1. The temporomandibular joint (TMJ) allows for several complex movements including opening and closing the mouth, as well as protrusion, retrusion, and lateral movements. 2. Examination of the TMJ involves assessing active movements, passive physiological movements, and passive accessory movements with attention to range of motion, reproduction of symptoms, and endfeel. 3. Resisted movements of the mouth are also tested to evaluate contractile tissues like muscles.

1. EXAMINATION OF TMJ Dr. Ayesha Anwer Ali

2. TEMPOROMANDIBULAR
KINEMATICS
Mouth Opening
 Initial mouth opening to consist of angular motion of the
condyle relative to the disc within the inferior joint space. The
late phase of opening the mouth consists on the transition
from primary rotation to primary translation. . During the
translation, anterior and inferior glide or translation of both
the disc and condyle occur within the superior joint space.
 Mouth closing

3. MANDIBULAR
DEPRESSION
A. early phase rotation which occurs in the inferior joint space and B. late phase translation which
occurs in the superior joint space.

4. CON…..
Protrusion involves anterior
glide or translation of both
condyles.
Retrusion involves
posterior glide or
translation back to the
resting position.

5. CON….
During lateral movements of the jaw,
different movements take place
simultaneously in the two
temporomandibular joints:
On the side opposite to the direction of
lateral gliding, the disc and mandibular
head glide ventrally in the superior cavity.
On the same side as the direction of lateral
gliding, the mandibular head rotates
laterally in relation to the disc in the
inferior cavity.
Example: with lateral movement to the
right, rotation occurs in the right joint and
ventral gliding in the left joint.

6. CON…
Resting position
 Mouth slightly open
Close-packed position
 Mouth closed
Capsular pattern
 Restriction in opening the mouth

7. TMJ EXAMINATION
Active Movement
Passive physiological Movement
Passive Accessory Movement
Resisted Movement

8. ACTIVE MOVEMENT
Reproduction of the symptom
Symmetry
AROM measure with ruler or tape.
Full mouth opening approximately 35 to 50 mm.
Protrusion - 3-6mm
Retrusion - 3 - 4mm.
Lateral Deviation – 8mm

10. PASSIVE MOVEMENT
Reproduction of the symptom
During PROM check endfeel.
A comparison of the response of symptoms to the active and passive
movements can help to determine whether the structure at fault is
non-contractile (articular) or contractile (extra-articular).
If the lesion is non-contractile, such as ligament, then active and
passive movements will be painful and/or restricted in the same
direction. If the lesion is in a contractile tissue (i.e. muscle) then
active and passive movements are painful and/or restricted in
opposite directions.

11. PASSIVE ACCESSORY
MOVEMENT
Traction
Ventral glide
Medial glide
Lateral glide

14. RESISTED MOVEMENT
Mouth Opening Mouth Closing Lateral Deviation