40, 41- TMJ/TMJD

Which of the following is true about TMJD?

At stage 2 Wilkes classification, there is inflammation and injury but not necessarily damage to the disc. Clicking without pain can be indicative of a reducing disc out of place.

A patient comes to you unable to open their mouth. There is no trauma and they claim to have woken up like that. What is this?

In arthrocentesis, the needle which injects a solution containing medication, a steroid and hyaluronic acid goes into the glenoid fossa to the superior joint space. The best position for the patient is a closed jaw.

Arthrocentesis is indicated for Wilkes stages 1-5 although its effectiveness in pain reduction tends to decrease at later stages of disc degeneration. The drawbacks include a lack of ability to debride the area, distinguish or enhance a pathology diagnosis, and you go in more or less blind.

Which of the following is true?

The outer fibers of the TMJ limit excessive posterior motion and protect retrodiscal tissues. The horizontal fibers prevent excessive opening and provide stability.

Extra-articular disorders present with ipsilateral pain, intra-articular present with contralateral pain. Extra-articular make up the majority of TMJD complaints and are generally treated non-surgically.

TMJD are more common in men and commonly manifests between ages 40-70. Common co-morbidities include irritable bowel syndrome, fibromyalgia, and patients experiencing chronic pain with TMJD are often victims of abuse.

Vascular supply to the TMJ disk comes from