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TRISMUS

It is the inability to open the mouth wide due to the reflex muscular spasm (contraction)of the masticatory muscles and is usually a temporary rather than permanent condition.

CAUSES
Intra articular
a. Infective arthritis

b. c. d. e. f.

Osteoarthrosis Rheomatoid arthritis Ankylosis of the TMJ Intra capsular condylar fracture Dislocation

Extra articular
1.infections

Pericoronitis Ludwigs angina Submasseteric abscess infratemporal abscess Chronic infec.of the jaws Tuberculous osteomylitis of the ramus/body Sialoadenitis.Mumps

2.Inflammation.
Myositis or muscular atrophy.
Myositis ossificans.masseter muscle. Haematoma, inflammation or infection following mandibular block injection

3.Trauma.
Oedema, facial trauma, fracture z.arch and mandible.

4.Fibrosis
Ch.cervicofacial sepsis Post radiation therapy Ossification of the the sph.mand.ligament Band of scars and burns of the face/neck Oral submucous fibrosis Systemic sclerosis

5.TMPDs 6.Tetany 7.Tetanus 8.Neurological disorders


Epilepsy. Brain tumour, bulbar paralysis, embolic haemorrhage in medula oblongata.

9.Psychosomatic trismus 10.Drug induced(Strychnine 11.Neoplasms

poisoning,metoclopramide,phenothiazine neuroleptic

MANAGEMENT OF TEMPORO MANDIBULAR JOINT DISORDERS

DIAGNOSIS

HISTORY

Biodata Chief Complaint History of presenting complaint Past medical history Family history Social/personal history Systemic review/examination

Maxillofacial

examination

Extra oral Intra oral

DIFFERENTIAL DIAGNOSIS

Investigations
Radiological Haematological Histopathological

DIAGNOSIS

TREATMENT PLANNING

REVIEW