TEMPOROMANDIBULAR JOINT DISORDERS DR.LINDA MAHER

TMJ The temporomandibular joint is the joint of the jaw and is frequently referred to as TMJ bilateral articulation between the mandible and temporal bone FUNCTION OF TMJ: Speech and mastication

COMPOSED OF: 1\Mandibular condyle 2\Articular surface of the temporal bone(mandibular fossa) 3\Capsule 4\Articular disc 5\Ligaments(TEMPOROMANDIBULAR-SPHENOMANDIBULAR –STYLOMANDIBULAR)

JAW MOVEMENT Normal full jaw opening is 4-5 cm as measured from edge of lower front teeth to edge of upper front teeth During jaw movements, only the mandible moves

TMJ DISORDERS TMJ DISORDERS IN GENERAL CAN CAUSE VARIOUS COMBINATIONS OF 1\LIMITATION OF MOVEMENT (Can be temporary or persistent) 2\PAIN 3\CLICKING SOUNDS

1\LIMITATION OF JAW MOVEMENT

1\TEMPORARY LIMITATION OF MOVEMENT (TRISMUS) CAUSES: 1\infection and inflammation of the joint 2\injuries and fractures of the condoyler neck 3\tetanus 4\TMJ pain dysfunction syndrome 5\dislocation TREATMENT: In all conditions the treatment is to relieve the underlying cause

TMJ dislocation The joint become fixed in the open position by anterior dislocation. CAUSES: 1-forcible opening of the mouth by a blow on the jaw 2-during dental extractions under general anesthesia 3-occasionaly a patient will dislocate spontaneously whilst yawning

MANAGEMENT: Manual reduction by pressing downwards and backwards on the lower posterior teeth

PERSISTANT LIMITATION OF MOVEMENT KNOWN AS ANKYLOSIS CAUSES: 1\developmental abnormalities in the growth of the coronoid process 2\malignant tumors of TMJ bone 3\ fibrosis of the joint or the attached muscles as result of trauma or irradiation 4\certain diseases like oral submucous fibrosis and scleroderma 5\forceps delivery at birth

MANAGEMENT: 1\establish joint movement by removal of the underlying cause 2\prevent relapse 3\excercise of the joint

2\Myofacial pain-dysfunction syndrome .

Myofacial pain-dysfunction syndrome IT IS A CHRONIC PAIN DISORDER AETIOLOGY: in most cases it is caused by muscle spasm(involuntary muscle contraction) There is an association with stress and bruxism (grinding of the teeth) and many patients have a night-time tooth grinding habit

CLINICAL FEATURES: 1\Pain associated with the joint or the attached muscles. 2\Limitation of opening (trismus) or deviation of the jaw on opening. 3\Clicking of the joint . 4\ It may be associated with a headache and misdiagnosed as migraine 5\The pain is often worse in the morning

MANAGEMENT: 1\ explanation of the condition and reassurance. 2\A soft diet and jaw rest 3\ in severe cases analgesics and anti-inflammatory drugs may be prescribed.

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