Tmj (nx power lite) /certified fixed orthodontic courses by Indian dental academy
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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats. Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics, Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call 0091-9248678078
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Tmj (nx power lite) /certified fixed orthodontic courses by Indian dental academy
- 1. TEMPEROMANDIBULAR JOINT DISORDERS INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com dr.godhi TMJ
- 2. CLASSIFICATION OF JOINTS CLASS -1 Synartrosis Synostosis Gomphosis Syndesmosis Symphysis Synchondrosis CLASS -2 Amphyartrosis CLASS -3 Diartrosis www.indiandentalacademy.com dr.godhi TMJ
- 3. CLASSIFICATION OF TMJ DISORDERS MUSCULAR DISODERS Myositis MPDS DISC-CONDYLE INCOORDINATION Internal derangement Subluxation Dislocation STRUCTURAL Capsulitis FRACTURE OF TMJ NEOPLASIA ARTHRITIS OF TMJ Non inflammatory Inflammatory Rheumatoid Infectious Metabolic-gout DOVELOPMENTAL Condylar hyperplasia Condylar hypoplasia Condylar aplasia ANKYLOSIS OF TMJ Fibrous Bony www.indiandentalacademy.com dr.godhi TMJ
- 4. SUBLUXATION It is a triad of Ligamentous & capsular laxity Eminential erosion & flattening Trauma. MANAGEMENT •IMF With elastics •Sclerosing agents Sodium psylliate Sodium morrhuate Sodium tetradecyl sulfate www.indiandentalacademy.com •Capsulorrhapy dr.godhi TMJ
- 5. DISLOCATION OF TM JOINT ACUTE, CHRONIC RECURRENT, LONG STANDING--Uni/Bi Dislocation is a displacement of the condylar head completely out of glenoid fossa, which usually can not be reduced by the patient. Subluxation is a displacement of condylar head, which patient can reduce himself CAUSES: Extrinsic forces Trauma GA Extraction Intrinsic forces Excessive yawning, Vomiting, Blowing, Hysterical fits www.indiandentalacademy.com dr.godhi TMJ
- 6. UNILATERAL DISLOCATION: •Difficulty in mastication , swallowing & speaking •Deviation of chin to opposite side •Cross bite & open bite on opposite side •Depression in pre auricular area BILATERAL DISLOCATION: •Pain & inability to close the mouth •Excessive salivation •Protrusion of chin •Gagging of molar teeth with anterior open bite •“Halllowness” in preauricular area www.indiandentalacademy.com dr.godhi TMJ
- 7. MANAGEMENT •Reassuring patient •Tranquilizers/sedatives •Pressure &massage to the area •Manipulation -Manual reduction -Indirect reduction •Direct reduction - Condylotomy,condylectomy - Eminectomy - Augmentation of eminence - Dautery’s procedure - Osteotomy - Chemical capsulorrhaphy www.indiandentalacademy.com dr.godhi TMJ
- 8. LIMITED MANDIBULAR MOBILITY: •TRISMUS •MECHANICAL INTERFERENCE •EXTRA CAPSULAR CAUSE •ANKYLOSIS www.indiandentalacademy.com dr.godhi TMJ
- 9. TRISMUS: •Odontogenic --- MPDS, Malocclusion •Infective •Traumatic •Neoplastic •Pharmacological --- Phenothiazene •Neurotoxic --- Tetanus •Neurological --- Central & peripheral lesion •Psychological --- Historical trismus www.indiandentalacademy.com dr.godhi TMJ
- 10. Significance ? • Still common in Asia • Disabling condition • Affects growth www.indiandentalacademy.com dr.godhi TMJ
- 11. Union between the two articulating surfaces of the joint www.indiandentalacademy.com dr.godhi TMJ
- 12. ANKYLOSIS OF TMJ VICTIM INTERFERENCE WITH MASTICATION & DIGESTn OF FOOD DECREASED BALANCE DIET--MALNUTRITION UNABLE TO PARTICIPATE IN PUBLIC FUNCTION CHILDHOOD > FACIAL DEFORMITY PSYCHOLOGICAL STRESS PHYSICAL HANDICAP EMOTIONAL DISTARBANCES www.indiandentalacademy.com dr.godhi TMJ
- 13. CHILD CONDYLAR NECK IS BROAD SUBARTICULAR LAYER INTERCONNECTING PLEXES OF BLOOD VS PENETRATE BONE & EXTENDS TO CAPSULE INJURY TO TMJ HAEMARTHROSIS HIGH OSTEOGENIC PARTICLES FIBRO-OSSEOUS MASS ANKYLOSIS www.indiandentalacademy.com dr.godhi TMJ
- 14. CAPSULE ADULT EXTRA CAPSULAR # CHILD Thin cortex periosteum in Active Osteogenic www.indiandentalacademy.com Phase Intra capsular # Vascular Bone Haemathrosis dr.godhi TMJ
- 16. ETIOLOGY OF ANKYLOSIS TRAUMA Intra capsular # Penetrating wounds Forceps delivery INFECTION Otitis media Osteomyelitis of the jaw Haematogenous SYSTEMIC ARTHROPATHY Still’s disease Osteo arthritis Rheumatoid arthritis NEOPLASIA Chondroma/Osteo chondroma Sarcoma/ Fibro sarcoma Metastasis to condyle www.indiandentalacademy.com dr.godhi TMJ
- 17. • Birth trauma • Forceps delivery • Condylar fractures www.indiandentalacademy.com dr.godhi TMJ
- 18. Sequelae ? Direct Unable to open the mouth Indirect Poor oral hygiene Abnormal feeding habits Prone for snoring Effect on growth www.indiandentalacademy.com dr.godhi TMJ
- 19. CLINICAL FEATURES: UNILATERAL ANKYLOSIS •Chin deviated towards affected side •Affected side being foreshortened •Lack of contour on unaffected side •Ramus & body on ankylosed side are underdeveloped •Presence of ANTIGONIAL NOTCH •Malocclusion & tilting of lower incisors & posterior crossbite www.indiandentalacademy.com dr.godhi TMJ
- 20. Unilateral Ankylosis Effects on Growth • Fullness of affected side • Flat normal side • Deviation of mandible to affected side www.indiandentalacademy.com dr.godhi TMJ
- 21. CLINICAL FEATURES BILATERAL ANKYLOSIS •Age at the time of injury •Degree of unilateral/bilateral involvement •Failure of development of lower jaw •Deficiency of ramus height •Downward inclination of mandible •Double chin effect “Bird face” deformity •“Ande-gump” profile •Effect upon growth & development www.indiandentalacademy.com dr.godhi TMJ
- 22. Bird face deformity Retruded chin &double chin effect www.indiandentalacademy.com dr.godhi TMJ
- 23. • Retruded chin • Bird face appearance www.indiandentalacademy.com dr.godhi TMJ
- 27. SURGICAL MANAGEMENT Objectives: to 1. Establish joint movt & jaw function 2. Prevent relapse 3. Restore appearance & occlusion 4. Achieve normal growth & occlusion in child by interceptive surgery & orthodontics APPROACHES TO TMJ 1. Pre auricular 2. Pre auricular with temporal extension 3. Endaural 4. Sub mandibular 5. Al-kayat bramley 6. Hemicoronal 7. Bi coronal www.indiandentalacademy.com dr.godhi TMJ
- 29. OPERATIVE TECHNIQUE OSTEO ARTHROTOMY OSTEO ARTHRECTOMY •Condylectomy •Gap arthroplasty •Inter-positional arthroplasty www.indiandentalacademy.com dr.godhi TMJ
- 30. Condylectomy Condyle is removed by sectioning at the neck • Fibrous ankylosis • Bony ankylosis where configuration of condyle is seen www.indiandentalacademy.com dr.godhi TMJ
- 31. Gap Arthroplasty Bony Ankylosis A piece of bone from the ankylosed mass is removed to create the gap www.indiandentalacademy.com dr.godhi TMJ
- 33. Inter Positional Arthroplasty Materials interposed to prevent bony contact • Temporal fascia • Temporalis muscle • Costochondral grafts www.indiandentalacademy.com dr.godhi TMJ
- 34. Inter Positional Arthroplasty Temporalis muscle & fascia www.indiandentalacademy.com dr.godhi TMJ
- 35. Costochondral Grafts Indicated In Children • Maintains height of ramus • Further growth of condyle? www.indiandentalacademy.com dr.godhi TMJ
- 36. Surgeons Perspective Total Rehabilitation • Release • Reconstruction www.indiandentalacademy.com dr.godhi TMJ