Download some aspects of temporomandibular joints anatomic structure

SOME ASPECTS OF TEMPOROMANDIBULAR JOINTS ANATOMIC STRUCTURE
Zhachko M., Plyska V., Zhachko S.
National medical university by A.A. Bogomolets, human anatomy department
The diseases of the organs in mandibular-facial area, accompanied with malocclusion, occupy the third place
on their frequency and spread among all stomatological problems. The malfunction of dental-jaw connection,
accompanied with malocclusion formation, is difficult to treat and it leads to a significant reduction of its functions
with a long-standing rehabilitation. The malfunction of the dental-jaw system, caused by malocclusion, is seen 5-6
times more often, than at caries complications that is an additional reason to pay attention to prevention and
treatment of temporomandibular joint diseases mostly.
Many questions of temporomandibular joint pathology remain actual, as the new investigative methods appear
and are being improved, elaborating morphology and functional anatomy of articulatio temporomandibularis,
promoting the optimal opinion about etiology, pathogenesis and methods of the treatment. The modern methods of
investigation such as spiral tomography and magneto-resonance tomography, allow to study the pathological
processes developing in the structures of such complex anatomical formation.
The formation of the temporomandibular joint is completed in 18-20 years approximately, but in men it’s
earlier, than in women. However, after that process the joint surfaces, ligaments of the temporomandibular joint and
chewing muscles are affected by long-lasting changes, they are constantly being reformed due to the intense
exercise. The realignment (remodulation) of the joint is considered to be a normal process, connected with the
tissues’ adaptation to derived exercise on the temporomandibular joint. The progressive and regressive remodulation
has been described.
The remodulation of the joint leads to another form of the joint head and dimple with visual changes resulting
in the normal biomechanic’s failure. Due to the derived form of the joint surface the degree of their discrepancy can
be increased with the disk afflicted with the significant stress joint capsule of the articulatio temporomandibularis,
that is fixed on a joint disk perimeter as well as lateral and mesial ligaments of the articulatio temporomandibularis.
The form of the joint disk corresponds to the form of the head of the lower jaw and dimple and can be varied
significantly in different people. The degree of double-concavation of the disk depends on the depths of the dimple
in temporomandibular joint: if the temporomandibular joint dimple is deep, the disk is more concave for account of
its thick back part, but if the temporomandibular joint dimple is flat, the disk is less concave then, since it has a
visual thickness. The thickness and degree of the disk concavity can vary even in mesio-lateral direction; the disk
may be thicker from the mesial or lateral side in dependence of the form of the joint surface of the temporal.
The joint disk does not contain the vessels and nerves, but its flexibility is in concern with the following
problems:
 Increases the movements in articulatio temporomandibularis, diving the cavity of the joint into two
regions: upper and lower;
 During articulation the form of the disk is changed in accordance with the form of the joint head and
mandibular dimрle;
 Disk reduces the stress, resulted in discrepancy of the joint surfaces, and improves the exercises’
distribution.
Such ability depends on the thickness of the disk: the more it is the better is distributed exercise. Taking into
consideration that mechanical characteristics, of the disk promote the functions of the sharing stress, you may expect
that the longevity of the temporomandibular joint structures is defined by the physical condition of the disk. Hence,
the exercises, that lead to the joint disk malfunction, can cause the risk of the main mechanism regulation of the
exercise in temporomandibular joint finally.
The study of anatomy and temporomandibular joint morphological structures allows to raise the treatment of
the temporomandibular joint diseases’ efficiency as well as the life quality of these patients, by the elimination of
etiological factors, malocclusions and normal activity of muscular-ligamentous connection.