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?

    <p>To diagnose synovitis</p> Signup and view all the answers

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

    <p>Joint distraction test</p> Signup and view all the answers

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

    <p>Stress and fatigue</p> Signup and view all the answers

    How is the lateral pterygoid muscle palpated?

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

    What is the purpose of resisted isometric muscle testing?

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

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

    <p>40-55 mm</p> Signup and view all the answers

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

    <p>&gt;7mm</p> Signup and view all the answers

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

    <p>To increase the range of motion of the TMJ</p> Signup and view all the answers

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

    <p>To prevent the upper and lower teeth from coming together</p> 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?

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

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

    <p>Correcting the rest position of the tongue, jaw, neck, and back</p> Signup and view all the answers

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

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

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

    <p>Reduce the stressors and make a plan to manage them</p> Signup and view all the answers

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

    <p>To restore the normal function of the TMJ</p> Signup and view all the answers

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

    <p>Temporary Occlusal Therapy with splints</p> 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.

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