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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(TEMPOROMANDIBULARSPHENOMANDIBULAR –
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 paindysfunction 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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