TEMPOROMANDIBULAR
JOINT
TYPE OF JOINT
This is a synovial joint of
the condylar type
ARTICULAR SURFACES
ARTICULAR SURFACE: is formed by the
following parts of temporal bone and
mandible:
Articulation occurs between the articular
tubercle and the anterior portion of the
mandibular fossa of the temporal bone
above and the head (condyloid process)
of the mandible below.
The articular surfaces are covered with
fibrocartilage.
The joint cavity is divided into the upper and
the lower parts by an intra articular disc
Capsule
The capsule
surrounds the joint
and is attached
above to the
articular tubercle
and the margins
of the mandibular
fossa and below
to the neck of the
mandible.
LIGAMENTS
Fibrous capsule
Lateral ligament
Sphenomandibular ligament
Stylomandibular ligament
FIBROUS CAPSULE
ABOVE: articular eminence
Below: neck of mandible
The capsule is loose above the intra-
articular disc and tight below it
The synovial membrane lines the
fibrous capsule and the neck of the
mandible
LATERAL LIGAMENT
Or lateral temporomandibular
ligament
It strengthens the lateral part of
mandible
ABOVE: articular tubercle
BELOW: posterolateral aspect of neck
of mandible.
Its fibers run downward and
backward from the tubercle on the
root of the zygoma to the lateral
SPHENOMANDIBULAR
LIGAMENT
Is an accessory ligament
SUPERIORLY: spine of sphenoid
INFERIORLY: lingula of mandibular
foramen.
lies on the medial side of the joint
STYLOMANDIBULAR LIGAMENT
Another accessory ligament
ABOVE: lateral surface of the styloid
process
BELOW: angle and posterior border
of the ramus of mandible
TMJ Ligaments
ARTICULAR DISC
Oval fibrous plate
Divides the joint into upper and lower
compartments
Upper compartment permits gliding
movements
Lower compartment permits rotatory
and gliding movements
It has concavo-convex superior
surface and concave inferior surface
Its periphery is attached to fibrous capsule
BLOOD SUPPLY
From superficial temporal artery
Maxillary artery
Veins follow arteries
NERVE SUPPLY
Auriculotemporal nerve
Masseteric nerve
MOVEMENTS
DEPRESSION
ELEVATION
PROTRUSION
RETRACTION
LATERAL OR SIDEMOVEMENTS
DEPRESSION
Mainly by lateral pterygoid muscle
Digastric
Geniohyoid
Mylohyoid
ELEVATION
Masseter
Temporalis
Medial pterygoid muscles
These are antigravity muscles
PROTRUSION
Lateral pterygoid
Medial pterygoid
RETRACTION
Posterior fibers of temporalis
LATERAL MOVEMENTS
TURNING THE CHIN TO THE LEFT
SIDE:
Left lateral pterygoid
Right medial pterygoid
CLINICALNOTES
Clinical Significance of the Temporomandibular
Joint
The Temporomandibular joint lies immediately in front
of the external auditory meatus.
The great strength of the lateral
Temporomandibular ligament prevents the head
of the mandible from passing backward and
fracturing the tympanic plate when a severe
blow falls on the chin.
The articular disc of the Temporomandibular
joint may become partially detached from the
capsule, and this results in its movement
becoming noisy and producing an audible click
CLINICALNOTES
Dislocation of the Temporomandibular Joint
Dislocation sometimes occurs when the mandible is
depressed. In this movement, the head of the mandible and the
articular disc both move forward until they reach the summit of
the articular tubercle. In this position, the joint is unstable, and a
minor blow on the chin or a sudden contraction of the
lateral pterygoid muscles, as in yawning, may be sufficient
to pull the disc forward beyond the summit. In bilateral
cases, the mouth is fixed in an open position, and both
heads of the mandible lie in front of the articular tubercles.
Reduction of the dislocation is easily achieved by pressing the
gloved thumbs downward on the lower molar teeth and pushing
the jaw backward.
The downward pressure overcomes the tension of the
temporalis and masseter muscles, and the backward
pressure overcomes the spasm of the lateral pterygoid
muscles.
