DISORDERS OF THE JAW.pptx

1. DISORDERS OF THE
JAW
PRESENTED BY :
V.RAMYA
TUTOR
SRMTCON

2. STRUCTURE

3. INTRODUCTION
• Abnormal conditions affecting the mandible (jaw) and the
temporomandibular joint ( which connects the mandible to
the temporal bone at the side of the head in front of the ear )
• Include congenital malformation ,fracture ,chronic
dislocation, cancer,and syndromes characterized by pain and
limited motion.
• Temporomandibular disorders and jaw surgery ,a treatment
common in many structural abnormalities or cancer of the
jaw, are presented in this section.

4. TEMPOROMANDIBULAR
DISORDERS
• Temporomandibular disorder as categorized as follows (national institute of
dental and craniofacial research (NIDCRI)]
• Myofascial pain – a discomfort in the muscles controlling jaw function and in
neck and shoulder muscles.
• Internal derangement of the joint - a dislocated jaw , a displaced disc, ,or an
injured condyle.
• Degenerative joint disease – rheumatoid arthritis or osteoarthritis in the jaw
point .

5. INCIDENCE
• Diagnosis and treatment of temporomandibular disorders remain
somewhat ambiguous ,but the condition is thought to affect about 10
million people in the united states
• A study done in a tertiary care center in southern india revealed
22.6% prevalence of temporomandibular disorder .
• It was found that women are twice more commonly affected than
men.

6. CLINICAL MANIFESTATIONS
• Patients have jaw pain ranging from a dull ache to throbbing ,
• Debilitating pain that can radiate to the ears ,teeth ,neck muscles ,and
facial sinuses.
• They often restricted jaw motion and locking of the jaw
• There also may be a sudden change in the way the upper and lower
teeth fit together

7. CLINICAL MANIFESTATIONS
• Chewing and swallowing may be difficult.
• Symptoms such as headaches
• Earaches,
• Dizziness
• And hearing problems may sometimes related to temporomandibular
disorders.

8. DIAGNOSTIC FINDINGS
•Diagnosis based on the patients report of pain,
•Limitations in range of motion
•Dysphagia ( difficulty in swallowing)
•Difficulty chewing

9. DIAGNOSTIC FINDINGS
•Difficulty with speech,
•Or hearing difficulties
•Magnetic resonance imaging and other imaging
studies are generally only used for severe or chronic
symptoms

10. MEDICAL MANAGEMENT
• Signs and symptoms improve over time for the majority of patients
with temporomandibular joint disorders, with or without treatment .
• Conservative treatment is recommended .
• Most patients improve with a combination of simple noninvasive
therapies that may include ;
• Patient educate on self care ,

11. MEDICAL MANAGEMENT
• Cognitive behavioural therapy
• Physical therapy
• Exercise and
• Manual therapy
• Analgesics (NSAIDS – nonsteroidal anti –inflammatory drugs )
• Muscle relaxants initially and oral appliance therapy

12. SURGICAL MANAGEMENT
• Correction of mandibular structural abnormalities may require
surgery involving repositioning or reconstruction of the jaw.
• Simple fractures of the mandible without displacement ,resulting
from a blow of the chin and planned surgical interventions ,as in the
correction long and short jaw syndrome.
• Jaw reconstruction may be necessary in the aftermath of trauma from
a severe injury or cancer ,both of which can cause tissue and bone
loss .

13. SURGICAL MANAGEMENT
• Mandibular fractures are usually closed fractures.
• Rigid plate fixation (insertion of metal plates and screws or
arch bars into the bone to approximate and stabilize the
bone.) is the current treatment of choice in many cases of
mandibular fracture and in some mandibular reconstructive
surgery procedures.

14. SURGICAL MANAGEMENT
• Current research revolves around the use of various types of
various reconstruction plates and fixation plates, and fixation
devices ,quality of life after specific instrumentation and device
choice .
• Bone grafting may be performed to replace structural defects
using bones from the patients own ilium, ribs ,or cranial sites.

15. NURSING MANAGEMENT
• Depending on the fracture ,surgical reduction
,and extent of maxillomandibular fixation (
wiring the jaw shut’’)
• Patients may have various levels of diet
restrictions
• A liquid or soft diet may be recommended for up
to 4 to 6 weeks
• If this is the case ,dietary counselling should be

16. NURSING MANAGEMENT
• Nutritional supplements may be recommended.
• The patients needs specific guidelines for mouth care
and feeding
• Any irritated areas in the mouth should be informed in
the primary provider
• The importance of keeping scheduled appointments to
assess the stability of the fixation appliance is
emphasized

17. BIBLIOGRAPHY
• Ansari and kaur ,medical surgical nursing ,published by pee vee ,2011 edition page referred 446
to 449.
• Brunner and suddarth’s textbook of medical – surgical nursing south asian edition volume
1,page no 844 -845.
• .Https://https://www.Slideshare.Net/praveenaveena4/tmj-disorder-50204635
• Www.Slideshare.Net/drsanthu1/developmental-disturbances-of-the-jaws
• Https://www.Slideshare.Net/sheetalkapse/jaw-deformities-30837054