Category Archives: Management of Temporomandibular Disorders

Patient Education

Patient Education The first step in involving patients in their own treatment is to make them aware of the pathology producing their pain and dysfunction and to describe the prognosis or possible progression of their pait’l and dysfunction. Many problems of masticatory pain and dysfunction stabilize or Improve-with conservative therapy, despite patients’ cone cerns that they may be on a continually


Infections Infections in the TMJ area are extremely rare, even in the case of trauma or surgical intervention in this area. In third world countries where antibiotic therapy of middle ear infections is not available, extension of infectious processes. may occasionally involve theH,1J and result in intracapsu lar ankylosis.


Neoplasia Neoplasms in the TMJ are extremely rare. They can occasiona11y  result in restriction of opening and joint pain. Tumors within the TMJ may result in an abnormal condyle and fossa relationship or an itracapsular ankylosis. A complete discussion of the neoplastic processes known to occur in the TMJ area is beyond the scope of this chapter.


Ankylosis [1I1nlcujJ\lIltll ankylosis. lntracapsular ankylosis, or fusion of the joint, leads to reduced mandibular opening that ranges from partial reduction in function to complete immobility of the jaw. Intracapsular ankylosis results from a fusion  of the condyle, disk, and fossa complex, as a result of the formation of fibrous tissue, bone fusion, or a combination of the two (Fig. 30-17). The most commo

Systemic Arthritic Conditions

Systemic Arthritic Conditions A variety of systemic arthritic conditions are known to affect-the TMJ. T rlorly in front of the articular eminence and becomes locked in that position (Fig. 30-16). Dislocation may be  unilateral or bilateral and may occur spontaneously afteropening the mouth widely, such as when yawning; eating, or during a del}tal procedure. Dislocation of the mandibular condyle that persist

Degenerative Joint Disease (Arthrosis, Osteoarthritis)

Degenerative Joint Disease (Arthrosis, Osteoarthritis) ‘DJD 1ncludes a •variety of anatomic findings, including irregular, ‘perforated, or severely damaged disks in association with articular surface abnormalities, such as articular surface flattening, erosions, or osteophyte formation (Fig: 30-14). The mechanisms of TMJ degenerative diseases are not clearly understood but are thought to be multi

Disk Displacement Disorders

Disk Displacement Disorders In a normally functioning TMJ the condyle functions in  both a hinge and a sliding fashion. Ouring full openingthe condyle not only rotates on a hinge axis but  translates forward to a position near the most Inferior portion of the articular eminence (Fig.30-1l). During function the biconcave disk remains interpositioned between the condyle and fossa, with the condyle remaining aga

Myofascial Pain

Myofascial Pain Myofascial pain and dysfunction (:-‘1PO)is the most common  cause of masticatory pain and limited function for which patients seek dental consultation and treatment.The source of the pain and dysfunction is muscular, with masticatory muscles developing tenderness and pain as a result of abnormal muscular function or hyperactivity. This abnormal muscular function is frequently but not a&#

Psychologic Evaluation

Psychologic Evaluation Many patients with temporomandibular pain and ‘dysfunction of long-standing duration develop manifestations  of chronic pain syndrome behavior. This complex may include gross exaggeration of symptoms and clinical depression.”. To evaluate possible behavioral changes associated with pain and dysfunction, the history should include questions regarding functional limitation tha

Radiographic Evaluation

Radiographic Evaluation Radiographs of the TMJ are extremely helpful in the diagnosis Of lntraarticular, osseous, and soft tissue pathology. The use of radiographs in the evaluation of the patient with TMD should be based on the patient’s sigs and symptoms instead of routinely ordering a “standard” set of radiographs. In many cases the panoramic radiograph provides adequate information as a