TMJ CASE

REPORT

Facilitator: drg. Maulida Hayati M,KES.

 Group 5:
Nina Febriani 2110070110053
Zelin Jelita 2110070110054
Tasya Fauziah Utari 2110070110055
Winda Sari Darmawan 2110070110056
Nurmaulina Siregar 2110070110057
Resa Meilinda Ramadani 2110070110058
Wikhe Baslen Raflesia 2110070110059
Violeta Audia Putri 2110070110060
Tasya Azzahra Putri 2110070110061
Wilda Dwi Zulfa 2110070110062
Wirhan Ramadhan Letmi 2110070110063
Natasya Salsabila 2110070110064
Cut Intan Alfilona 1910070110088
 Scenario 1

In a case report a student discussed the history of a

patient with unilateral hypertrophy. Another case report
deals with infection of the TMJ synovial fluid. From the
two case reports, the students were interested in deeper
discussions regarding the role of the muscles around the
TMJ, synovial fluid, biomechanics and occlusion of the
teeth when opening and closing the mouth when chewing
food.
 Identify Of Term
Unilateral Synovial Fluid
01 Hipertrophy 02

03 TMJ 04 Biomechanics

05 Occlusion
Problem Analysis
 Learning Objective

a. Students are able to understand and explain the stomatognathic system

b. Students are able to understand and explain the meaning and function of the TMJ
c. Students are able to understand and explain the role of muscles around the TMJ
d. Students are able to understand and explain the role of synovial fluid
e. Students are able to understand and explain biomechanics and dental occlusion
f. Students are able to understand and explain disorders caused by TMJ
g. Students are able to understand and explain verses of the Qur'an or hadith related to
scenarios.
 01
The Stomatognathic System
The stomatognathic system is a functional unit in the head, which
includes several tissue components with various structural origins. The
stomatognathic component consists of hard and soft tissues. This
component is composed of teeth, bones, joints, ligaments, and other
supporting tissues around the head, upper jaw, lower jaw, neck,
vascular system, nerves, and salivary glands. The hard skull bones have
a big role in supporting the work of the stomatognathic system, namely
as a barrier to the chewing load caused by the masticatory movement
driven by the lower jaw against the upper jaw.
 02
Defenition and
Function of thE TMJ
 a. defenition
The TMJ is one of the most complex joints in the body and is the
place where it articulates with the caranium. This articulation
allows for movement of a joint called the ginglimoid joint and at
the same time smooth movement is classified as an arthrodial joint.
The TMJ is formed from the mandibular condyle which is located
in the mandibular fossa of the temporal bone. The two bones are
separated from the direct articulation by a joint plate. The TMJ is
classified as a compound joint.
 b. function
To talk and chew
 03
The Role of the
Muscles Around the
TMJ
General function
of the muscles of
mastication:
a) For movement of the jaw and larynx
b) Mandibular protrusion
c) Mandibular retrusion
d) Lateral deviation of the mandible
e) Mandibular depression
f) laryngeal movement
Musculus
Masseter
Elevating the mandible, also assists
protraction, retraction and side-to-side
movements.
Musculus
Temporalis
Vertical (anterior) fibers: lift the
mandible Horizontal (posterior) fibers:
mandibular retraction Unilateral:
lateral movement of the mandible
(chewing)
Musculus
Pterygoid
Lateralis
Bilateral: mandibular protrusion (pulls
the articular disc forward)Unilateral:
mandibular lateral movement
(chewing)
Musculus
Medial
Pterygoid
lift (adduction) the mandible
 04

Synovial Fluid
This fluid is thick and sticky which serves to flex the joint under pressure without
causing injury. Synovial fluid is formed from the ultrafiltration of serum by the
cells that make up the synovial membrane. Synovial cells also make hyaluronic
acid (HA), which is a glycosaminoglycan. Synovial fluid provides nutrition to the
articular cartilage and also fulfills the viscosity requirements to absorb shock from
slow movements, and the elasticity requirements from fast movements
Synovial fluid contains:
a) Hyaluronan is secreted by fibroblasts which causes the synovial fluid to thicken
b) Lubricin is secreted by the chondocyte surfaces of articular cartilageInterstitial
fluid is filtered from blood plasma
 Synovial Fluid Function
• a) Reduced friction, by lubricating the articulating joints
b) Becomes more viscous under applied pressure
c) Transport of nutrients and wastes, by supplying oxygen and
nutrients and removing carbon dioxide and metabolic wastes from
chondrocytes in the surrounding cartilage
d) Molecular sieve, in which the pressure within the hyaluronan joint
forces in the fluid against the synovial membrane which forms a
barrier against cells migrating into or out of the joint space. This
function depends on the molecular weight of hyaluronan
Anatomy
Synovial Fluid
 05

Dental Occlusion
Occlusion was defined as the intercuspal contact between the maxillary
and mandibular teeth in all positions and movements of the mandible.
Occlusion is controlled by components of the neuromuscular and
masticatory system, namely teeth, periodontal structures, maxilla and
mandible, temporomandibular joints, muscles and ligaments.
There are two types of occlusion:
1. Centric occlusion, which is the contact relationship between the
maxillary and mandibular teeth when the mandible is in a centric
relation.
2. 2. Active occlusion, is a contact relationship between the teeth in the
upper and lower jaws when the lower jaw teeth move or shift
forward, backward, left and right or laterally.
 06

TMJ Disorder
a) Temporomandibular disorder is a term used for a group of disorders
that affect the temporomandibular joint, masticatory muscles, and related
structures causing general symptoms of pain and limitation of mouth
opening.
b) This disorder is most experienced by women (15%), and often occurs
in early adulthood.
• Jaw clenching
• Teeth grinding (bruxism)
• Rheumatoid arthritis • Fibromyalgia
• Facial and jaw trauma • Congenital
abnormalities in facial bones
 07

Al-Qur’an or Hadith
 ْ‫ص ٍل فَ َمن‬
ِ ‫ث ِماَئ ِة َم ْف‬ِ ‫ين َوثَاَل‬ َ ِّ‫ست‬ِ ‫ان ِمنْ بَنِي آ َد َم َعلَى‬ ٍ ‫س‬َ ‫ق ُك ُّل ِإ ْن‬ َ ِ‫ِإنَّهُ ُخل‬
ْ‫ستَ ْغفَ َر هَّللا َ َو َع َز َل َح َج ًرا َعن‬ْ ‫سبَّ َح هَّللا َ َوا‬
َ ‫َكبَّ َر هَّللا َ َو َح ِم َد هَّللا َ َو َهلَّ َل هَّللا َ َو‬
ٍ ‫س َوَأ َم َر بِ َم ْع ُر‬
‫وف‬ ِ ‫يق النَّا‬ ِ ‫ط ِر‬ َ ْ‫ش ْو َكةً َأ ْو َع ْظ ًما َعن‬ َ ‫س َأ ْو‬ ِ ‫يق النَّا‬ ِ ‫ط ِر‬ َ
‫ساَل َمى‬ُّ ‫ث ِماَئ ِة ال‬ِ ‫ين َوالثَّاَل‬ ِّ ‫َأ ْو نَ َهى َعنْ ُم ْن َك ٍر َع َد َد تِ ْل َك ال‬
َ ِّ‫ست‬
In another narration, Rasulullah SAW said:"In man there are three hundred and
sixty joints, so let him give alms for each joint." The companions said, "O
Prophet of Allah, who will be able to do it!" He said: "Buying spittle in the
mosque or something you throw out of the way (removing thorns or other
things that can disturb passers-by) is charity, if you don't find it then two
rak'ahs of dhuha are enough for you" (Narrated by Abu Dawud).
 َ ‫ش ۤا َء اتَّ َخ َذ اِ ٰلى َربِّ ٖه‬
‫س ِب ْياًل‬ َ ْ‫اِ َّن ٰه ِذ ٖه تَ ْذ ِك َرةٌ ۚ فَ َمن‬

Indeed, these (verses) are a warning, so whoever wills (good for himself) of
course he takes the way to his Lord. (QS. Al-Insan Ayat 29)
Thank
You!!!
Any Question???
1.
2.
3.