52 Jaw conditions: Temporomandibular pain-dysfunction
Figure 52.1a TMJ anatomy.

Figure 52.1b Temporomandibular joint.

Figure 52.2 Causes of TMJ dysfunction.

Table 52.1 Main causes of restricted jaw opening.
Extra-articular | Intra-articular |
Condylar neck fracture | Ankylosis |
Coronoid hypertrophy | Condylar intracapsular fracture |
Fibrosis (scar, scleroderma, submucous fibrosis) | Joint arthritis, dislocation or subluxation |
Hysteria | |
Masticatory muscle infection, hematoma or inflammation | |
Neoplasm | |
Temporomandibular joint dysfunction | |
Tetanus | |
Tetany |
Table 52.2 Investigations used in temporomandibular joint disease.
Procedure | Advantages | Disadvantages |
Arthrography (double contrast) | Provides excellent information | Danger of infection Painful |
Arthroscopy | Good visualization Minimally invasive |
Requires anesthesia Technically demanding |
Magnetic resonance imaging (MRI) | Excellent information without exposure to ionising radiation Non-invasive | Expensive Not universally available |
Radiography | Simple, can reveal much pathology DPT demonstrates both TMJs CT, especially cone beam, can provide excellent information |
— Ex/> |

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