examination: 1-joint examination: static: palpation x.rays ( tomography) dynamic: mobility limitation sounds 2-muscle examination: palpation movement limitation pain on movements 3-occlusal examination: study cast facebow regestration

  24. Examination of the TMJ

  25. Management: Goals: - decreased pain - decreased loading - restored function - restored daily activities

  26. Management options: 1-Pt.education & palliative home care:yawning 2-Behaviour modifications: habits 3-Drug therapy: e.g: NSAID, analgesics 4-Exercise therapy 5-Splint therapy 6-Occlusal therapy 7-mobilization 8-Physical agents: heat,cold,muscle relaxation 9-Other therapy: joint surgery, orthodontics.

  27. Thank you

More Related