slide1 n.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
TEMPROMANDIBULAR JOINT PowerPoint Presentation
Download Presentation
TEMPROMANDIBULAR JOINT

Loading in 2 Seconds...

play fullscreen
1 / 32

TEMPROMANDIBULAR JOINT - PowerPoint PPT Presentation


  • 65 Views
  • Uploaded on

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

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'TEMPROMANDIBULAR JOINT' - channery-wong


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.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
slide2
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

slide5
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.

slide6
Ligaments :

1-collateral(discal)

2-capsular

3-tempromandibular

4-sphenomandibular

5-stylomandibular

slide7
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.

slide9
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

slide10
Control of TMJ movements:

-Vertical jaw reflexes:

1-jaw jerk

2-jaw opening

3-jaw unloading

-horizontal jaw reflexes

slide11
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

slide12
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

slide14
Disorders of the TMJ:

1- limitation of movement:

- temporary

- permanent

2- dislocation

3- pain

4- hyperplasia

5- neoplasm

6- loose bodies in the TMJ

slide15
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

slide16
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

slide17
Limitation of TMJ movements:

Temporary persistent

(trismus) (ankylosis)

slide18
1-Temporary (trismus):due to:
  • infection & inflammation in or near the joint
  • Injuries
  • tetanus & tetany
  • TMJ dysfunction syndrome
  • drugs
  • hysterical
slide20
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.

slide22
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

slide23
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
slide24
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

slide25
5-Neoplasms:(rare):
  • osteochondroma
  • osteoma
  • chondroma
slide26
6-Loose bodies in the TMJ: (rare):
  • osteochondritis disssecans:

due to trauma

  • synovial chodromatosis

benign neoplasm

slide27
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

slide30
Management:

Goals:

- decreased pain

- decreased loading

- restored function

- restored daily activities

slide31
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.