Board Review DH227 Dental Anatomy Lisa Mayo, RDH, BSDH Concorde
Career College
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Review Identify human dentition with terminology specific to: #
of dentitions Types of teeth Terminology not related to man
Identify component of periodontium Be able to relate eruption dates
for primary and permanent teeth to clinical situations If given a
picture of a dentition, identify age of pt.
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How Old Is This Patient?
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How old is this patient?
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Review Heterodont: man is because have many diff. types teeth
Homodont: all teeth the same Dispyodont: man: 2 different
dentitions Monodont: 1 set of teeth Polydont: many diff. sets of
teeth
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Review Know key calcification times of teeth to know later in
life what caused certain conditions (fluorosis, tetracycline
staining, hypocalcification, etc) Know how primary roots are in
relation to erupting permanent teeth Succedaneous teeth: permanent
teeth that replace primary (incisors, canines, premolars)
Resorption Exfoliation Non-succedaneous permanent teeth that do not
replace baby tooth
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Primary Teeth Also called baby, milk, temporary, deciduous,
primary teeth Exfoliation = process of losing tooth Resorption =
physiological removal of tissue or body products
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Primary Teeth Bud = individual tooth buds/cap Bell = major
amount of enamel and dentin are laid down Root development = begins
when CEJ area is formed at end of the bell Root completion = 1-2yrs
after eruption Ankylosed root = when primary tooth fuses to
alveolar bone and will not exfoliate
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Primary Tooth Eruption ERUPTION Mand Central (8-12mo) Mand
Lateral (9-13mo) Max Central (8-12mo) Max Lateral (9-13mo) 0-1
years Mand 1 st Molar (13-19mo) Max 1 st Molar (13-19mo) Mand
Canine (16-22mo) Max Canine (16-22mo) 1-2 years Mand 2 nd Molar
(25-33mo) Max 2 nd Molars (25-33mo) 2-6 years Eruption Sequence:
central, lateral, 1 st molar, canine, 2 nd molar
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Permanent Tooth Eruption ERUPTIONROOT COMPLETION Man 1 st Molar
Max 1 st Molar Mand Central Mand Lateral Max Central Max Lateral
6-9 years9-11 year Mand canine Mand 1 st Premolar Max 1 st Premolar
Mand 1 st Premolar Max 2 nd Premolar Max Canine 9-12 year 12-15
years Mand 2 nd Molar Max 2 nd Molar 12-17 years14-16 years Mand 3
rd molar Max 3 rd Molar 17-21 years18-25 years Permanent Tooth
Eruption
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Primary Teeth vs Permanent Enamel is thinner and whiter Roots
Same # molar-molar Mesial root wider Longer and thinner More flared
No root trunks Pulp chambers large, pulp horns close to enamel
Crown Shorter Wider M-D than Occlusal-Gingival
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Primary Teeth vs Permanent Ant smaller than perm Post wider M-D
More bulbous or bell shaped Cervical ridges are bulky/prominent
Occlusal tables narrower Thin dentin layer between pulp and
enamel
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Review Know general differences between perm and primary teeth,
know which ones resemble each other (next slide) Enamel Color
Cervical ridges Size Flare of roots
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Primary vs Perm PRIMARY TOOTH PERM TOOTH IT RESEMBLES ROOTS Max
1 st MolarMax 1 st Premolar3 Max 2 nd MolarMax 1 st Molar3 Mand 1
st MolarUnique crown2 Mand 2 nd MolarMand 1 st Molar2
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Primary/Permanent Mixed Dentition: 6-12 years Most common
congenitally missing permanent teeth Max laterals 3 rd molars Mand
2 nd premolars
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Review Identify key points to teeth Angle of a tooth Types of
ridges # of roots # of lobes and cusps Fossas Grooves
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Review Know numbering systems Relate the size of an embrasure
to contact areas of teeth Related the size of interdental papillae
to the contact area between teeth, and to the curvature of the
cervical line Know shapes of teeth from F and interprox Know what
makes certain teeth unique Ridges Concavities/Convexities
Furcations
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Structures to Review Boney alveolar process surrounds each
tooth Bone socket or alveolus is part of the alveolar bone in which
teeth are set Crown anatomical vs clinical Root - anatomical vs
clinical Enamel: 96% calcified Dentin: 70% calcified Cementum: 65%
calcified Cervical line /CEJ/DEJ
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Structures to Review Pulp: canal, chamber, horns Surfaces:
mesial, distal, occlusal, incisal, buccal/labial, lingual Anterior
teeth, posterior teeth Know which teeth have occ vs incisal edges
Know which teeth have buccal or labial Lingual sometimes referred
to as palatal for max. post. Contact area: where 2 adjacent teeth
meet Proximal surface: surfaces in-between 2 teeth Height of the
contour between 2 teeth (gets larger with age): The line encircling
a tooth or other structure at its greatest bulge or diameter with
respect to a selected path of insertion
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Structures to Review PDL: attaches tooth to bone Gingiva
Gingival line Free gingiva Sulcus Epithelial attachment Gingival
groove Attached gingiva Mucogingival junction Alveolar mucosa
Fibers
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Structures To Review Line Angles: Imaginary line formed by the
junction of 2 surfaces Become more rounded as go from ant to post
Point Angle: formed by the junction of 3 surfaces Cusps: less
pointed or steep as go from canine to molar
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Roots Named for where they are Root termination = apex Root
usually/typically deflect towards the distal Concavities: 4 key
areas (remember all teeth have M/D concavities!) Max 1 st premolar
(M) Very prominent Max 1 st Molars (L/M/D) Max Lateral(L) Mand 1 st
Premolar (M/D) Numbers Anterior: 1 Premolars: 1, except maxillary 1
st premolars (2) Maxillary molars: 3 (2F, 1L) Mandibular molars: 2
(M&D)
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Roots
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Lobe Primary division of a tooth 4 or 5 4- all ant and
premolars except for mand molars that have 2 lingual cusps these
teeth arise from 5 lobes Molars develop from 4 lobes except mand
first that have 5 cusps and develop from 5 lobes Developmental
depressors on labial aspect separate lobes on ant teeth and buccal
of premolars, not on molars (grooves)
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Shapes Trapezoidal: from F and L Triangular: Max anterior
Ovoid: Canines Elliptical: Mand anterior Rhomboidal: Mand posterior
Trapezoidal: Max posterior
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Special/Unique Structures Max Central Lingual groove Lingual
pit Mamelons Max Lateral Linguogingival groove Lingual pit
Linguogingival fissure Mamelons
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Special/Unique Structures Mand Central: smallest teeth in mouth
Mamelons Root concavity Longitudinal groove Mand Lateral Mamelons
Root concavity More prominent cingulum then #24,25 and deeper L
fossa Cingulum: lingual cervical of ant teeth
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Special/Unique Structures Canines: longest, strongest teeth,
most stable tooth, provides guidance for occlusion Max canine
Canine eminence Mesioincisal/distoincisal cusp ridge/slope Labial
ridge Linguogingivial groove Lingual pit Mesio/distolingual fossa
Lingual ridge
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Special/Unique Structures Mand canine Canine eminence Slopes
Labial ridge Mesio/distolingual fossa Lingual ridge Root concavity
Narrower then maxillary
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Canine Eminence
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Vocabulary Ridge Marginal: found at M and D terminations of
occlusal surfaces of post teeth and form the lateral borders of L
surfaces ant teeth Cusp Ridge: each cusp has 4 extending from its
tip (M,D,B,L) Triangular: ridge that descends from tips of cusps
toward central area of occlusal surface Transverse: 2 triangular
ridges merging Oblique: special type of transverse unique to MAX
MOLARS from the ML to DB cusps (ML distal cusp ridge and DB
triangular ridge)
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Vocabulary Mamelons: small, rounded projections on incisal
edges of newly erupted teeth usually worn away soon after eruption.
Common on adults with malocclusion (ant open bite) Fossa: rounded
depression, pit at bottom Developmental groove: One of the fine
lines found in the enamel of a tooth that marks the junction of the
lobes of the crown in its development Secondary groove: auxiliary
groove
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Individual Teeth: ANT Max incisors More developed than mand
Fossa and cingulum Marginal ridges Incisal edges straight except
for mand lateral twisted Max/Mand canines Max more developed
Lingual ridge forms ML and DL fossas
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PREMOLARS
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Max Premolars General Max premolars GENERAL More similar then
mand premolars 2 pointed cusps: B longer than L M marginal groove,
M depression on mid-1/3 of crown down to root Single or bifrucated
root (B,Palatal) and occurs apical 1/3 of root 7mm
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Max 1 st premolar Max 1 st premolars: Well-developed line
angles Mesial concavity extends onto root Root bifurcated Mesial
marginal groove Long central groove Lingual cusp tip offset to
mesial
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Max 2 nd premolar More rounded line angles 1 root usually and
is larger than 1 st premolar Central groove shorter with more
supplemental grooves M groove absent
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Max 2 nd premolar L cusp larger than L cusp on Max 1 st
premolar B cusp shorter than 1 st premolar and less pointed Both
cusps near same length and width Both 1 and 2 have transverse
ridges
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Mand 1 st Premolar Mand 1 st premolar Sharp B cusp Short
nonfunctional L cusp Central groove not always present M, D fossae
with pits B cusp tip centered over root
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Mand 1 st premolar Transitional teeth more resemblance to
canine as far as masticatory function Transverse ridge ML
developmental groove separates M marginal ridge from L cusp
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Mand 2 nd premolar 2 or 3 cusps, no transverse ridges, more
supplemental grooves than 1 st premolar Larger than 1 st premolar B
cusp shorter than 1 st premolar ML cusp is larger than DL Root
wider than 1 st premolar with a blunt apex Y-shape to central and
lingual groove If 2 cusps can have a U-shape or an H-shape to
central groove
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MOLARS
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Maxillary 1 st Molars Max 1 st Molars 1 st rhomboid occlusal
pattern to cusp tip alignment Cusp of carabelli that is
non-functional Largest tooth in the mouth in regards to overall
bulk/ surface area Crown is wider F-L than M-D Roots trifurcated:
2B, 1 palatal (DB is the narrowest)
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Max 1 st molar cusps
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Max 2 nd Molars Max 2 nd molars Smaller than the 1 st No 5 th
cusp Rhomboid shape to occlusal is more accentuated Can have a
heart shaped form like 3 rd molar For both L root is largest then
MB then DB 2 roots: MB root tip curves distally
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Mandibular Molars First Second Third
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Mand 1 st molar Mand 1 st Molars 1 st pentagon/rectangular
wider M-D than B-L Largest tooth of mand arch Bifuracted roots:
roots twice as long as crown, M root longer/stronger, root apex of
M turns toward D
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Mand 1 st molar Mand 1 st Molars 5 Cusps D, 2B grooves, B and
DB. (D smallest. MB cusp wider than DB No transverse ridges 4
developmental grooves: Central, B, DB, L Central groove
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Mand 2 nd molar Mand 2 nd Molars Rectangle for both distal
roots are straighter, M are widest B-L than D Roots: shorter than 1
st molar, closer together, M root less broad then on 1 st
molars
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2 transverse ridges: 1 st molar has NONE!
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Contact Areas Become more cervical as go from ant to post
Distal usually more cervical then mesial Size from ant to post Ant
teeth contacts centered F-L Post teeth contacts slightly B of
center
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Interprox Space Triangular and filled with interdental papillae
Triangle is formed by proximal surfaces of adjacent teeth, the apex
is the contact of adjacent teeth and the base is the alveolar bone
Shape changes ant to post
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Embrasures Named for location: F, L, Cervical, Occlusal For
protection and stimulation of the periodontium Form directly
related to contact areas: ie. post teeth the lingual embrasures are
larger than the F because the contact is to the Facial/Buccal of
center
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Heights of Contour For anterior: height on the labial and
lingual is in the cervical third Posterior: the B is in the
cervical third Posterior: the L is in the middle to occlusal thirds
Thirds of crowns and roots: horz and vert thirds Cervical lines
always steeper on M and D
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Comparing ant-post Proximal curvature of CEJ flattens M/D CEJ
curvatures of an individual tooth: M curvature D curvature Lingual
height of contours shift from cervical to middle 1/3 Contact areas
shift from incisal 1/3 to middle 1/3
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Anomalies Max Central 1.Dwarfed root 2.Hutchinsons incisors
3.Talon cusp 4.Supernumerary Max Lateral 1.Peg lateral 2.Cingulum
may have tubercle 3.Congenitally missing (agenesis) 4.Dens in dente
Mand Central 1.Bifurcated root Mand Lateral 1.Bifurcated root
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Anomalies Max Canine 1.Tubercle on lingual surface Mand Canine
1.Bifurcated root
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Anomalies Max 1 st Premolar 1.3 roots 2.Antrum (root
penetrating max. sinus) Max 2 nd Premolar 1.Absent central groove
2.Antrum Mand 1 st Premolar 1.ML developmental groove absent
2.Bifurcated root Mand 2 nd Premolar 1.Congenitally missing
2.Bifurcated root 3.Supernumerary
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Anomalies Max 1 st molar 1.Mulberry molar 2.Root variations
(fusion, length) 3.Carabelli Max 2 nd molar 1.Heart-shaped occlusal
2.Tubercle on B 3.Root fusion Max 3 rd molar 1.Peg 3 rd molar
2.Everything!
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Mulberry Molars
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Anomalies Abnormal # Adontia: any missing teeth total or
partial Supernumerary: mesodens most common supernumerary tooth
followed by maxillary molar areas Abnormal Size Macrodontia: true
assoc. with gigantism, more commonly see large teeth Microdontia
True: pituitary dwarfs False=more common, see Max laterals, peg
laterals, max 3 rd molars
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Development of two maxilla together- Genetic Malformation
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Anomalies Abnormal Shape Dens in Dente: external structures
become reversed in pulp chamber. Tooth Within A Tooth Dilaceration:
linear distortion (bend) in root/crown from trauma Flexion:
dilaceration root only Gemination: splitting of single tooth germ
single root but looks like 2 crowns Fusion: union of 2 tooth buds
only involving crowns
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Dens in Dente
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Dilaceration
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Anomalies Concrescence: union of 2 teeth at roots Molars most
common Segmented roots Dwarfed roots Hypercementosis: excessive
cementum Enamel Pearls (Ectopic enamel): on root surface furcation
areas, developmental issue Hutchinsons Teeth: prenatal syphilis,
incisor may be screwdriver Mulberry: notch-shaped in incisal edge
and molars
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Enamel Pearl
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Anomalies Attrition: Mechanical wearing. Abrasive tp, oral
habit, improper tb technique Erosion: Chemical wearing. Acid or
low-pH, acidic foods, drinks
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HELPFUL LINK
http://dentistry.umkc.edu/Practicing_Communities/asset
/AbnormalitiesofTeeth.pdf
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Anomalies Abnormal calcification and apposition: Both may be
local, systemic, hereditary factors Enamel Dysplasia / Hypoplasia
Disturbance occurs during enamel matrix formation Dentiogenesis
Imperfecta Affects mesodermal formation, enamel normal, tooth
opalescent, gray to blue color, obliteration of pulp chambers and
root canals, root shorter Genetic Amelogenesis Imperfecta
Malfunction of tooth germ Enamel appears pitted, aplasia,
yellow/dark brown, unusual wearing, enamel thin, hypocalcification
Genetic Hypocalcification Later stage during maturation Rickets,
birth trauma, idiopathic factors, congenital syphilis,
fluoride
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What is this?
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Answer: Dentiogenesis Imperfecta
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What is this?
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Answer: Amelogenesis Imperfecta
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Amelogenesis Imperfecta
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Anomalies Abnormal calcification and apposition Fluorosis:
chalky white or brown, mottled teeth Focal hypomaturation: chalky
white, circular, soft enamel Turners Teeth: injury to follicle
during extraction of baby tooth or from abscess Tetracycline
staining: o Minocycline: blue/gray o Tetracycline: yellow/brown
Taurodontism: large pulp chamber, location of the furcation is more
apical, elongated crown, Downs syndrome, Bulls tooth
A&P: Mand Tooth Innervation MolarsPremolarsAnterior
PulpInferior Alveolar B/F gingivaBuccalBuccal/MentalMental L
gingivaLingual
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A&P: Max Tooth Innervations 2,3 Molars 1st
MolarPremolarCanineIncisors PulpPost Superior Alveolar Post &
Middle Superior Alveolar Middle Superior Alveolar Anterior Superior
Alveolar B/F Gingiva Post Superior Alveolar Middle Superior
Alveolar Anterior Superior Alveolar Palate Gingiva Greater Palatine
Nasopalatine
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A&P: Muscles of Mastication Innervation: Mandibular
Division of the Trigeminal Nerve (V3) Blood Supply: Maxillary
Artery (Branch of the external carotid artery) Medial pterygoid
& masseter have similar functions & positions Medial
pterygoid is internal Masseter external Temporalis, medial
pterygoid, masseter muscles all close the mouth (elevate the
mandible) Lateral pterygoid opens the mouth
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A&P: Muscles of Mastication TemporalisMasseterMedial
Pterygoid Lateral Pterygoid OriginTemporal fossa Zygomatic arch
Medial surface lateral pterygoid plate, max tuberosity Lateral
surface lateral pterygoid plate, infratemporal surface sphenoid
bone InsertionCoronoid process & mand post to 3 rd molar Outer
surface of the mand, angle of the mandible Inner surface angle of
the mandible TMJ disc, neck mand condyle FunctionRetract, elevate
mandible Elevate the mandible Elevate & protrude mandible
Protrude & depress mand, lateral shift of mand
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A&P: TMJ Components Temporal Bone Mandibular fossa, glenoid
fossa, articular fossa Articular eminence just ant to the fossa
Mandible Condyle Articular Disc Fibrous pad of dense collagen
tissue Prevents bone to bone contact Divides joint into upper and
lower synovial joints Thickest at the posterior, thinner in center
Moves with condyle under normal function Capsule Thick, fibrous
tissue surrounding joint Reinforced by the temporomandibular
ligament Inner lining secretes synovial fluid
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A&P: TMJ Movement 1.Rotation Condyle rotates in the fossa
2.Translation Condyle slides forward along the articular fossa to
the articular eminence Disc moves with condyle in health 3.Trismus
Hypomobility from trauma, disease, bruxism