The temporomandibular joint (TMJ) is the most powerful and frequently used joint in our body. It is used for eating, talking, yawning, kissing and sucking, through this complex of possible actions: depression elevation lateral deviation (left and right) retraction protrusion and various A combination of these actions. TMJ EXAMINATION
The TMJ is a two-joint hinge joint that allows for these complex movements. The temporomandibular joint between the mandibular condyle and the temporomandibular fossa. The TMJ complex consists of TMJ teeth and soft tissue.
The TMJ is a synovial condylar and hinge-type joint with a fibrocartilaginous surface and an articular disc; the disc completely divides each joint into two cavities. Sliding translational or sliding motion occurs in the upper chamber of the TMJ, while rotational or hinged motion occurs in the lower chamber cavity.
Read more about TMJ anatomy here: TMJ Anatomy.
A thorough subjective examination may provide key elements to help best diagnose and treat a patient’s TMJ problems. The assessment should include determining the following
- Location and onset of symptoms
- mechanism of injury (if appropriate)
- severity of symptomology
- level of irritability
- aggravating and easing factors
- joint crepitus, clicking or locking
- Important medical history (prior fracture or trauma dental history bruxism, etc.)
- Timing of symptoms
- Red and yellow flag identification
- Referral area problems (neck pain dizziness headache migraine or other neurological symptoms)TMJ EXAMINATION
- Facial symmetry
- Swelling or deformation
- muscle bulk
- jaw position at rest
- audible joint noise
- cervical spine disposition
Range of motion
- Compare all movements of the TMJ from left to right and from active to passive.
- Therabite tool to measure can be used.
- If assessment of the cervical spine is required, include a combination of TMJ range of motion.TMJ EXAMINATION
- Areas of tenderness and or swelling
- Sensitivity and distribution of symptoms
- Muscular assessment
- Cervical spine screening
Special Tests & Outcome measures
1. Tongue blade test
This test is used to screen patients for the need for diagnostic imaging. It’s no different than Ottawa’s ankle rule. The patient clamped the spatula between his teeth while the doctor tried to break it. If this operation is illegal As shown in the video below, the discomfort of forcing the patient to release the spatula before it snaps off.
2. Oral Behaviours checklist (OBC)
The checklist helps to objectively document whether any accessory behaviors caused by situations such as stress and anxiety contribute to this condition.
examination of tmj
examination of tmj
- ↑ Gil-Martínez A, Paris-Alemany A, López-de-Uralde-Villanueva I, La Touche R. Management of pain in patients with temporomandibular disorder (TMD): challenges and solutions. Journal of pain research. 2018;11:571.
- ↑ Armijo-Olivo S, Silvestre RA, Fuentes JP, da Costa BR, Major PW, Warren S, Thie NM, Magee DJ. Patients with temporomandibular disorders have increased fatigability of the cervical extensor muscles. Clin J Pain. 2012 Jan;28(1)