Temporomandibular joint: anatomy, structure

Temporomandibular joint - TMJ - Surgical dentistry from A to Z

Temporomandibular joint (TMJ) (articulatio temporomandibularis), is formed by the head of the lower jaw and the mandibular fossa of the temporal bone (Fig. 1-24).

Fig. 1-24.Temporomandibular joint (TMJ).

A: 1 - zygomatic arch; 2 - malar bone; 3 - coronoid process of the lower jaw; 4 - maxillary bone; 5 - the second molar; 6 - lower jaw; 7 - the third molar; 8 - chewing tuberosity; 9 - branch of the lower jaw; 10 - ankle-jaw joint; 11 - condylar process of the lower jaw; 12 - anterior (external) part of the lateral ligament temporomandibular joint; 13 - posterior (internal) part of the lateral ligament of the temporomandibular joint; 14 - mastoid process of the temporal bone; 15 - outdoor auditory canal.

B: 1 - sphenoid sinus; 2 - lateral plate of the pterygoid process of the sphenoid bone; 3 - winged bony ligament; 4 - the sphenoid bone; 5 - neck of lower jaw; 6th - wedge-shaped lumbosacral ligament; 7 - styloid process of the temporal bone; 8 - condylar process of the lower jaw; 9 - awl-maxillary ligament; 10 - the opening of the lower jaw; eleven - pterygoid hook; 12 - pterygoid tuberosity; 13 - angle of the lower jaw; 14 - maxillofacial line; 15 - molars; 16 - premolars; 17 - fangs; 18 - hard palate; 19 - medial plate of pterygoid process; 20 - lower nasal shell; 21 - wedge-shaped notch aperture; 22 - an average nasal conch; 23 - upper nasal concha; 24 - frontal sinus

Lower jaw head- Cylindrical thickening of ellipsoid form, elongated in the transverse direction. The axes, extended along the length of the head, converge at the anterior edge of the large occipital orifice, forming an obtuse angle.

In front of the head, in the pterygoid fossa, the lateral pterygoid muscle is attached. The posterior surface of the head is slightly convex, triangular in shape, with a base facing upward. The joint surface of the mandibular fossa is 2-3 times larger than the head of the lower jaw.

It has an ellipsoidal shape. The fossa is divided into two parts: the anterior part - the intracapsular and the posterior - the extra-capsular. The incongruence between the head and the pit is equalized by the articular disc and the attachment of the capsule of the joint to the temporal bone.

The intracapsular part of the articular fossa is confined to the front by a slope of the articular tubercle, and from behind - by a rocky-drum slit. Outside the fossa is limited by the root of the zygomatic process, from the inside - by the angular spine of the sphenoid bone.

The shape of the mandibular fossa is different and depends on individual factors of development, as well as the nature of dental occlusion. There are two extreme forms - deep and flat.

One of the characteristic features of the TMJ- the presence of an articular tubercle, which is inherent only in humans.

There are two extreme forms of the tubercle: the low and broad tubercle corresponds to the flat mandibular fossa, the high and narrow - to the deep pit (Fig. 1-25).

Fig. 1-25.The form of the articular tubercle:

a is flat; b - medium convex; in - steep

The articular disc (discus articularis)consists of fibrous cartilaginous tissue. He divides the joint cavity into two isolated cracks - the upper and lower. The disk has the form of a biconcave lens, in which the front and rear sections are distinguished.

Between the latter is the thinner and narrower middle part of the disk. The front of the disk is thicker than the rear. Its thickness depends on the shape of the joint fossa: the deeper and narrower the fossa, the thicker the disc, and vice versa, the fatter and wider the fovea, the thinner the disc (Fig. 1-26).

Fig. 1-26.

Differences in the structure of articular surfaces of the TMJ: a - ovoid form of the condylar process and deep mandibular fossa; b - flat form of condylar process and mandibular fossa: 1 - mandibular fossa, 2 - articular disc, 3 - condylar process; 4 - mandibular fossa (view from below), 5 - isolated condylar process

Therefore, the two extreme forms of the articular disc are distinguished: with one of them the articular disk is flat and thin, while the other is narrow and thick.

The purpose of the disc is to align the discrepancy between the joint fossa and the head and, due to its elasticity, to soften the chewing impulses. The upper joint gap is located between the joint fossa and the articular tubercle and the upper surface of the articular disc.

The lower joint gap at the top is limited by the concave surface of the disc, and from below - by the joint head of the lower jaw. Articulated surfaces in the lower joint slit fit more closely to each other, so it is narrower than the upper one.

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In the anterior medial region of the articular disk, the tendon fibers of the lateral pterygoid are intertwined, so that it can move along the slope of the articular tubercle downward and forward.

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The joint capsule of the TMJis extensive and pliable, allows significant movements of the lower jaw.

At the top the capsule is attached at the front along the edge of the zygomatic arch, from behind - fissura petrotympanica, medially - on spina angularis and sutura petrotympanica, then turns outward and in front grasps the articular tubercle.

On the lower jaw, the capsule runs along the neck of the articular process, leaving the fovea pterygoidea outside the capsule. The capsule is thickened posteriorly, and the extra-capsular part of the mandibular fossa is filled with a loose connective tissue tissue, forming a numeral pillow.

The ligaments of the TMJ are divided into intracapsular and extra-capsular.

Intracapsular ligaments include the anterior and posterior discoidal bands, which extend from the upper edge of the disc upward and forward and backward towards the root zygomatic arch; lateral and medial disco-maxillary, located from the lower edge of the disk down to the attachment of the capsule to the lower neck jaws. Three ligaments are extra-capsular.

The bunch has the shape of a triangle, with a base facing the zygomatic arch, and consists of two parts: back, in which bundles of fibers go from above and forward, and in front - fiber bundles go from top to bottom and back.

This ligament brakes the lateral movements of the lower jaw inwards.

2. The wedge-mandibular ligament (ligamentum sphenomandibulare)It originates from the angular spine of the sphenoid bone, spreading downward, attaching itself to the tongue of the lower jaw. The ligament delays the lateral and vertical movements of the lower jaw.

3. Shilonizhnachelastnaya ligament (ligamentum stylomandibular)passes from the styloid process of the temporal bone down to the posterior margin of the branch of the lower jaw. This ligament brakes the extension of the lower jaw forward.

TMJis a combined joint. Its articular surfaces are covered with fibrous cartilage. According to the nature of movements, the joint belongs to the blocklike. In the joint, lowering and lifting of the lower jaw is possible.

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With a slight lowering of the lower jaw, movement occurs around the frontal axis in the lower slot of the joint, while the head of the lower jaw produces rotational movements along the lower surface of the disc.

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Movement of the lower jaw forward is carried out in the upper slit of the joint. In this case, the head together with the disk is one unit and slides forward and down the slope of the articular tubercle.

Simultaneously with this movement, the jaw head performs rotational movements in the lower slot of the joint.

The lateral movements of the lower jaw are due to the one-sided contraction of the lateral pterygoid muscle and the anterior tufts of the temporal muscle of the opposite side. The angle of deflection toward the lower jaw is 15-17 °.

In the joint of the opposite side, where the lower jaw extended, the head remains in the joint fossa, making rotational movements around the vertical axis. In addition, the head moves back and forth. Movement occurs in the lower chamber of the joint between the lower surface of the disc and the joint head (Fig. 1-27).

Fig. 1-27.Sagittal incision of the temporomandibular joint (TMJ)

In the joint cavity is a biconcave Z-shaped warped cartilaginous disc. Since the mandibular anatomically has two joints, it is classified as a combined and complex, and biaxial. The movements in it are complex.

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The structure of the joint allows the lower jaw to rotate around the front axis - lower the jaw (open the mouth) at a distance of 5 cm between the anterior teeth of an adult. Further lowering leads to dislocation.

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With excessive opening of the mouth, the condyles of the lower jaw can slip forward through the tubercle and contract muscles in this position. All this causes the dislocation of the lower jaw, which can be on one or both sides.

With this position, the movement of the lower jaw is impossible, speech is absent, only inarticulate sounds are produced. The dislocation should be corrected, and as soon as possible, otherwise the stretched capsule creates conditions for repeated phenomena.

But this should be done by a doctor, since ineffectual correction can be complicated by a fracture of the neck of the condylar process of the lower jaw.

Since the joints are separated from each other, the movements in them can be separate. This is facilitated by a wide capsule and ellipsoid condyle of the jaw, i. E. presence of a vertical axis.

More precisely, it is possible to push the jaw forward in one joint, and not to do this in the second joint, thus, in the non-retracted joint of the condyles rotates around the vertical axis. The chin of the jaw moves like a circle around the center.

This displacement is limited by the joint of the opposite side and, first of all, by the depth of its fossa of the temporal bone, the severity (height) of the articular tubercle and the strength of the articular ligaments. From the average position, the chin can move to the sides no more than 15-17 °, i.е. on,% of the circle.

Combinations of the described movements make it possible to chew, not only squeezing, but also crushing food by the type of shear (shift the jaw forward, sideways). This is also the relief of teeth.

Materials used: Anatomy, physiology and biomechanics of the dentoalveolar system: Ed. L.L. Kolesnikova, S.D. Arutyunova, I.Yu. Lebedenko, V.P. Degtyaryova. - Moscow: GEOTAR-Media, 2009

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Anatomy and pathology of the temporomandibular joint

The bones of the human skull are interconnected practically motionless. And only one joint in the front has a large volume of movements.

This is the temporomandibular joint. Thanks to his work, a person can open his mouth, eat, speak, yawn. The structure of the joint is quite complicated.

It is formed by cartilaginous and bone parts, ligaments, muscles.

Structure, articulation functions

The formation of the temporomandibular joint involves temporal bones and the lower jaw. Its head is in contact with the fovea and tubercle of the temporal bones.

Strengthened articulation of the joint capsule, developed ligaments and muscles. For the most mobility in its composition includes a special education - the articular disc.

A complex anatomy makes possible movements in three different directions:

• horizontal;
• vertical;
• back and forth.

The main function of this joint is to ensure the mobility of the lower jaw.

Complaints of affection

The location of the temporomandibular joint and its anatomy lead to a variety of complaints in the disease:

1. Pain syndrome. Pain in the jaw joint can be noted at rest or only when the mouth is opened, chewing. By nature, it is aching and acute. Often there is a shooting kind of pain, especially with inflammation of the jaw joint. Sometimes patients notice other symptoms - pain in the ear or head.
2. Disturbances of movements in the joint. These symptoms can manifest themselves in different ways depending on the disease. Often there are difficulties in opening and closing the mouth - joint stiffness. It is also often possible to hear that the joint clicks when moving. A crunch near the ear is noted with the development of degenerative processes in the articulation. Motor dysfunction of the temporomandibular joint leads to difficulties in chewing, talking.
3. Edema. Inflammatory processes in this part of the head are accompanied by swelling. The anatomy of the temporomandibular region is such that the edema is visible to the naked eye. Sometimes it reaches the ear area. Palpation during examination can be painful. With severe inflammation, the skin over the joint becomes red, local temperature may increase.
4. Complaints from other bodies. The close relationship of the temporomandibular joint with other structures of the head and neck leads to the emergence of specific complaints. These include hearing loss, ear congestion due to edema of the eustachian tube, burning in the mouth and tongue, a feeling of dryness in the mouth.
5. Bruxism. Sometimes relatives of patients note that they grind their teeth in a dream. This is called bruxism. If the grinding, especially paroxysmal, is noted during the waking period, this is called bruxomania and also speaks of the disease of the mandibular joint. The causes of bruxism are excessive muscular tension, and sometimes inflammation of the jaw joint.

Diseases of the mandibular joint

Diseases of the temporomandibular joint are often found in any age group. For elderly patients degenerative-dystrophic pathologies are characteristic - arthrosis, deforming osteoarthritis, ankylosis. But arthritis can also be observed.

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In young and middle age, subluxation predominates, dislocation of the joint and its inflammation. The fact that the joint is formed not only by bones and ligaments, but also by muscles, leads to the development of a separate group of diseases - neuromuscular.

Osteoarthritis

Arthrosis is a chronic disease, which is based on dystrophic changes in articulation. Gradual destruction of his cartilaginous, bone and connective tissue parts, with which the joint is formed.

The causes of the development of arthrosis can serve as the transferred inflammation or trauma in the mouth and ear, the absence of teeth for a long time.

The main symptoms of arthrosis are dull pain and stiffness. Often a complaint is noted that the joint clicks or crunches.

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In severe forms of the disease, displacement of the lower jaw towards the lesion can be observed.

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There is also a noticeable deepening of nasolabial folds, expressed mimic wrinkles near the mouth.

Arthritis

Arthritis is characteristic for young patients and the middle age group. This is an inflammatory process in the jaw area.

Unlike arthrosis, it usually begins sharply, with severe symptoms - severe pain in the jaw and ear area, mouth. With jaw movements, the pain intensifies.

If the arthritis is purulent, then in the affected area it will be possible to notice swelling with redness. There may be painful palpation of the points of the exit of the facial nerve, the very articulation and tragus of the ear.

Inflammatory processes, especially purulent, always have a clear cause of occurrence. In the temporomandibular joint, the infection usually comes from the middle ear, inflamed salivary glands or skull bones in osteomyelitis.

Temporomandibular syndrome, neuromuscular diseases

The syndrome of painful dysfunction of the mandibular joint refers to neuromuscular diseases. It occurs more often in young and middle age.

Patients note how the injured lower jaw joints click. The click is almost constant. In addition, the syndrome of painful dysfunction is characterized by pain in the chewing muscles. There may be attacks of facial and headache, neuralgia, increased muscle tone.

Dislocation of the lower jaw

The dislocation of the lower jaw is a very unpleasant condition. Jaw movements are blocked. The mouth of a man with a mandibular dislocation is open. It is impossible to close it independently. Salivation is noted, speech becomes indistinct.

In addition to acute, there are chronic dislocations of the lower jaw. They are also called familiar. With a habitual dislocation, a person can cope on his own. But their constant occurrence (when coughing, yawning, biting) acts depressingly on the psyche.

Causes of acute and chronic dislocation:

1. Injuries to this area.
2. Inflammatory and degenerative processes.
3. Neuromuscular disorders of the facial segment.
4. Congenital malformations of the nervous system.

In addition to the lower jaw, the mandibular disc can dislocate. This process is accompanied by a sharp pain and a complete blockade of the joint. Dislocation of the disc is most difficult to diagnose.

Subluxation of the mandibular joint is an incomplete displacement of the mandibular head beyond the upper part of the articular tubercle. Spontaneous redirection usually does not occur. The mandibular subluxation may be one - or two-sided, acute and habitual.

Symptoms of subluxation are not as severe as in the case of dislocation. Usually the jaw is fixed with a sharp opening of the mouth, with chewing, trauma. The subluxation can be corrected by yourself, if you do it carefully, do not use too much effort.

People with a habitual subluxation can hear how the joint flips when the mouth moves.

Diseases of the temporomandibular joint in children

Diseases of the temporomandibular joint in children have their own characteristics. Given the anatomy and physiology of childhood, the pathology of the mandibular joint can be divided into two groups:

• Primary-osseous. It is associated with birth trauma, malformations of the skull bones.
• Functional. Prolonged dysfunction leads to its loss in adulthood.

At teenage girls at the age of 13-14 years there can be a habitual subluxation of the lower jaw. Usually this is preceded by the feeling that the joint is clicking, which have been observed for several years.

Diagnostics

The examination in diseases of the temporomandibular region is carried out by a dentist. This joint is available for inspection and palpation. During the palpation of the joint, the points of greatest soreness, the displacement of the joint elements, their stiffness or excessive mobility are determined.

An auxiliary method of examination is auscultation - listening with a phonendoscope. With degenerative lesions, destruction of bone or cartilage, subluxations, the doctor can hear clicks, crunching, crepitus (a sound similar to the rustling of paper).

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If the development of synovial fluid is disturbed by the phonendoscope, the sound of friction of the articular surfaces will be clearly heard.

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The diagnosis is confirmed during radiography or arthrography. Magnetic resonance imaging and arthroscopy of the temporomandibular joint are more informative methods of investigation. Computed tomography of this area is also used.

Treatment

In the treatment of diseases of the temporomandibular joint, a variety of methods are used. These include:

• Anti-inflammatory and chondroprotective therapy.
• Antibacterial treatment.
• Orthopedic correction.
• Surgical intervention.
• Physiotherapeutic effect.

Therapy of arthrosis

Conservative treatment of temporo-mandibular arthrosis includes medicamentous and physiotherapeutic methods.

From drugs, anti-inflammatory and chondroprotective drugs, analgesics are more often used. Complementary treatment with gymnastics of the lower jaw, phonophoresis, galvanization, massage.

But the main method of treatment remains orthopedic. Its main task is to reduce the burden on the affected area. Operative methods are used less often.

Therapy of arthritis

Acute purulent arthritis is treated with the mandatory use of antibacterial drugs.

At first, antibiotics of a wide spectrum of action with selective accumulation in bone tissue-the lincomycin group-are used.

If they are ineffective, bacterial culture is performed, and the treatment is prescribed taking into account the sensitivity of the pathogens to antibiotics.

Chronic arthritis in the acute stage is treated as acute.

Treatment of the syndrome of painful dysfunction

Given that the basis of the development of this syndrome lies spasm and increased tone of the chewing musculature, the medications are widely used muscle relaxants (drugs that relax the muscles).

In case of severe pain, analgesics with anti-inflammatory drugs are prescribed.

In the syndrome of painful dysfunction, an important thing is orthodontic treatment - correction of an incorrect occlusion. If necessary, the mandible is fixed. It helps well in the temporomandibular joint syndrome and physiotherapy treatment - thermal procedures.

Treatment of dislocation and subluxation of the lower jaw

In the case of acute pathology, a dislocation or subluxation is corrected, the mobility of the joint is limited by the tire or by a sling dressing.

Usually immobilization (immobilization) is required within two weeks. In the case of a habitual dislocation, the correct role is played by the correct opening of the mouth.

For this purpose, fixed or removable opening limiters are used.

Complementary treatment with medicines and physiotherapy methods. The best effect is achieved with surgical intervention - fixation or movement of the joint disc, strengthening the ligaments of the articulation.

A source: http://MedOtvet.com/stroenie-sustavov/anatomiya-i-patologiya-visochno-nizhnechelustnogo-sustava.html

Temporomandibular joint: structural features and types of diseases

Often a person does not think about the strain that these or other joints experience during the day.

One of the most involved is the temporomandibular joint.

Mimic movements, conversation, chewing food, and many other functions - the daily work of this type of joints.

Temporomandibular joint of a person, one of the most complex in structure, in connection with this, its inflammation, can lead to extremely negative consequences.

Brief description of temporomandibular joints

The temporomandibular joint (articulatio temporomandibularis) is the only kind of paired joints in the human body. By the level of strength and load on it, the temporomandibular joint can compete only with the knee.

The temporomandibular joint of a person has a strength that reaches 200-300 kg. During sleep, the parafunction of the temporo-facial musculature is not uncommon. It manifests as uncontrolled clenching of teeth (dental scraping), and is called bruxism.

Features of the TMJ structure

The temporomandibular joint is a paired, combined joint, the articular surfaces of which are covered with fibrous cartilage. They form the temporomandibular joint, the head of the lower jaw and the mandibular fossa.

The temporomandibular joint consists of muscles, tendons and temporo-facial bone and has a complex structure.

The main components of the jaw joint:

• articular surface of the temporo-facial bone;
• mandibular block;
• intraarticular disc;
• capsule;
• ligaments.

The head of the lower jaw has the form of a roll-shaped thickening of the ellipse shape, which is elongated in the lateral direction. The mandibular fossa is more than about 2-3 times and also has the shape of an ellipse.

The tympanum-scaly cleft divides the mandibular fossa into two parts. Between the fossa and the head of the mandibular joint is an articular disc, similar in shape to a biconcave lens, which, due to its elasticity, is intended to soften the masticatory movements.

The temporomandibular joint has ligaments of two types: intracapsular and extra-capsular.

Intracapsular, in turn, are divided:

• on the front and rear of the disc;
• lateral and medial disco-maxillary.

Extra-capsular ligaments:

• lateral;
• wedge-mandibular;
• ankle-jawed.

It should be noted that if the elasticity of the articular disc is lost, it can change its shape. As a result of such changes:

• frequent clicks and crunching when chewing or yawning;
• jaw movements are difficult;
• there is soreness.

All these signs are the first prerequisites for the development of temporomandibular joint dysfunction.

Diseases of the temporomandibular joint

Temporomandibular joint, has not pronounced symptoms of the development of the inflammatory process at its early stage.

In this regard, the first signs of the disease of the mandibular joint remain without due attention.

Meanwhile, the disease is progressing and can have a serious impact on the health of the whole organism.

The most common types of diseases that affect the temporomandibular joint are:

• arthritis;
• arthrosis;
• dislocation;
• ankylosis;
• musculo-articular dysfunction.

Arthritis and arthrosis

Speaking about arthritis and arthrosis, it should be noted that the temporomandibular joint is not distinguished by the main symptomatology, signs and causes of origin, from those analogous to the same indices valid for arthritis and arthrosis of others departments.

Arthritis can be characterized by several criteria.

By the nature of the current:

For reasons of occurrence:

• infectious;
• traumatic.

In turn, infectious arthritis is divided into:

• specific;
• nonspecific.

Arthrosis is a dystrophic change of intraarticular tissues. Most often it is chronic.

Symptomatic of these diseases is very similar:

• clicks and crunch when driving;
• soreness in the ears and joint;
• in some cases, swelling;
• limited movement;
• In arthritis, joint deformity may occur.

Dislocations

With a dislocation, the temporomandibular joint is characterized by the displacement of the head of the lower jaw beyond the joint pits. It can be front and back, as well as one-sided and two-sided.

Anterior dislocation occurs as a consequence:

• impact;
• strong opening of the mouth (eg, yawn or dental treatment).

Clinical signs of anterior TMJ dislocation:

• my mouth is open, and I can not close it;
• slurred speech;
• copious salivation;
• pain in the joint;
• chin mixing.

Posterior dislocation is extremely rare.

There are several types of dislocations:

• hypermobility;
• sprain;
• subluxation of the head;
• displacement of the joint disc (dislocation of the disc);
• falling out of the slave disk.

Ankylosis

Ankylosis of the mandibular joint arises as a result of the formation of adhesions between the head of the lower jaw and the articulating surfaces. It appears as a persistent reduction of the jaw. Ankylosis happens:

The cause of development can be both trauma, and the transferred infectious disease. In neglected form, it can cause complete loss of motion.

Musculo-articular dysfunction

The main causes of dysfunction of the mandibular joint are:

• stress;
• improperly placed seals;
• injuries;
• loss of chewing teeth, as a consequence of decreased bite;
• bruxism;
• malocclusion.

Signs of the disease are pain and tension in the muscles:

• chewing;
• temporal;
• sublingual;
• cervical;
• pterygoid;
• trapezius muscle of the back;
• sternocystis-mastoid;
• as well as frequent headaches, different in severity.

Treatment of TMJ diseases

Diseases of the mandibular joint are very often protracted (up to several years), so it is very important to diagnose the disease in time and begin treatment.In the early stages of inflammation, curing the temporomandibular joint awakens faster and easier than the neglected chronic form of the disease.

The necessary treatment of diseases of the temporomandibular joint is prescribed by the doctor, after a thorough diagnosis, depending on the type and form of inflammation.

It is possible to identify the main methods of treatment of the mandibular joint, common for most types of disease.

Most often, with the defeat of the mandibular joint requires a comprehensive treatment.

1. Treatment by physiotherapy includes: electrophoresis, massage, dynamic currents and other types of physiotherapy.
2. Resting treatment: restriction of the load on the joint, soft food, silence, you can not open your mouth wide.
3. Treatment with compresses: cold to reduce pain, warm to reduce tension from muscles and cramps.
4. Restoration of the natural height of the occlusion: various methods of restoration and prosthetics of teeth, dental crowns.
5. Limit bruxism by applying a trainer treatment.
6. Drug treatment: anesthesia and the taking of anti-inflammatory drugs.
7. Surgery. These methods include: restructuring, prosthetics and arthroscopy of the joint.

It should be noted that the temporomandibular joint is treated by the operating method only in cases when treatment with traditional methods did not yield significant results.

A source: http://bolit-sustav.ru/bolezni/visochno-nizhnechelyustnoj-sustav-ego-bolezni-i-ih-predposylki/

Anatomy of the temporomandibular joint of a person - information:

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

Temporomandibular joint, articulatio temporomandibularis, caput mandibulae and fossa mandibularis of the temporal bone are formed. The articulating surfaces are supplemented by the interarticular fibrous cartilage lying between them, discus articularis, which by its edges fuses with the capsule of the joint and divides the joint cavity into two separate departments. The joint capsule is attached to the edge of the fossa mandibularis to the fissura petrotympanica, enclosing the tuberculum articulare, and below covers the collum mandibulae.

About the temporomandibular joint there are 3 ligaments, of which only lig has a direct relationship to the joint.

laterale, going on the lateral side of the joint from the zygomatic process of the temporal bone obliquely back to the neck of the condylar process of the lower jaw. It inhibits the movement of the articular head posteriorly. The remaining two ligaments (lig.

sphenomandibulare et lig. stylomandibulare) lie at a distance from the joint and are not ligaments, but artificially allocated sections of the fascia, forming a loop, as it were, contributing to suspension of the lower jaw.

Both temporomandibular joints function simultaneously and therefore represent one combined articulation.

Temporomandibular joint refers to condylar articulations, but due to the intraarticular disk, movements in three directions are possible in it.

The movements that the lower jaw performs are as follows:

1. lowering and lifting of the lower jaw with simultaneous opening and closing of the mouth;
2. shifting it forward and backward
3. lateral movements (rotation of the lower jaw to the right and left, as is the case with chewing).

The first of these movements occurs in the lower part of the joint, between the discus articularis and the head of the lower jaw. Movements of the second kind occur in the upper part of the joint.

In lateral movements (third genus), the head of the lower jaw along with the disc leaves the joint fossa on the tubercle only on one side, while the head of the other side remains in the joint cavity and rotates about the vertical axis. Small circular motions in 3 planes are possible.

Vessels and nerves:the joint is fed from a. maxillaris.

Outflow of lymph is carried out along deep lymphatic paths in nodi lymphatici parotidei and then into deep cervical nodes.

The joint of n is innervated. auriculotemporalis (from the III branch of n. trigeminus).

Maxillofacial Surgeon

Dentist

Surgeon

Syndrome of dysfunction of the temporomandibular joint

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It is necessary to carefully approach the state of your health in general.

There are many diseases that initially do not manifest themselves in our body, but in the end it turns out that, unfortunately, they are already being treated too late.

For this, it is simply necessary several times a yearundergo medical examination, not only to prevent a terrible disease, but also to maintain a healthy mind in the body and the body as a whole.

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What is the temporomandibular joint?

There are some joints in our body, on which not only movement depends, but also the work of other organs.Temporomandibular joint anatomy is quite complicated, takes part in the chewing process, and the lower jaw occupies a significant part of the face.

Muscles

Chewing muscles are significant, but rather decisive in the activity of the temporomandibular joint. They, like bones, have their location and special purpose. What chewable muscles are responsible for can be guessed by the name.

The most specific function among the muscles that has a temporomandibular joint is the pterygoid muscle area. It has a branch, where one of the bundles is attached to the articular bag, and the other muscle bundle goes to the pterygoid fossa of the lower jaw.

When this muscle contraction occurs, the synchronous movement of the lower jaw and the joint disc is performed, respectively.

Chewing muscles make the lower jaw normally move.

These muscles are relatively strong, as it is necessary to exert force in order to pressurize when chewing and to allow the teeth to snack and chew food.

In addition, the human anatomy ordered that these muscles have a role in the swallowing process. Also temporomandibular joint has such a structure that chewing muscles play a role in the process of speech formation.

As for the functions that the muscle performs in contrast to the ligament and bone, it raises the lower jaw, lowers it, and pulls it up.

Facial nerve

As for the facial nerve, then unlike the location of the bones and ligaments, it is very mobile. In the jaw, there are special fibers that are perceived as part of the facial nerve (other names are the nerve of Sapolini, the nerve of Vrisberg).

This suggests that in the area of ​​the facial nerve there are fibers that are constituents of several nuclei.

There are several groups of cells, the same nerve, which is responsible for ensuring that a person has a certain facial expression. It is the nerve of the face that is responsible for the normal operation of the mimic muscles.

In addition, the nerve of the face is responsible for other facial features of the person.

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The lower part of the facial nerve that interests us more than others has such an arrangement that its fibers go toward the cheeks and mouth, which shows its connection with the temporomandibular joint. And in the process of eating or the same facial expressions, the muscles that help the lower jaw work asymmetrically.

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There is the possibility of affecting the facial nerve, there are several variants of diseases that can be accompanied by different changes. If the nerve of the face is affected, then, most likely, there will be a paralysis of the muscles with which it is connected.

Therefore, you can often hear that when the nerve of the face is affected, the patient develops an asymmetric face.

Also, if the nerve of the face is damaged, then there are problems with facial expressions, a person does not always get to show emotional features on his face.

When the facial nerve is affected, this manifests itself in such a way that a person can not wrinkle his forehead or normally open his eyes.

Do not exclude cases of neuropathy, in which case the nerve of the face peculiarly pulls the face into its healthy side.

There are variants of destruction not only of the facial nerve, but also that another nerve will be struck. Then to problems with the fact that the nerve of the face does not function, the features of the functioning of other nerves are added, if they also failed, then the person will have cerebral symptoms.

In degenerative diseases, the human nucleus of the facial nerve is damaged, after such damage to the face the active nerves are paralyzed, the features of the disease are that peripheral paralysis.

Articular head

This part, which has a temporomandibular joint, differs in its cylindrical shape, there are also variants that it is very similar to the ball played in rugby. Its dimensions are as follows more precisely, 10 m: 0mm.

10 will be if we consider it in the anteroposterior direction, and 20 if it is mediated in the material medium. The structure of the articular head is arranged so that it is located completely opposite the articular tubercle.

The convex surface is opposite to convex.

If we consider the frontal plane, the level of the lateral pole will be located just below the medial pole. The upper surface of the head touches the articular fovea, since it mainly participates in the movement.

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Because of this, it is covered with cartilage, as in principle and any joint in the human body.

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If you look at the head in a section, you can see that after the cartilaginous tissue to which it is covered, there is a cortical bone, and underneath is a trabecular bone.

The articular head can receive changes after the person will lose one, two or more teeth.

So what happens when the temporomandibular joint loses its teeth? Depending on how much teeth are lost, there will be changes and the most articular head.

In addition, changes can occur due to resorption or as a result of the formation of depressions that occur on the articulation surface. The appearance of resorption is usually a purely individual process, with regard to placement. But in most cases this happens lateral department.

Articular fossa

Considering in detail the ligaments, the bones of which the temporomandibular joint consists temporally, it is impossible not to mention the joint fossa. It looks like a kind of depression for the head of the lower jaw.

Limited articular fossa behind the drum plate of the temporal bone. It is difficult to say that the joint fossa is excessively active, like some ligaments and bones.

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Due to this, in the deep sections this part of the temporomandibular joint is missing cartilages, which are usually present in the active movement of a particular bone.

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Also there is a special gap, one of the features of the structure of the human body, where the facial nerve passes. With the loss of some teeth, the depth of this part of the jaw becomes smaller.

Not only bones but also ligaments

In the lower jaw, the human faces of the ligament are usually divided into species, and, accordingly, a peculiar classification takes place. This classification is that there are ligaments intracapsular, and there are extra-capsular ligaments.

The classification of intracapsular lies in the fact that the posterior and anterior disc-ligament ligament are divided, the lateral and medial discomandibular ligaments. The classification of extra-capsular is slightly different.

There are three ligaments, they are called: ankylogenous, lateral, sphenoid-mandibular.

Diseases that may be associated with the temporomandibular joint

Human anatomy is arranged in such a way that many movements, which, at first glance, are complex, are not problematic for a person to perform.

But on the other hand, the anatomy binds all the organs together, so when one organ is damaged, the neighboring ones may suffer.

Therefore, against the background of one disease there may be problems in the vertebrae, larynx, jaw, some bone, and cartilage may suffer.

In this case, the area of ​​the vertebrae and larynx is rarely affected, usually the human jaw itself suffers, as well as the bones and cartilage that it consists of.

If the lower jaw is damaged during the impact, the features are that the joints, and consequently the cartilage, can be severely damaged. The person's face swells and the masticatory function is significantly impaired.

Also, the classification of diseases includes a disease such as osteomyelitis. The peculiarities are that there are infections in the body that form an infectious and inflammatory process in the face area.

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Human anatomy allows us to distinguish three types of osteomyelitis. Acute osteomyelitis is characterized by the fact that pulsation goes under the jaw and can even give to the larynx region.

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And besides, what it gives to the larynx, more often the patients feel the fever and chills.

Treatment will depend on the stage of the disease, whether there are symptoms with fever and pain in the larynx, and other related factors.

Dysfunction of the high-jaw joint affects a large part of the human body. These can be bones, cartilage, and larynx, vertebrae.

There may be problems in the joints, where there are cartilages. Due to the fact that the cartilage is affected, there is a clicking of the jaw.

It is possible that the region of the larynx will be affected. Usually, when they complain of pain in the upper part of the larynx, the problem is somewhat different. If there is pain in the larynx, it is more likely that problems have arisen with the nerve, neuralgia of the laryngeal nerve causes such symptoms.

Anatomy, the structure of the human body suggests that the disease can affect the bones, cartilage, the vertebrae.

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Problems with the lymph nodes act in such a way that there is pain in the neck, some patients complain that they give to the area of ​​the vertebrae.

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Usually such a situation indicates that there is another ailment, when the cartilage in the vertebrae is aching.

The description of this disease is more aimed at the fact that the pain appears in the neck, rather than the cartilage and the vertebrae. Therefore, if in addition to the fact that there is pain in the neck, several vertebrae in the cervical region suffer, it is better to go to an additional consultation with a doctor.

The lower jaw performs a huge role in human life, this is confirmed both by the anatomy and the very structure of the temporomandibular joint.

Anatomy shows that the diseases of this part of the body can be different, and the damage to any organ, be it the jaw, any of the vertebrae, the leg or hand, always have negative consequences. Therefore, the fastest treatment and recovery will save you from health problems in the future.

A source: http://drpozvonkov.ru/sustavy/anatomy/visochno-nizhnechelyustnoy-sustav-anatomiya.html