1. TEMPOROMANDIBULAR JOINT DISORDERS
DR.LINDA MAHER

2. 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

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

6. 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

7. 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

8. 1\LIMITATION OF JAW MOVEMENT

9. 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

10. 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

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

12. 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

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

14. 2\Myofacial pain-dysfunction syndrome.

15. 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

16. 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

17. 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.

18. Thank you ,