TMD Treatment Exercises

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Questions and Answers

During intra-auricular palpation, which structure can be palpated with the pulp of the little finger?

Lateral pole of the condyle

Posterior pole of the condylar head (correct)

Medial pole of the condyle

Anterior pole of the condyle

What is the characteristic of a 'click' joint sound?

Continuous grating noise

High-pitched noise

Single explosive noise of short duration (correct)

Low-pitched noise

Which muscle is NOT examined during clinical evaluation of muscles of mastication?

Temporalis

Masseter

Buccinator (correct)

Medial Pterygoid

What is the purpose of the joint compression test?

To diagnose synovitis Signup and view all the answers

Which special test is used to evaluate the joint capsule and ligaments?

Joint distraction test Signup and view all the answers

What is the primary cause of tenderness to muscles of mastication?

Stress and fatigue Signup and view all the answers

How is the lateral pterygoid muscle palpated?

By using the little or index finger lateral to the maxillary tuberosity and medial to the coronoid process Signup and view all the answers

What is the purpose of resisted isometric muscle testing?

To elicit pain or weakness in the presence of muscle problems Signup and view all the answers

What is the normal range of maximum opening distance between the incisal edges of upper and lower incisors?

40-55 mm Signup and view all the answers

What is the normal lateral range of movement in the TMJ?

>7mm Signup and view all the answers

What is the main goal of Post Isometric Relaxation technique in treating TMD disorders?

To increase the range of motion of the TMJ Signup and view all the answers

What is the primary purpose of using a splint in Temporary Occlusal Therapy?

To prevent the upper and lower teeth from coming together Signup and view all the answers

What is the recommended technique for treating unilateral anterior displacement of the articular disc with adhesion to the articular eminence?

Low-amplitude high-velocity thrust parallel to the slope of the articular eminence Signup and view all the answers

What is the primary focus of Posture correction in TMD treatment?

Correcting the rest position of the tongue, jaw, neck, and back Signup and view all the answers

What is the primary purpose of Trigger Point Pressure Release in TMD treatment?

To apply pressure to the trigger point and increasing the pressure as the trigger point releases and softens Signup and view all the answers

What is the recommended management strategy for patients with stress-related TMD?

Reduce the stressors and make a plan to manage them Signup and view all the answers

What is the primary goal of the 6x6 Exercise protocol of Rocabado?

To restore the normal function of the TMJ Signup and view all the answers

What is the recommended treatment for patients with pain and stiffness in the TMJ on awakening?

Temporary Occlusal Therapy with splints Signup and view all the answers

Study Notes

Treatment of TMD

Acute stage treatment involves the 6x6 Exercise protocol of Rocabado, Cork exercise, and Tongue positioning during mouth opening and closing.
Trigger Point Pressure Release involves applying pressure to the trigger point, increasing pressure as it releases and softens.
Post Isometric Relaxation technique restores decreased range of motion by stretching and providing resistance.
Manipulation-Mobilization involves treating unilateral anterior displacement of the articular disc with adhesion to the articular eminence using a low-amplitude high-velocity thrust.
TMJ mobilization is performed to tear joint capsule adhesions and realign collagen fibers.
Posture correction involves training for the neck, back, shoulder, and tongue to achieve optimal physiological state.
Temporary Occlusal Therapy uses splints to prevent the upper and lower teeth from coming together, reducing pressure on the jaw joints and muscles.

Recommendations for TMD Patients

Manage stress by identifying stressors and making a plan to reduce and manage them.
Avoid opening mouth wide and moving excessively from one side to another.

Common Disorders of TMJ

Myogenic Disorders

Myofascial pain
Myofibrotic contracture
Myospasm
Neoplasia

Articular Disorders

Congenital or developmental disorders
Disk derangement disorders
Fracture of the condylar process
Inflammatory disorders
Osteoarthritis
TMJ dislocation

Signs and Symptoms of TMD

Pain
Impaired jaw function
Malocclusion
Deviation with/without correction
Limited range of motion
Joint noise and locking
Headache, tinnitus, visual changes, and other neurologic complaints

Clinical Examination of TMJ

Inspection

Maximum opening distance between the incisal edges of upper and lower incisors is 40-55 mm
Normal opening can be estimated by patient's own finger (three finger end on end)
Lateral range of movement is >7 mm

Palpation

Intra-auricular palpation can be achieved by placing a little finger inside the external auditory meatus
Extra auricular examination of TMJ is done by placing index finger in the pre-auricular region

Joint Sounds

Clicks: single explosive noise of short duration
Crepitus: continuous 'grating' noise

Range of Motion

Clinical evaluation of muscles of mastication is essential for TMD patients
Tenderness to muscles of mastication results from stress and fatigue

Muscles of Mastication to be Examined

Masseter
Temporalis
Medial Pterygoid
Lateral Pterygoid

Palpation of Specific Muscles

Temporal muscle: palpate multiple areas
Masseter muscle: palpate multiple areas
Lateral Pterygoid muscle: palpate by using the little or index finger and placing it lateral to maxillary tuberosity and medial to coronoid process

Special Tests

Joint compression test: manually loading the intraarticular structures
Joint distraction test: evaluating the joint capsule and ligaments
Resisted isometric muscle testing: pain or weakness may be elicited in the presence of muscle problems

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Description

This quiz covers treatment exercises for Temporomandibular Joint Disorder (TMD), including the Rocabado exercise protocol, trigger point pressure release, and post-isometric relaxation techniques. Test your knowledge of these therapies and their applications.