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Temporomandibular Joint

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Temporomandibular Joint

  1. 1. TEMPOROMANDIBULAR JOINT Batallones, Amery Rose Galeno, Chris Carlo Saunar, Maurice Cheekz Talag,Bryan Matthew Ursal, Alyssa Mae Villacorta, Aimee Carmina
  2. 2. Prepared by Chris Carlo M. GalenoINTRODUCTION TO TMJ(FUNCTION, FEATURES, CLASSIFICATION OF JOINTS)
  3. 3. Temporomandibular Joint• Craniomandibular Joint• Articulation between the condylar head of mandible and the anterior part of the glenoid fossa of two temporal bones.• Frequently termed as TMJ
  4. 4. Features of TMJ• Coordinated movements of the right and left joints are complex and usually are controlled by reflexes.• The maxillae and mandible carry teeth whose shape and position greatly affect the most closed portions of mandibular movements.• Articulating surface of the TMJ is not formed of Hyaline cartilage but of a sturdy avascular fibrous layer.• Only synovial joint in the human body with an articulating disc which is present between the joint surfaces of cranium and mandible which makes the TMJ a double joint.
  5. 5. Classifications of Joints• Fibrous Joint• Cartilaginous Joint• Synovial Joint
  6. 6. Classifications of Joints• Fibrous joints • Suture- articulation by processes and indentation interlocked together • Gomphosis- articulation by insertion of a conical process into a socket • Syndesmosis- united by interosseous ligament
  7. 7. Classifications of Joints• Cartilaginous joints • Primary Cartilaginous • Secondary Cartilaginous
  8. 8. Classifications of Joints• Synovial joints – According to number of axes in which the bones involved can move: • Uniaxial • Biaxial • Multiaxial or Polyaxial – According to the shapes of the articulating surface: • Planar • Ginglymoid • Pivot • Condyloid • Saddle • Ball-and-socket
  9. 9. Fibrous: A-syndesmosis (tibiofibular), B-suture (skull). Cartilaginous: C-symphysis (vertebral bodies), D-synchondrosis (first rib and sternum). Synovial:E-condyloid (wrist), F-gliding (radioulnar), G-hinge or ginglymus (elbow), H-balland socket (hip), I-saddle (carpometacarpal of thumb), J-pivot (atlantoaxial).
  10. 10. Hilton’s Law• The principle that the nerve supplying a joint also supplies both the muscles that move the joint and the skin covering the articular insertion of those muscles.
  11. 11. Type of joint of Temporomandibular Joint• Synovial joint• Described as synovial sliding-ginglymoid joint articulation • Rotational movements • Translational movements
  12. 12. Innervation and Vascularization• Sensory innervation from auriculotemporal and masseteric branches of mandibular branch of the trigeminal nerve• Branches of the external carotid artery, predominately the superficial temporal branch, deep auricular artery, anterior tympanic artery, ascending pharyngeal artery, and maxillary artery
  13. 13. Specific Mechanics of Proprioception• Ruffini endings• Pacinian corpuscles• Golgi tendon organ• Free nerve endings
  14. 14. Prepared by: Maurice Cheekz A. SaunarANATOMY AND HISTOLOGYOF THE STRUCTURESINVOLVED IN THE TMJ
  15. 15. Anatomy ofTMJ•Condyle of theMandible•MandibularFossa/GlenoidFossa/Temporoman-dibular Fossa•Articular SurfaceProper: Articular Disc Articular Capsule
  16. 16. Ligaments•LateralTemporomandibularLigament•SphenoparietalLigament•Stylomandibularligament•Stylohyoid Ligament
  17. 17. SynovialTissue-filled with SynovialFluidFunction:-Lubricant- Nutrition- Regulatory
  18. 18. HISTOLOGY OF THECOMPONENTS OF TMJ
  19. 19. Condyle of the Mandible• Composed of fibrous tissue• Cells: Chondrocytes
  20. 20. Articular Disk• Composed of fibroelastic connective tissue
  21. 21. Articular Capsule
  22. 22. Articular Tubercle
  23. 23. Fetal and Adult TMJ
  24. 24. Prepared by Aimee Carmina VillacortaDEVELOPMENT OF THE TMJ
  25. 25. • Involves the development of the following structures – Mandible – Glenoid fossa – Condyle – Articular disc – Upper and lower joint cavity
  26. 26. Mandible• Meckel’s Cartilage• Begins at week 6 to 7
  27. 27. • At week 12 of gestation: – temporal/ glenoid blastema • Ossifies and becomes glenoid fossa – condylar blastema • Becomes the condylar cartilage• Clefts are formed – lower joint cavity – upper joint cavity
  28. 28. 4 1. Primitive articular disc 2. Upper cleft 3. Lower cleft 4. Temporal blastema 5. Condylar blastema33
  29. 29. 1. Glenoid fossa2. Upper joint cavity3. Articular disc4. Lower joint cavity5. Condyle
  30. 30. Prepared by: Talag, Bryan Matthew E.MUSCLES OF MASTICATION
  31. 31. Masseter- Thick- Quadrilateral muscle- Superficial and deep portion
  32. 32. Masseter: Superior portionOrigin: thick, tendinous aponeurosis from the zygomatic process of the maxillaInsertion: angle and lower half of the lateral surface of the ramus of the mandible• its fibers pass downward and backward
  33. 33. Masseter: deep portion• Smaller and more muscular in texture• Downward and forward• Partly concealed• Origin: posterior third of the lower border and from the whole of the medial surface of the zygomatic arch• Insertion: the upper half of the ramus and the lateral surface of the coronoid process of the mandible
  34. 34. Masseter
  35. 35. Temporal Muscle• Broad• Radiating• Side of the head• Origin: Whole of the temporal fossa (except that portion of it which is formed by the zygomatic bone)• Insertion: the medial surface, apex, and anterior border of the coronoid process, and the anterior border of the ramus of the mandible nearly as far forward as the last molar tooth
  36. 36. Temporal muscle
  37. 37. Lateral pterygoid muscle• A.k.a. pterygoideus externus or external pterygoid muscle• Short• Thick• Conical• Upper and lower part – Common insertion: depression in front of the neck of the condyle of the mandible, and into the front margin of the articular disk of the temporomandibular articulation.
  38. 38. Lateral pterygoid: Upper part• Origin: lower part of the lateral surface of the great wing of the sphenoid and infratemporal crest
  39. 39. Lateral pterygoid: Lower part• Origin: lateral surface of the lateral pterygoid plate
  40. 40. Lateral pterygoid
  41. 41. Medial pterygoid muscle• A.k.a. pterygoideus internus or internal pterygoid muscle• Thick• Quadrilateral• downward, lateralward, and backward• Origin: medial surface of the lateral pterygoid plate and the grooved surface of the pyramidal process of the palatine bone – Has a second slip of origin • lateral surfaces of the pyramidal process of the palatine and tuberosity of the maxilla• Insertion: lower and back part of the medial surface of the ramus and angle of the mandible, as high as the mandibular foramen
  42. 42. Medial pterygoid
  43. 43. Nerve supplyMandibularbranch of thetrigeminalnerve
  44. 44. Action• Temporalis, Masseter, and Medial pterygoid raise the mandible against the maxillæ with great force.• Lateral pterygoid protrodes the mandible and the inferior incisors projectes in front of the upper antagonist – draw forward the condyle and articular disk – assists in opening the mouth – assisted by the Medial pterygoid The posterior fibers of Temporalis retracts the mandible When Medial and Lateral pterygoid of one side act, the corresponding side of the mandible is drawn forward while the opposite condyle remains comparatively fixed, and side-to-side movements. Such as occur during the mastication of food, take place.
  45. 45. SummaryMuscles of MasticationMuscle Origin Insertion Nerve Supply ActionMasseter Zygomatic arch Lateral surface Elevates ramus of mandible to mandible occlude teethTemporalis Floor of temporal Coronoid process Anterior and fossa of mandible superior fibers elevate mandible: Mandibular posterior fibers division of retract mandible trigeminal nerveLateral pterygoid Greater wing of Neck of Pulls neck of (V3)(two heads) sphenoid mandible mandible Lateral pterygoid Articular disc forward plateMedial pterygoid Tuberosity of Medial surface of Elevates (two heads) maxilla angle of mandible Lateral pterygoid mandible plate
  46. 46. Mandibular Positions• Postural Position of Mandible• Centric Occlusal Relation• Right Lateral Occlusal Relation• Left Lateral Occlusal Relation• Protrusive Occlusal Relation
  47. 47. Prepared by Alyssa Mae UrsalMOVEMENTS OF THE TMJ
  48. 48. Mandibular Positions• Postural Position of Mandible Free Way Space or Vertical Dimension of Rest
  49. 49. Mandibular Positions• Postural Position of Mandible• Centric Occlusal Relation• Right Lateral Occlusal Relation• Left Lateral Occlusal Relation• Protrusive Occlusal
  50. 50. Mandibular Positions• Postural Position of Mandible• Centric Occlusal Relation• Right Lateral Occlusal Relation• Left Lateral Occlusal Relation• Protrusive Occlusal Relation
  51. 51. Mandibular Positions• Postural Position of Mandible• Centric Occlusal Relation• Right Lateral Occlusal Relation• Left Lateral Occlusal Relation• Protrusive Occlusal Relation
  52. 52. Mandibular Positions• Postural Position of Mandible• Centric Occlusal Relation• Right Lateral Occlusal Relation• Left Lateral Occlusal Relation• Protrusive Occlusal Relation
  53. 53. Mandibular Movements• Classification: Border Movements Intraborder Movements Contact Movements Free Movements
  54. 54. Mandibular Movements• Classification: Border Movements Intraborder Movements Contact Movements Free Movements
  55. 55. Mandibular Movements• Classification: Border Movements Intraborder Movements Contact Movements Free Movements
  56. 56. Mandibular Movements• Classification: Border Movements Intraborder Movements Contact Movements Free Movements
  57. 57. Mandibular Movements• Right Lateral Movement• Left Lateral Movement• Protrussive Movement• Retrussive Movement• Bennett Movement
  58. 58. Mandibular Movements• Right Lateral Movement• Left Lateral Movement• Protrussive Movement• Retrussive Movement• Bennett Movement
  59. 59. Mandibular Movements• Right Lateral Movement• Left Lateral Movement• Protrussive Movement• Retrussive Movement• Bennett Movement
  60. 60. Mandibular Movements• Right Lateral Movement• Left Lateral Movement• Protrussive Movement• Retrussive Movement• Bennett Movement
  61. 61. Mandibular Movements• Right Lateral Movement• Left Lateral Movement• Protrussive Movement• Retrussive Movement• Bennett Movement
  62. 62. Envelope of Mandibular Motion (by Posselt) Superior Lateral View View Frontal View
  63. 63. Prepared by Amery Rose BatallonesCLINICAL CONSIDERATIONS
  64. 64. Clinical Considerations• Bruxism• Arthritis• Fractures• Structural Changes• Disharmony in the relation of teeth and the TMJ
  65. 65. Clinical Considerations• Myofacial Pain Dysfunction Syndrome• Luxation or Dislocation of Temporomandibular Joint• Ankylosis• Aplasia• Hyperplasia• Hypoplasia
  66. 66. Thank you!

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