APPLIEDS

Temporomandibular
Joint

Neetu Gupta
Roll No. 28

CONTENTS
Quick

Review
Classification
Intracapsular Disorders
Extra capsular Disorders
Summary
Bibliography

Quick
Review
Components:

Articular Surfaces

Cartilages

Ligaments

Muscles

Classification
INTRACAPSULAR

Articular Disc
Internal Derangement
Ankylosis

Dislocations
Luxation
Subluxation

Fractures
Inflammations

EXTRACAPSULAR
Trismus
Infections
Muscle

Disorders

1. INTERNAL DERANGEMENT

Abnormal position of
the disc in relation to
the mandibular
condyle and articular
surfaces.
Normal gliding
movement of condyle
affected.

Can be reducing or
non-reducing.

CAUSES:
Trauma (Malocclusion,
tear In joint capsule)
Laxity Of the elastic of
the fibers.

 C/f

Clicking during mouth

opening, Crepitus

Limited mouth opening

Tenderness, pain,
headache.
May ppt. Osteoarthritis.

Treatment:

Acute jaw locking episodes

to be taken care off.
PLICATION
Implants be used (proplast
teflon implants)

2. ANKYLOSIS
STIFF JOINT
It involves fusion of head
of condyle and the
temporal bone.
CAUSES:
Traumatic injuries,
infection in & about the
joint, loss of tissue with
scarring.
Treatment:
Surgical : Arthroplasty

2. DISLOCATIONS
Can

be classified as

Complete Dislocation

OR Luxation
Incomplete Dislocation

OR Subluxation

1. COMPLETE

DISLOCATION
Abnormal positioning
of the head of
mandible out of
articular fossa.
Commonest : Anterior
dislocation (head of
mandible slips into
infratemporal fossa)
Post. Is uncommon
(due to support from
post glenoid tubercle
and lateral lig.)

CAUSE:

Excessive opening of
mouth, yawning/large
bite
(excessive contr.of
lateral pterygoids)
Sideways blow to the
chin
with a clenched hand
when mouth open.

Mandible remains
depressed
Inability to close moth

TREATMENT:
Manual
manipulation is done.
As shown in the
figure.

2. Incomplete
Dislocation
Subluxation
Refers to incomplete
dislocation as the
joint is still attached
to the bone.
Hypermobility

FRACTURES
Fractures maybe of
the mandible , Fossa
in the temporal bone
or the ear canal .
Condyle of the
mandible most
commonly fractured.
Mandible is the most
commonly fractured
facial bone ( MAXILLA
being next).
Condylar Fractures
May occur
Unilaterally,
Bilaterally.

CAUSES:

Direct blow to the

chin during road
accidents, sports
injury, falls, industrial
injuries.

C/f:

Instable joint ( due to

laxity, damage to
articular capsule &
lateral ligament)
Facial contour affected
Tenderness,
Swelling,haemotomas

TREATMENT:

Surgical approach.
Care be taken not to
injure the Facial N. & the
auriculotemporal N.
Both br. Of the facial N.
overlying the joint .
Articular br. Of the ATN.
That enter the joint from
its post. Part.
.

Inflammation of the this

synovial joint commonly
ARTHIRITIS
includes DEGENERATIVE
ARTHIRITIS.
Articular cart. Softens,
subchondral bone
reabsorbs.
MAJOR CAUSE:
Overload on the joint
C/F:
Dental Occlusion,
Crepitus
Pain, Swelling
Sec.complication :
Synovitis

OTHER INFLAMMATORY
DISORDERS COMMON
CAUSE OF TMJ DISORDERS.

EXTRACAPSULAR DAMAGES

1. TRISMUS
2. INFECTION
3. MUSCLE
DISORDERS

TRISMUS / LOCKED
JAW
Traditionally refers to the tonic
contraction of the MOM.
CURRENT DEFINATION:
Any restriction in mouth
opening secondary to infection,
trauma, surgery.
CAUSES:

Infection of muscles of
mastication
Hematomas In Medial Pterygoid
Dentoalveolar
sugeries,Removal of wisdom
tooth

COMPLICATIONS:

Poor Oral hygiene

Dysphagia
Malnutrition
Speech Deficit
C/F :
Chewing, talking painful, pain
around ear, clicking occurs In an
attempt to open mouth.

TREATMENT:
Symptomatic treat.
Pain relievers like
PCM, NSIADs
Physiotherapy
Muscle relaxants
administration

2. INFECTIONS
These infections may
include:
Tetanus, Parotid abscess,
Brain abscess etc.
TEATNUS:
Common cause of TMJ
dysfunction.
Causes muscle spasm.

C/F:

Classic feature: TRISMUS

DUE TO Muscle spasm,
Masseter

TREATMENT:

IMMUNIZATION

3.Muscle Disorders:

SUMMARY