单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,*,TEMPOROMANDIBULAR DISORDERS,TEMPOROMANDIBULAR DISORDERS,1,American Dental Association,1983,defined TMD as a group of orofacial disorders characterized by:,Pain,in the preauricular area,TMJ,or muscles of mastication,Limitations,/deviations in mandibular range of motion,TMJ sounds,during jaw function,1990Y Craniomandibular Disorders(CMD),Definition,Definition,2,Epidemiology of TMD,TMD pain has been estimated to affect 10%(5-12%)of the population,It is at least twice as common in women as in men,It occurs more frequently in people 20-50 years old,Epidemiology of TMDTMD pain ha,3,Anatomy of TMJ,Mandibular condyle,Joint surface of temporal bone,Articular disc,TMJ capsule,TMJ ligament,Anatomy of TMJMandibular condy,4,Multi-axis&multi-direction,Movement agility,A important part in stomatognathic system,A remodeling in all lifetime joint,Anatomy of TMJ,Multi-axis&multi-direction,5,Sagittal plane view:The relationship among dics&condyle&glenoid in COP,Normal:,One plane:front bevel of condyle/middle part of disc/posterior bevel of node,One line:cross ridge of condyle/posterior border of later belt of disc/peak of glenoid,Abnormal:,1.Retrusion of condyle,2.Hyperfunction of lateral pterygoid muscle,Anatomy of TMJ,Sagittal plane view:The rela,6,Coronal plane view:the relationship of disc&condyle&node in COP,Normal:,middle position condyle and disc in middle position,Abnormal:,Ingression or out-shift of condyle and disc,Anatomy of TMJ,Coronal plane view:the relati,7,Etiology of TMD,Psychic factor,Bad habits,Trauma,Others,Etiology of TMDPsychic factorB,8,Occlusal factor:,Occlusal interfere,Protrusive occlusal interfere,Lateral occlusal interfere,Retrusive occlusal interfere,High spot,occlusion,Etiology of TMD,Occlusal factor:Occlusal inter,9,Lateral occlusal interfere,Lateral occlusal interfere,10,颞下颌关节紊乱病(英文)课件,11,Occlusal factor,Premature contact,：,interfere happened in PP to ICP,Elongation of upper 3rd molar,Anterior superior displacement of condyle,Elongation of lower 3rd molar,Posterior displacement of condyle,Etiology of TMD,Occlusal factorPremature conta,12,Occlusal factor,Malocclusion:,Malocclusion of individual tooth,Malocclusion of dentition,Etiology of TMD,Occlusal factorMalocclusion:Ma,13,Anterior teeth lingual tipping deep overbite,Anterior teeth lingual tipping,14,Occlusal factor,More teeth losed,Lateral molars loss,：,unilateral mastication,Bilateral molars loss,：,Posterior displacement of condyle,Maladjustment of Reverse tensile reflection,Etiology of TMD,Occlusal factorMore teeth lose,15,Occlusal factor,Change of interarch distance:,More higher:apertognathia,More lower:excessive wear,Anterior inferior displacement of condyle,Sustained tension of masticational muscle,Posterior superior displacement of condyle,Maladjustment of reverse tensile reflection,Etiology of TMD,Occlusal factorChange of inter,16,More higher vertical distance with more tenser muscles,More higher vertical distance,17,More lower in interarch distance,serious teeth wear,More lower in interarch distan,18,Occlusal factors,Latrogenic factors:,Oral madicine,Prosthodontics,Orthodontics,Etiology of TMD,Occlusal factorsLatrogenic fac,19,Predisposing factors,Initiation factors,Perpetuating factor,Etiology of TMD,Predisposing factorsEtiology o,20,Pain,TMJ sounds,Limitations in mandibular range,Others,Clinical manifestation of TMD,PainClinical manifestation of,21,Muscle derived,pain,Articular derived,pain,protective muscle splinting,local muscle soreness,myofascial pain,myospasm,chronic myosis,pain happened in disc and ligament,retrodiscitis,synovitis or capsulitis,osteoarthritis,Clinical manifestation of TMD,protective muscle splinting p,22,Displacement of disc,Recoverablity disc dislocation,Unrecoverability disc dislocation,Recoverablity disc dislocation,Unrecoverability disc dislocation,Clinical manifestation of TMD,Displacement of discRecoverabl,23,Antiorer diplacement of disc,Antiorer diplacement of disc,24,Antiorer diplacement of disc,Antiorer diplacement of disc,25,TMJ sounds,TMJ sounds,26,TMJ sounds,TMJ sounds,27,Hyperosteogeny&disc perforation,Synovium lesions,Clinical manifestation of TMD,Hyperosteogeny&disc perforat,28,Opening limitation,Abnormal opening,Clinical manifestation of TMD,Opening limitationClinical man,29,Tension type headache,Migraine,Others,Clinical manifestation of TMD,Tension type headacheClinical,30,Clinical examination of TMD,Clinical examination of TMD,31,Opening patterns,Straight,Deviation(right&left),Corrected deviation,Others,Clinical examination of TMD,Opening patternsClinical exami,32,Opening patten,Straight,Deviation(right&left),Corrected deviation,Others,Clinical examination of TMD,Opening pattenClinical examina,33,Clinical examination of TMD,Clinical examination of TMD,34,Clinical examination of TMD,Clinical examination of TMD,35,Clinical examination of TMD,Clinical examination of TMD,36,Clinical examination of TMD,Clinical examination of TMD,37,患者自身条件评价（,patient asse