Description
TMJ shown in the box
The temporomandibular joint (TMJ), or jaw joint, is a synovial joint that allows for the complex movements needed for life. It is the joint between the condyle of the mandible and the mandibular fossa of the temporal bone. The system consists of TMJ teeth and soft tissue in Breathe eat and talk. [1]
The TJM is defined as a gingival joint [2] because it has rotational motion in the sagittal plane and translational motion on its own axis – this translational motion creates more motion. [3] These movements are constrained by various passive factors as well as passive tension. Ligaments and muscles. [4]
TMJ dysfunction can lead to severe pain and lifestyle restrictions.
Temporomandibular joint disorders are common, and patients often seek physiotherapy advice and treatment.
A good understanding of the anatomy of the TMJ and associated structures is essential for proper diagnosis and appropriate treatment.
Joint
The TMJ is a synovial condyle and hinge type joint. The joint involves a fibrocartilaginous surface and an articular disc that divides the joint into two cavities. [5] These superior and inferior articular cavities are lined with separate superior and synovial membranes [6].
Joint capsule – The joint capsule is a fibrous membrane that surrounds the joint and attaches to the articular process, articular disc, and neck of the mandibular condyle.
Articular disc – The articular disc is the fibrous extension of the joint capsule that runs between the two articular surfaces of the temporomandibular joint. The intervertebral discs articulate with the mandibular fossa of the temporal bone above and the condyle joints of the mandible below. The disc divides the joint into two parts Each part has its own synovium. The discs are also attached medially and laterally to the condyles by collateral ligaments. The anterior disc attaches to the joint capsule and the superior head of the lateral pterygoid. The posterior part is attached to the mandibular fossa and is Known as the retrodiscal tissue [7].
Retrodiscal tissue – Unlike the disc itself, the retrodiscal tissue is vascular and highly innervated. Thus, retrodiscal tissue is often the primary cause of pain in temporomandibular disorders (TMD), especially when there is inflammation or compression within the joint [8]
Ligaments
Ligaments provide passive stability to the TMJ.
The temporomandibular ligament is the thickened part of the outer joint capsule, which is divided into two parts: the external oblique part and the internal horizontal part.
The stemmandibular ligament extends from the styloid process to the angle of the mandible. The sphenomandibular ligament arises from the sphenoid spine and inserts on the mandibular tongue.
The auriculomandibular ligament is the intermallear ligament (DML) that originates from the malleus (a small bone in the middle ear) and extends to the medial retrodiscal tissue of the TMJ and the anterior malleolus ligament (AML) that originates from the malleus and connects to the The mandible passes through the sphenomandibular ligament [9][10]. The auromandibular ligament may be involved in TMD-related tinnitus. A positive correlation between tinnitus and ipsilateral temporomandibular joint disturbances has been found [11][12]. It has been suggested that TMJ disorders may stretch DML and AML Thus affecting the structural balance of the middle ear [13][14][15][16]. “Therefore, ear symptoms (tinnitus, otalgia (ear pain), dizziness, and hearing loss) that appear to correspond to altered spatial relationships of the ossicles (such as conductive middle ear lesions) can also be caused by Lesions of the masticatory system. “[17]
Movements
Various movements occur at the TMJ. These movements are mandibular depression elevation lateralization (occurring on the right and left side) retraction and protrusion.
Each of these movements is accomplished by a number of muscles that work together to perform the movement while controlling the position of the condyle within the mandibular fossa.
Chewing and speaking require a combination of jaw movements in multiple directions [18][19].
[20]
Muscles
For a more detailed description, see the Masticatory Muscles page.
Muscle action Temporal muscle elevates mandible Masseter elevates mandibular lateral pterygoid Rear extension Mandible depresses lateral mandibular deflection Medial pterygoid elevates mandible with masseter auxiliary protrusion bone mandible resistance resistance The platysma depresses the mandible against resistance while the infrahyoid stabilizes or depresses the hyoid
Adapted from Moore[6]
static position and close-packed position
The resting position of the TMJ is with the mouth slightly open, the lips together, and the teeth not touching. This is in contrast to the closed position of the teeth clenched. [5]
Nerve Supply
Muscles acting on the TMJ are innervated by the mandibular nerve (CN V) and the facial nerve (CN VII) C 1 C 2 and C 3. [6]


Movements of the TMJ
References
↑ Di Fabio RP. Physiotherapy in patients with TMD: a descriptive study of treatment barriers and health status. Journal of Orofacial Pain. 1998 Apr 1; 12(2). ↑ Maini K Dua A. Temporomandibular joint syndrome. November 17, 2020. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Published; January 2021–. PMID: 31869076. ↑ Reboredo V. Introduction to temporomandibular joint courses. add. 2021. ↑ Abdi AH Sagl B Srungarapu Vice President Stavness I Prisman E Abolmaesumi P et al. Characterizing motor control of chewing with a soft-actor critic. Front Hum Neurosci. 2020;14:188. ↑ Jump up to: 5.0 5.1 Magee DJ. Orthopedic physical assessment. 6th edition. Elsevier; 2014 ↑ Jump up to: 6.0 6.1 6.2 Moore KL Dalley AF Agur AM. Clinically oriented anatomy. Lippincott, Williams and Wilkins; September 13, 2017. Galliger; Larson P; Waiting P; Peterson’s Principles of Oral and Maxillofacial Surgery Volume 2 Chapter 47 2004. ↑ Langendoen J; Miller J; Jull GA Temporomandibular joint retrodiscal tissue: clinical anatomy and its role in the diagnosis and treatment of arthrosis Manipulative therapy 2(4) 191-198 1997. ↑ Loughner BA Larkin LH Mahan PE. Discomalleolar and anterior malleolus ligaments: possible causes of middle ear injury during temporomandibular joint surgery. Oral Surg Oral Med Oral Pathology. Jul;68(1):14-22 1989. ↑ Rowicki T; Zakrzewska J. A study of ankle ligaments in adults. Folia Morphine. (Watts). 65 (2): 121–125 2006. ↑ Kuttila S; Kuttila M; Lebel; Allen P; Suonpaa J. Recurrent tinnitus and associated ear symptoms in adults. int. J. Audiol. 44:164-70 2005.↑ Ren Yufeng; Isberg A. Tinnitus in patients with internal disturbances of the temporomandibular joint. Skull 13:75-80 1995. ↑ Cheynet F; Juyo L; Richard O; Layoun W; Gola R. Discomallear and ankle-mandibular ligaments: anatomical studies and clinical applications. Surgery. radiation. anat. 25:152-7 2003. ↑ Eckerdal O. The petrotympanic fissure: a link between the tympanic cavity and the temporomandibular bone United. Cranium 9:15-22 1991. ↑ Kim HJ; Jung; Guo HH; Shim KS; Hu Kaisheng; Park HD; Park HW; Chung IH. The submalleus and anterior ligaments: an anatomical study in adults and fetuses. Surgery. radiation. anat. 26:39-45 2004. ↑ Wright EF; Bifano SL. tinnitus improvement Through TMD therapy. J. Am. dent. Associate Professor. 128:1424-32 1997. ↑ Ramirez LM; Ballesteros ALE; Sandoval OGP. Direct anatomical study of the morphology and function of the disco-ankle and anterior malleolus ligaments. int. J. Morphine. 27(2):367-379 2009. ↑ Saladin KS; Human Anatomy. New York: McGraw-Hill 2005. ↑ Standring S Editor Gray’s Anatomy 40th ed. Elsevier Churchill Livingstone 2008. ↑ Functional Anatomy in TMJ. TMJ movement. Available from https://www.youtube.com/watch?v=SCS4MiHJ5Xw [last accessed 07/01/2018]