ANATOMI DAN

FISIOLOGI TMJ SERTA

PERGERAKAN MANDIBULA
OLEH
RIKI INDRA KUSUMA
 TEMPORO MANDIBULAR
JOINT
■ Pergerakan Hinging -> Ginglymoid joint
■ Pergerakan Gliding -> Arthrodial joint
■ TMJ -> Ginglymoarthrodial Joint
■ TMJ -> Compound Joint : Sendi yang
tersusun atas 3 tulang:
– Tulang Kondilus mandibula
– Tulang Temporal
– Non-Ossified Bone (Diskus Artikularis)
Sumber: Okeson JP. Management of temporomandibular disorders and occlusion. sixth ed:
Elsevier Health Sciences; 2008
 PENYUSUN TMJ

■ Kondilus Mandibula
■ Diskus Artikularis
■ Eminensia Artikularis dan Fossa Glenoidalis
os Temporalis
■ Kapsul Artikularis & Membran Sinovial
■ Zona Bilaminar
■ Ligamentum TMJ
Sumber:
1. Okeson JP. Management of temporomandibular disorders and occlusion. sixth ed: Elsevier Health Sciences; 2008
2. Malik, Neelima Anil, ed. Textbook of oral and maxillofacial surgery. 3rd ed., Jaypee Brothers Publishers, 2012.
3. Bumann A., Lotzmann U. TMJ Disorders and Orofacial Pain, The Role of Dentistry in a Multidisciplinary Diagnostic Approach.
Color Atlas of Dental Medicine. 2002. p.16-31
 KONDILUS MANDIBULA

Sumber:
Bumann A., Lotzmann U. TMJ Disorders and Orofacial Pain, The Role of Dentistry in a Multidisciplinary Diagnostic Approach.
Color Atlas of Dental Medicine. 2002. p.16-31
 KONDILUS MANDIBULA

Sumber:
Okeson JP. Management of temporomandibular disorders and occlusion. sixth ed: Elsevier Health Sciences; 2008
 DISKUS ARTIKULARIS

Fungsi utama dari diskus adalah untuk

mengurangi friksi sliding dan untuk meredakan
beban tekanan

Sumber:
1. Okeson JP. Management of temporomandibular disorders and occlusion. sixth ed: Elsevier Health Sciences; 2008
2. Bumann A., Lotzmann U. TMJ Disorders and Orofacial Pain, The Role of Dentistry in a Multidisciplinary Diagnostic Approach
Color Atlas of Dental Medicine. 2002. p.16-31
 EMINENSIA ARTIKULARIS &
FOSSA GLENOIDALIS

Sumber:
Okeson JP. Management of temporomandibular disorders and occlusion. sixth ed: Elsevier Health Sciences; 2008
 KAPSUL ARTIKULARIS &
MEMBRAN SINOVIAL

Sumber:
Atkinson M. Anatomy for Dental Students. 4th edition. Oxford University Press. 2013. p.241-256
 KAPSUL ARTIKULARIS &
MEMBRAN SINOVIAL

Sumber:
Bumann A., Lotzmann U. TMJ Disorders and Orofacial Pain, The Role of Dentistry in a Multidisciplinary Diagnostic Approach.
Color Atlas of Dental Medicine. 2002. p.16-31
 KAPSUL ARTIKULARIS &
MEMBRAN SINOVIAL
■ Fungsi Kapsul : Proprioseptif -> 4 tipe
– Tipe 1: Ambang Rendah, Adaptasi lambat,
memberikan info postur, efek hambatan
refleks otot antagonis
– Tipe 2: Ambang rendah, Adaptasi cepat,
memberikan info pergerakan
– Tipe 3: Ambang tinggi, Adaptasi lambat
– Tipe 4: siaga persepsi sensori nyeri, tidak
aktif dalam kondisi normal
Sumber:
1. Okeson JP. Management of temporomandibular disorders and occlusion. sixth ed: Elsevier Health Sciences; 2008
2. Bumann A., Lotzmann U. TMJ Disorders and Orofacial Pain, The Role of Dentistry in a Multidisciplinary Diagnostic Approach.
Color Atlas of Dental Medicine. 2002. p.16-31
 KAPSUL ARTIKULARIS &
MEMBRAN SINOVIAL
■ Cairan sinovial -> 2 fungsi : sebagai medium
suplai metabolisme dan lubrikan
■ Boundary lubrication: Sendi bergerak ->
cairan sinovial terdorong ke area batas dan
tepi dari gaya permukaan artikulasi
■ Weeping lubrication: Permukaan artikularis
menyerap sedikit cairan -> sendi berfungsi ->
sejumlah cairan keluar dan masuk
Sumber:
1. Okeson JP. Management of temporomandibular disorders and occlusion. sixth ed: Elsevier Health Sciences; 2008
2. Bumann A., Lotzmann U. TMJ Disorders and Orofacial Pain, The Role of Dentistry in a Multidisciplinary Diagnostic Approach.
Color Atlas of Dental Medicine. 2002. p.16-31
 ZONA BILAMINAR
■ Zona bilaminar, retroarticular plastic pad, retroarticular
pad, retrodiscal fat pad, atau zona trilaminar

■ Struktur: Stratum Superior – Genu Vasculosum – Stratum

Inferior

■ Genu Vasculosum -> kaya pembuluh darah, saraf, dan

sel-sel lemak

■ Stratum superior -> jaringan longgar, serat elastik dan

kolagen, lemak, dan pembuluh darah

■ Stratum inferior -> serat kolagen

Sumber:
Bumann A., Lotzmann U. TMJ Disorders and Orofacial Pain, The Role of Dentistry in a Multidisciplinary Diagnostic Approach.
Color Atlas of Dental Medicine. 2002. p.16-31
 ZONA BILAMINAR

Sumber:
Bumann A., Lotzmann U. TMJ Disorders and Orofacial Pain, The Role of Dentistry in a Multidisciplinary Diagnostic Approach.
Color Atlas of Dental Medicine. 2002. p.16-31
 LIGAMENTUM TMJ

■ 3 Fungsi utama:
– Stabilisasi
– Memandu Pergerakan
– Membatasi Pergerakan -> Paling penting
■ Ligemantum TMJ: Ligamen Kolateral, Ligamen
Kapsular, Ligamen Lateral (Temporomandibula),
Ligamen Stylomandibula, Ligamen
Sphenomandibula, Ligamen Tanaka
Sumber:
1. Okeson JP. Management of temporomandibular disorders and occlusion. sixth ed: Elsevier Health Sciences; 2008
2. Bumann A., Lotzmann U. TMJ Disorders and Orofacial Pain, The Role of Dentistry in a Multidisciplinary Diagnostic Approach.
Color Atlas of Dental Medicine. 2002. p.16-31
 LIGAMEN KOLATERAL /
DISKAL
Bertanggung jawab terhadap
pergerakan hinging dari TMJ

Memiliki suplai vaskular dan

terinervasi

Memberikan informasi posisi dan

pergerakan sendi

Sumber:
Okeson JP. Management of temporomandibular disorders and occlusion. sixth ed: Elsevier Health Sciences; 2008
 LIGAMEN KAPSULAR

Mengarahkan sendi, mempertahankan

cairan sinovial, terinervasi baik dan
memberikan umpan balik proprioseptif
atas posisi dan pergerakan dari sendi

Sumber:
Okeson JP. Management of temporomandibular disorders and occlusion. sixth ed: Elsevier Health Sciences; 2008
 LIGAMEN LATERAL /
TEMPOROMANDIBULAR

Memberikan hambatan atas gerakan retrusi dan laterotrusi, melindungi

zona bilaminar

Sumber:
1. Okeson JP. Management of temporomandibular disorders and occlusion. sixth ed: Elsevier Health Sciences; 2008
2. Baker E.W., et al. Anatomy for Dental Medicine, Latin Nomenclature. Thieme. 2016. p.164-167
 LIGAMEN STYLOMANDIBULA

Membatasi pergerakan protrusif dan mediotrusif

Sumber:
1. Baker E.W., et al. Anatomy for Dental Medicine, Latin Nomenclature. Thieme. 2016. p.164-167
 LIGAMEN SPHENO
MANDIBULA
Disebut juga ligamen
diskomalleolar (=pinto’s ligament)

Membatasi pergerakan protrusif

dan mediotrusif serta pembukaan
rahang secara pasif

Kurang memiliki kepentingan

dalam pergerakan fisiologis bila
dibandingkan dengan ligamen-
ligamen sebelumnya

Sumber:
1. Baker E.W., et al. Anatomy for Dental Medicine, Latin Nomenclature. Thieme. 2016. p.164-167
 VASKULARISASI TMJ

Sumber:
Bumann A., Lotzmann U. TMJ Disorders and Orofacial Pain, The Role of Dentistry in a Multidisciplinary Diagnostic Approach.
Color Atlas of Dental Medicine. 2002. p.16-31
 INERVASI TMJ

Sumber:
Bumann A., Lotzmann U. TMJ Disorders and Orofacial Pain, The Role of Dentistry in a Multidisciplinary Diagnostic Approach
Color Atlas of Dental Medicine. 2002. p.16-31
 INERVASI TMJ

Sumber:
Bumann A., Lotzmann U. TMJ Disorders and Orofacial Pain, The Role of Dentistry in a Multidisciplinary Diagnostic Approach.
Color Atlas of Dental Medicine. 2002. p.16-31
 PERGERAKAN TMJ

Sumber:
Atkinson M. Anatomy for Dental Students. 4th edition. Oxford University Press. 2013. p.241-256.
 PERGERAKAN FUNGSIONAL
MANDIBULA

■ DEPRESI
■ ELEVASI
■ PROTRUSI DAN RETRUSI
■ EKSKURSI LATERAL

Sumber:
Atkinson M. Anatomy for Dental Students. 4th edition. Oxford University Press. 2013. p.241-256.
 PERGERAKAN FUNGSIONAL
MANDIBULA

Sumber:
Baker E.W., et al. Anatomy for Dental Medicine, Latin Nomenclature. Thieme. 2016. p.164-167.
 PERGERAKAN FUNGSIONAL
MANDIBULA

Sumber:
Baker E.W., et al. Anatomy for Dental Medicine, Latin Nomenclature. Thieme. 2016. p.164-167.
DAFTAR PUSTAKA

■ Okeson JP. Management of temporomandibular disorders and occlusion.

sixth ed: Elsevier Health Sciences; 2008.
■ Malik, Neelima Anil, ed. Textbook of oral and maxillofacial surgery. 3rd
ed., Jaypee Brothers Publishers, 2012.
■ Bumann A., Lotzmann U. TMJ Disorders and Orofacial Pain, The Role of
Dentistry in a Multidisciplinary Diagnostic Approach. Color Atlas of
Dental Medicine. 2002. p.16-31.
■ Atkinson M. Anatomy for Dental Students. 4th edition. Oxford University
Press. 2013. p.241-256.
■ Robin J.M. Gray, Temporomandibular Disorders: A problem-based
approach, Wiley-Blackwell, 2011.
■ Baker E.W., et al. Anatomy for Dental Medicine, Latin Nomenclature.
Thieme. 2016. p.164-167.
terima kasih.