Hd Temporomandibular

Front 1

What is TMD?

Back 1

a collective term for a number of clinical problems which involve the jaw muscles, the TMJ and associated orofacial structures.

Front 2

What are the associated factors to increase a predisposition to TMD?

Back 2

trauma, anatomical malformation, systemic or genetic disorders and psychosocial factors

Front 3

What is temporal arteritis?

Back 3

inflamed superficial temporal artery

Front 4

What are some symptoms of temporal arteritis?

Back 4

temporal headaches in pts >50yr
visual disturbances
jaw feels tired when eating

Front 5

What is the treatment of temporal arteritis?

Back 5

urgent systemic steroids

Front 6

What is migraine?

Back 6

persistent throbbing pain lasting around 72hrs

Front 7

What are some symptoms of migraine?

Back 7

nausea
persistent throbbing pain
photo and phonophobia
pain aggravated by everyday normal function
need to close eyes

Front 8

What is trigeminal neuralgia?

Back 8

paroxysmal stabbing pain hot needle like sensation affecting >=1 trigeminal dermatome

Front 9

what is the treatment for trigeminal neuralgia?

Back 9

carbamezapine

in recalcitrant cases - surgical resection

Front 10

What is burning mouth syndrome?

Back 10

peripheral neuropathic pain affecting oral mucosa
persistant burning sensation

Front 11

What is the treatment for burning mouth syndrome?

Back 11

topical/systemic tca antidepressants
anxiolytic drugs

Front 12

What are some signs and symptoms of a patient with TMD?

Back 12

pain and tenderness around tmj/mom
limitation/incoordination jaw movemement (limited or deviated)
joint sounds (clicking or crepitus)
headaches
tinnitus (rare)

Front 13

What are the causes of TMD?

Back 13

there is no single cause for TMD, just facors which may :
predispose
precipitate and
prolong

Front 14

What are some predisposing factors to TMD?

Back 14

genetic
hormonal
anatomical

Front 15

What are some precipitating factors to TMD?

Back 15

trauma, occlusion, parafunction

Front 16

What are some prolonging factors for TMD?

Back 16

parafunction, psychological and stress

Front 17

How is TMD diagnosed?

Back 17

there are 2 axes of diagnosis according to the research diagnostic criteria (RCD/TMD)

AXIS 1 - PHYSICAL
AXIS 2 - PSYCHOSOCIAL (difficult to determine)

Front 18

What are the subsets of axis 1?

Back 18

group 1 - muscle (myofascial pain)

group 2 - disc displacement with or without reduction (clicking and locking)

group 3 - TMD pain and degeneration (arthralgia, arthrosis and arthritis)

Front 19

What is disc displacement with reduction?

Back 19

clicking of the jaw
disc displaced anteriorly and medially or both in ICP. on opening the disc CLICKS back into place, remains in place until max opening but slips off the condyle again in closing

Front 20

what is disc displacement without reduction?

Back 20

locking of the jaw

disc is displaced anteriorly and medially or both in ICP, on opening it does not go back into place and blocks condylar movememnt. the maximum opening is restricted and may cause mandibular deviation to the affected side

Front 21

What screening precaution should you take prior to undertaking complex restorative procedures?

Back 21

ensure pt clicking, locking, stiffness in jaw mm/joints, difficulty eating or jaw opening

tmj palpation, mm palpation and measure for restricted jaw opening

if positive signs then a full tmd analysis form

Front 22

How is TMD treated?

Back 22

initially reassurance and counselling

occlusal splints may be of use

Front 23

What are occlusal splints?

Back 23

removable appliances fitted to the teeth of either jaw and function to alter occlusal relationships, redistribute oclusal forces and reduce bruxism, wear , mobility

Front 24

What are the different types of splints?

Back 24

Partial coverage

soft splints

Stabilisation splints

Front 25

What is a partial coverage splint?

Back 25

these are generally unreccomended
may result in unwated tooth movement/.occlusal changes

they may be useful in the treatment of myofascial pain and the headache associcated with nocturnal parafunction - this should always only be night wear

Front 26

What is a soft splint?

Back 26

head and vacuum formed vinyl, generally useful overall tmd treatment but is of limited value in mandibular issues associated with deflective contacts

Front 27

Who is a stabilisation splint good for?

Back 27

these splints are good for patients who disrupted occlusion may have precipitated their condition either through increased muscle activitiy or adverse posture

Front 28

How does a stabilisation splint work?

Back 28

in allows the mandible to find an area of nm/ms balance, covers cusps and provides a flat surface with no deflective contacts

condyles are able to rest fully into the glenoid fossa in hinge axis

Front 29

What are the mand/max versions of stabilisation splints called?

Back 29

mand - tanner
max - michigan

Front 30

radiologically, what does a TMJ show when the patient has osteoarthritis?

Back 30

deformed or degenerative disc
irregular cortical outline with osteophytes and condyle sclerosis

Front 31

radiologically, what does a tmj show when the patient has rheumatoid arthritis?

Back 31

a completely destroyed disc replaced by fibrous/vascular pannus and cortical punched out erosion with sclerosis in condyle

Front 32

How would you manage chronic pain?

Back 32

combination of biological and psychosocial - biopsychosocial (pharmacological, physiotherapy and psychosocial intervention)

Front 33

What are the pharmacological agents in management of chronic pain and their important info?

Back 33

TCA
GABA MIMETICS
BETA BLOCKERS

all intended for use other than for chronic pain so describe to the patient
all target sensation (not b blockers)