8/3/2019 17 TMJ

1/23

DENT 5315/DH 2215 March 4, 2008

Here comesthe Quiz!

Yes!

8/3/2019 17 TMJ

2/23

KEY

8/3/2019 17 TMJ

3/23

Temporomandibular Joint

Dr. Sandra Myers

Director, NIDCRs TIRR TMJ Implant

Repository

NationalInstitute ofDental andCraniofacialResearch'sTMJImplantRegistry andRepository

8/3/2019 17 TMJ

4/23

Splints

QuickTime and aTIFF (Uncompressed) decompressor

are needed to see this picture.

QuickTime and aTIFF (Uncompressed) decompressor

are needed to see this picture.

Patient slides deleted to

protect patient identity.

8/3/2019 17 TMJ

5/23

Temporomandibular Joint (TMJ)

I. Classification of Joints

II. Temporomandibular Joint

8/3/2019 17 TMJ

6/23

I. Classification of Joints

3 Types of Joints:

A. Fibrous

B. Cartilaginous

C. Synovial

8/3/2019 17 TMJ

7/23

I. Classification of Joints

8/3/2019 17 TMJ

8/23

II. Temporomandibular Joint (TMJ)

A. Type of Joint

B. Development

C. Anatomy & Histology

D. Biomechanics

E. Innervation

F. Blood Supply

8/3/2019 17 TMJ

9/23

II. Temporomandibular Joint (TMJ)

A. Type of Joint

synovial sliding-

ginglymoid joint

Ginglymoid means:

Pertaining to, or resembling,a ginglymus, orhingejoint;

ginglyform.

8/3/2019 17 TMJ

10/23

II. Temporomandibular Joint (TMJ)

B. Development

Association of Meckels cartilage

with mandible

Condylar cartilage appears 12th

week

8/3/2019 17 TMJ

11/23

II. Temporomandibular Joint (TMJ)

C. Anatomy & Histology

8/3/2019 17 TMJ

12/23

Condylar Head

Bovine Condyle

8/3/2019 17 TMJ

13/23

Condylar Head

A - Fibrous layer

B - Reserve zone

C - Proliferative zone

D - Hypertrophic zone

E - Calcifying zone

F - Bone

8/3/2019 17 TMJ

14/23

Capsule

Functions:

Seals joint space

Passive stability

Synovial lining

Proprioceptive nerve

endings

Note synovial membrane over

villi (arrow):

8/3/2019 17 TMJ

15/23

Articular Disk

Acres of Collagen

Aneural & Avascular

8/3/2019 17 TMJ

16/23

Posterior Ligament

8/3/2019 17 TMJ

17/23

Synovial Membrane

Synovial Fluid:

Liquid environment

Lubrication

Nutrition?

8/3/2019 17 TMJ

18/23

Muscles

Muscles of

MasticationDifference

between

unipennate,

bipennate &

multipennate:

Muscles with

central tendon

Muscle fiber

bundles attachedto one side, two

sides or around

multiple central

tendons

8/3/2019 17 TMJ

19/23

D. Biomechanics

Complex combinations of

muscle activity

Disk enables complexmovements

8/3/2019 17 TMJ

20/23

D. Innervation

Movements of synovial joint initiated & effected by muscle coordination.

Achieved in part through sensory innervation.

Hiltons Law:

The muscles acting on a joint have the same nerve supply as the joint.

Therefore:

Branches of the mandibular division of the fifth cranial nerve supply

the TMJ (auriculotemporal, deep temporal, and masseteric)

8/3/2019 17 TMJ

21/23

D. Innervation

4 Types of nerve endings:

1. Ruffinis corpuscles (limited to capsule)

2. Pacinis corpuscles (limited to capsule)

3. Golgi tendon organs (confined to ligament)

4. Free nerve endings (most abundant)

8/3/2019 17 TMJ

22/23

Pacinian Corpuscle

http://www.kumc.edu/instruction/medicine/anatomy/histoweb/nervous/nervous.htm

Onion-like

encapusulated pressure

receptors

Surrounding concentric

lamellae respond to

distortion, generate

action potential in

unmyelinated fiber in

coreBar = 100 microns

8/3/2019 17 TMJ

23/23

Ruffinis & Golgi Corpuscle

Function:

Ruffinis =

Posture (proprioception),

dynamic and static

balance

Golgi tendon organ =

Static mechanoreception,

protection (ligament)

Free nerve endings = Pain(nociception) protection

(joint)

www.anatomyatlases.org/

MicroscopicAnatomy/Section06/

Section06.shtml

Ruffinis Corpuscle