ORAL SURGERY - Chapter 31 - Management of

Temporomandibular Disorders
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1. myofascial pain and What do you call the muscular 12. Tomograms This technique allows radiographic
dysfunction. disorders which commonly cause sectioning of the joint at different
temporomandu=ibular disorders? levels of the condyle and fossa
complex, which
2. internal Causes of TMD that originate primaritl
provides individual views visualizing
derangement within the TMJ
the joint in "slices" from the
medial pole to the lateral pole.
osteoarthritis
13. Temporomandibulat This imaging method
rheumatoid arthritis joint arthrography was the first technique available that
allowed visualization (indirect)
chronic recurrent of the intra-articular disk
dislocation
14. Computed provides a combination of
tomography tomographic views of the joint,
ankylosis
combined with
computer enhancement of hard and
neoplasia
soft tissue images

infection 15. Doesn't show soft major limitation to the

tissue CBCT
3. Dull Usual description for muscular pain
Achy 16. MRI most effective diagnostic
imaging technique to evaluate TMJ soft
4. Sharp Usual description for joint pain
tissues
Shooting
17. technetium-99 Isotope that is injected intrevenously in
5. systemic arthritis Common indication of paint that
nuclear imaging
such as rheumatoid occurs primarity in the morning
arthritis 18. Technetium-99 γ-emitting isotope that is concentrated
or myofascial pain in areas of active bone metabolism.
resulting from 19. chronic pain This complex may include gross
nocturnal bruxism syndrome behavior exaggeration of
6. Osteoarthritis Common indication of pain that symptoms and clinical depression
occurs toward the end of the day 20. Myofascial pain Classification of temporomandibualr
7. Clicking most common forms of joint noise disorders
Crepitus Internal
Derangements
8. 45 mm Normal range of movement of an
adult's mandible Vertically
Degenerative Joint
9. 10 mm Normal range of movement of an Disease
adult's mandible iprotrusively and (Arthrosis,
laterally Osteoarthritis)
10. Straight and Normal movement of the TMJ
Systemic Arthritic
symmetric
Conditions
11. Panoramic best overall radiographs for
Radiography screening evaluation of the TMJs Chronic Recurrent
Dislocation

Ankylosis

Neoplasia

Infection
21. Myofascial most common cause of masticatory pain 30. (1) direct Current concepts of Degenerative Joint
pain and and limited function for which patients seek mechanical Disorder incorporate three possible
dysfunction dental consultation and treatment trauma mechanisms of injury:
(MPD)
(2) hypoxia
22. MPD The source of the pain and
reperfusion
dysfunction is muscular, with masticatory
injury
muscles developing
tenderness and pain as a result of abnormal
(3)
muscular function or
neurogenic
hyperactivity
inflammation.
23. Internal abnormal
31. hypoxia- Theory that suggests that excessive
Derangement relationship among the condyle, the disk,
reperfusion intracapsular hydrostatic pressure within the
and the fossa
theory TMJ may exceed the blood vessel perfusion
24. Wilkes Staging Staging criteria for Internal Derangements pressure, resulting in hypoxia.
Classification
32. Degenerative includes a variety of anatomic findings,
for Internal
Joint DIsorder including irregular, perforated,
Derangement
or severely damaged disks in association
25. Early Wilkes Staging Classification for Internal with articular
Early Derangement surface abnormalities such as articular
intermediate surface flattening, erosions, or
Intermediate osteophyte formation
Intermediate
33. Rheumatoid Most common arthritic disorder known to
late
Arthritis affect TMJ
Late
34. Pannus In the case of rheumatoid arthritis, an
26. Stage 1 stage of internal derangement generally
formation inflammatory process
have no symptoms except minor joint noise
results in abnormal proliferation of synovial
27. Reciprocal Other name for closing click tissue in a so-called
Click
35. Flase. True or False
28. Stage II Stage of internal derangement that will Unilateral DJD affects the TMJ bilaterally
demonstrate joint noises but will also reveal
36. False. Bila True or Flase
joint tenderness
Rheumatoid arthritis affects the TMJ
29. stage III In this type of unilaterally
internal derangement, the disk displacement
37. rheumatoid Laboratory tests that are helpful in
cannot be
factor diagnosing Rheumatoid arthritis
reduced, and thus the condyle is unable to
translate to its full anterior
erythrocyte
extent, which prevents maximal opening
sedimentation
and causes deviation of the
rate
mandible to the affected side
38. Mandibular Cause of TMJ dislocation
hypermobility
39. Subluxation a displacement of the condyle, which
is self-reducing and generally requires no
medical management
40. auricular temporal These are anesthetized in cases where 50. COX-1 Prostaglandins produced by _______ activity
nerve and the simple reduction cannot be done appear to be
muscles of during dislocation required for normal physiologic function
mastication
51. COX-2 Prostaglandins produced by _______ activity
41. ... a displacement of the condyle, which appear to be
is self-reducing and generally requires required for normal physiologic function
no medical management
52. COX-2 Prostaglandins produced by _______ activity
42. Condyle Intracapsular ankylosis results from a appear to be
Disk fusion of the following: required for activation mediate pain and
Fossa COmplex inflammation
43. Macrotrauma Most common cause of ankylosis 53. 10days2 weeks Highly addictive pain medications such
as acetaminophen with hydrocodone or
44. 2-4 weeks How long is mandibular restriction
oxycodone should not be used longer
done in patients who experience
than _____
dislocation
54. Diazepam commonly used muscle relaxants
45. coronoid process Frequent causes of
(Valium)
enlargement, or extracapsular ankylosis
hyperplasia,
carisoprodol
(Soma)
trauma to the
zygomatic arch area
cyclobenzaprine
46. pseudodisk physiologic and (Flexeril)
adaptation anatomic adaptation of tissue within
the joint tizanidine
47. NSAIDs Medications typically used in the (Zanaflex)
treatment of TMDs include: 55. Tricyclic Antidepressants appear to be useful in
(2) stronger antidepressants the management of patients with
analgesics chronic pain
56. Botilinum toxin A a neurotoxin produced by the bacterium
(3) muscle relaxants
Clostridium botulinum produces a
paralytic effect on muscles by
(4) antidepressants
inhibiting the release of acetylcholine at
48. propionic acid Categories of NSAID the neuromuscular junction
derivatives
57. (1) Two distinct groups of splints
(ibuprofen,
autorepositioning
naproxen)
splints
salicylates (aspirin,
(2) anterior
diflunisal)
repositioning
splints
acetic acid 58. anterior Other names of autorepositioning splints
compounds guidance splints
(indomethacin,
sulindac) superior
repositioning
49. cyclo-oxygenase-2 have gained popularity in the
splints
(COX-2) treatment of inflammation
and pain
muscle splints
59. Autorepositioning most frequently used to treat muscle 67. formation of Cause of intracapsular ankylosis
splints problems or eliminate TMJ pain when no fibrous tissue
specific internal derangement or other
obvious pathologic condition can be bone fusion
identified
a
60. Anterior Splints that are constructed so that an
combination
repositioning anterior ramping effect forces the
of the two
splints mandible to function in a protruded
position 68. Extracapsular Ankylosis that usually involves
the coronoid process and the temporalis
61. occlusal Permanent occlusion modification may
muscle
equilibration include the following:
69. Intracapsular fusion of the joint that leads to reduced
prosthetic ankylosis mandibular opening that ranges from partial
restoration reduction in function to complete immobility
of the jaw.
orthodontics

orthognathic
surgery
62. Arthrocentesis a minimally invasive technique that
involves placing
ports (needles or small cannulas) into
the TMJ to lavage the joint and
to break up fine adhesions
63. Arthroscopy has become one of the most popular
and effective
methods of diagnosing and treating TMJ
disorders
64. Arthroscopy The technique
involves placement of a small cannula
into the superior joint
space, followed by insertion of an
arthroscope to allow direct visualization
of all aspects of the glenoid fossa,
superior joint space, and
superior aspect of the disk
65. Disk repositioning the displaced disk is identified and
surgery repositioned
into a more normal position by removing
a wedge of tissue
from the posterior attachment of the disk
and suturing the disk back
to the correct anatomic position
66. Diskectomy one of the earliest surgical procedures
without described for treatment of severe TMJ
replacement internal derangements