TMJ New 2

Question 1

FHP and TMD
Changes the resting position of the ________
May result in _________

Answer 1

mandible
malocclusion

Question 2

• General Treatment Principles
  
  • Pain and Inflammation

Answer 2

NSAIDS, ice,
Methods to relieve compression

Question 3

• Interventions
  
  • Disc Dislocations
    Evaluate for, and if present treat the following impairments

Answer 3

FHP

Too much anterior translation with opening

muscle imbalance esp if it results in an overpull of the lateral pterygoid

Joint hypo/hypermobility

Question 4

Interventions
Irreducible Disc

Answer 4

Palliative Treatment or surgery

Question 5

Interventions
Muscle Tightness and/or spams

Answer 5

soft tissue mobilization, ROM and/or stretching exercises

Question 6

Treatment for Capsular Restrictions

Answer 6

Aim is to stretch capsule

Manual distraction, joint play techniques

Question 7

self distraction techniques and low load prolonged stretch

Answer 7

gauze under molars of side to be stretched
opening or lateral deviation stretching

Question 8

Rocabado’s 6x6 Exercises
Clucking

Answer 8

make clucking noise

Question 9

Rocabado’s 6x6 Exercises
Tongue Positioning

Answer 9

tongue rests on the roof of the mouth, mouth is opened and closed while breathing through the noise

Question 10

Rocabado’s 6x6 Exercises
Rhythmic Stabilization

Answer 10

index finger placed against the chin, chin gently pushed against the finger in an upward, downward, and lateral directions

Question 11

Rocabado’s 6x6 Exercises
Nodding

Answer 11

Both hands clasped behind the neck, head is nodded slowly and gently

Question 12

Rocabado’s 6x6 Exercises
Axial Extension

Answer 12

one finger is pressed gently over the base of the nose, finger is allowed to guide the head back with face and eyes aligned horizontal

Question 13

Rocabado’s 6x6 Exercises
Shoulder Positioning

Answer 13

Jaw in resting position and axial extension, hands grasped together behind the back and arms are raised up slowly while shoulder blades are pinched together

Question 14

Anterior Disc Dislocation That Reduces
Dentist may use intra-oral appliance. Places mandible in more ___________
Takes stress off disc and retro-discal tissue to ________

Answer 14

more forward position so that the disc can’t sublux.
allow healing

Question 15

Anterior Disc Dislocation That Reduces
Neuromuscular control exercises to correct deviations and re-teach how to

Answer 15

open and close mouth in proper alignment.

Question 16

Anterior Disc Dislocation that does NOT reduce

Answer 16

TMJ distraction, sometimes combined with anterior translation may reduce disc.

If successful, patient should obtain an appliance.

Follow-up with neuromuscular control exercises

Question 17

• Examples of Simple NM Control Activities
  
  • Rotation-Translation Sequence
    Rotation sequence for first 11 mm

Answer 17

Have patient put tongue on palate, palpate chin and TMJ. Allow chin to drop.

Do this while looking in mirror to ensure proper alignment.

Question 18

Rotation-Translation Sequence
Progress to

Answer 18

w/o using chin palpation

Question 19

Rotation-Translation Sequence
Adding translation

Answer 19

Go as far as you can with tongue on palate, then drop tongue from palate and continue movement to end-range.

Start with finger on chin then progress to no finger on chin.

Monitor alignment in mirror, do not allow patient to exceed range with poor alignment.

As patient is able to control alignment, range can be increased.

Question 20

Stabilization Techniques

Answer 20

mandibular depressors, elevators, lateral deviators, protruders, retruders

isometrics in resting position

isometrics with mouth open 1 finger breadth and tongue on palate

Repeat above with mouth open to 2 finger breadths