1. TEMPOROMANDIBULAR
JOINT
Batallones, Amery Rose
Galeno, Chris Carlo
Saunar, Maurice Cheekz
Talag,Bryan Matthew
Ursal, Alyssa Mae
Villacorta, Aimee Carmina

2. Prepared by Chris Carlo M. Galeno
INTRODUCTION TO TMJ
(FUNCTION, FEATURES, CLASSIFICATION OF JOINTS)

3. Temporomandibular Joint
• Craniomandibular Joint
• Articulation between the condylar head of
mandible and the anterior part of the
glenoid fossa of two temporal bones.
• Frequently termed as TMJ

5. Features of TMJ
• Coordinated movements of the right and left joints are
complex and usually are controlled by reflexes.
• The maxillae and mandible carry teeth whose shape and
position greatly affect the most closed portions of mandibular
movements.
• Articulating surface of the TMJ is not formed of Hyaline
cartilage but of a sturdy avascular fibrous layer.
• Only synovial joint in the human body with an articulating disc
which is present between the joint surfaces of cranium and
mandible which makes the TMJ a double joint.

7. Classifications of Joints
• Fibrous Joint
• Cartilaginous Joint
• Synovial Joint

8. Classifications of Joints
• Fibrous joints
• Suture- articulation by processes and indentation
interlocked together
• Gomphosis- articulation by insertion of a conical
process into a socket
• Syndesmosis- united by interosseous ligament

9. Classifications of Joints
• Cartilaginous joints
• Primary Cartilaginous
• Secondary Cartilaginous

10. Classifications of Joints
• Synovial joints
– According to number of axes in which the bones involved can move:
• Uniaxial
• Biaxial
• Multiaxial or Polyaxial
– According to the shapes of the articulating surface:
• Planar
• Ginglymoid
• Pivot
• Condyloid
• Saddle
• Ball-and-socket

11. Fibrous: A-syndesmosis (tibiofibular), B-suture (skull). Cartilaginous: C-
symphysis (vertebral bodies), D-synchondrosis (first rib and sternum). Synovial:
E-condyloid (wrist), F-gliding (radioulnar), G-hinge or ginglymus (elbow), H-ball
and socket (hip), I-saddle (carpometacarpal of thumb), J-pivot (atlantoaxial).

12. Hilton’s Law
• The principle that the nerve supplying a joint
also supplies both the muscles that move the
joint and the skin covering the articular
insertion of those muscles.

13. Type of joint of Temporomandibular Joint
• Synovial joint
• Described as synovial sliding-ginglymoid joint
articulation
• Rotational movements
• Translational movements

14. Innervation and Vascularization
• Sensory innervation from
auriculotemporal and masseteric branches
of mandibular branch of the trigeminal nerve
• Branches of the external carotid artery,
predominately the superficial temporal branch, deep
auricular artery, anterior tympanic artery, ascending
pharyngeal artery, and maxillary artery

15. Specific Mechanics of Proprioception
• Ruffini endings
• Pacinian corpuscles
• Golgi tendon organ
• Free nerve endings

16. Prepared by: Maurice Cheekz A. Saunar
ANATOMY AND HISTOLOGY
OF THE STRUCTURES
INVOLVED IN THE TMJ

17. Anatomy of
TMJ
•Condyle of the
Mandible
•Mandibular
Fossa/Glenoid
Fossa/Temporoman-
dibular Fossa
•Articular Surface
Proper:
Articular Disc
Articular Capsule

18. Ligaments
•Lateral
Temporomandibular
Ligament
•Sphenoparietal
Ligament
•Stylomandibular
ligament
•Stylohyoid Ligament

19. Synovial
Tissue
-filled with Synovial
Fluid
Function:
-Lubricant
- Nutrition
- Regulatory

21. HISTOLOGY OF THE
COMPONENTS OF TMJ

22. Condyle of the Mandible
• Composed of fibrous
tissue
• Cells: Chondrocytes

24. Articular Disk
• Composed of
fibroelastic connective
tissue

25. Articular Capsule

26. Articular Tubercle

28. Fetal and Adult TMJ

29. Prepared by Aimee Carmina Villacorta
DEVELOPMENT OF THE TMJ

30. • Involves the development of the following
structures
– Mandible
– Glenoid fossa
– Condyle
– Articular disc
– Upper and lower joint cavity

31. Mandible
• Meckel’s Cartilage
• Begins at week 6 to 7

33. • At week 12 of gestation:
– temporal/ glenoid blastema
• Ossifies and becomes glenoid fossa
– condylar blastema
• Becomes the condylar cartilage
• Clefts are formed
– lower joint cavity
– upper joint cavity

35. 4
1. Primitive
articular disc
2. Upper cleft
3. Lower cleft
4. Temporal
blastema
5. Condylar
blastema
33

36. 1. Glenoid fossa
2. Upper joint cavity
3. Articular disc
4. Lower joint cavity
5. Condyle

37. Prepared by: Talag, Bryan Matthew E.
MUSCLES OF MASTICATION

38. Masseter
- Thick
- Quadrilateral muscle
- Superficial and deep portion

39. Masseter: Superior portion
Origin: thick, tendinous aponeurosis from the
zygomatic process of the maxilla
Insertion: angle and lower half of the lateral
surface of the ramus of the mandible
• its fibers pass downward and backward

40. Masseter: deep portion
• Smaller and more muscular in texture
• Downward and forward
• Partly concealed
• Origin: posterior third of the lower border and
from the whole of the medial surface of the
zygomatic arch
• Insertion: the upper half of the ramus and the
lateral surface of the coronoid process of the
mandible

41. Masseter

42. Temporal Muscle
• Broad
• Radiating
• Side of the head
• Origin: Whole of the temporal fossa (except that
portion of it which is formed by the zygomatic
bone)
• Insertion: the medial surface, apex, and anterior
border of the coronoid process, and the anterior
border of the ramus of the mandible nearly as far
forward as the last molar tooth

43. Temporal muscle

44. Lateral pterygoid muscle
• A.k.a. pterygoideus externus or external
pterygoid muscle
• Short
• Thick
• Conical
• Upper and lower part
– Common insertion: depression in front of the neck of
the condyle of the mandible, and into the front
margin of the articular disk of the temporomandibular
articulation.

45. Lateral pterygoid: Upper part
• Origin: lower part of the lateral surface of the
great wing of the sphenoid and infratemporal
crest

46. Lateral pterygoid: Lower part
• Origin: lateral surface of the lateral pterygoid
plate

47. Lateral pterygoid

48. Medial pterygoid muscle
• A.k.a. pterygoideus internus or internal pterygoid muscle
• Thick
• Quadrilateral
• downward, lateralward, and backward
• Origin: medial surface of the lateral pterygoid plate and the
grooved surface of the pyramidal process of the palatine
bone
– Has a second slip of origin
• lateral surfaces of the pyramidal process of the palatine and
tuberosity of the maxilla
• Insertion: lower and back part of the medial surface of the
ramus and angle of the mandible, as high as the
mandibular foramen

49. Medial pterygoid

50. Nerve supply
Mandibular
branch of the
trigeminal
nerve

51. Action
• Temporalis, Masseter, and Medial pterygoid raise the
mandible against the maxillæ with great force.
• Lateral pterygoid protrodes the mandible and the inferior
incisors projectes in front of the upper antagonist
– draw forward the condyle and articular disk
– assists in opening the mouth
– assisted by the Medial pterygoid
 The posterior fibers of Temporalis retracts the mandible
 When Medial and Lateral pterygoid of one side act, the
corresponding side of the mandible is drawn forward while
the opposite condyle remains comparatively fixed, and
side-to-side movements. Such as occur during the
mastication of food, take place.

52. Summary
Muscles of Mastication
Muscle Origin Insertion Nerve Supply Action
Masseter Zygomatic arch Lateral surface Elevates
ramus of mandible to
mandible occlude teeth
Temporalis Floor of temporal Coronoid process Anterior and
fossa of mandible superior fibers
elevate
mandible:
Mandibular posterior fibers
division of retract mandible
trigeminal nerve
Lateral pterygoid Greater wing of Neck of Pulls neck of
(V3)
(two heads) sphenoid mandible mandible
Lateral pterygoid Articular disc forward
plate
Medial pterygoid Tuberosity of Medial surface of Elevates
(two heads) maxilla angle of mandible
Lateral pterygoid mandible
plate

53. Mandibular Positions
• Postural Position of Mandible
• Centric Occlusal Relation
• Right Lateral Occlusal Relation
• Left Lateral Occlusal Relation
• Protrusive Occlusal Relation

54. Prepared by Alyssa Mae Ursal
MOVEMENTS OF THE TMJ

55. Mandibular Positions
• Postural Position
of Mandible
Free Way Space or
Vertical Dimension
of Rest

56. Mandibular Positions
• Postural Position of
Mandible
• Centric Occlusal
Relation
• Right Lateral Occlusal
Relation
• Left Lateral Occlusal
Relation
• Protrusive Occlusal

57. Mandibular Positions
• Postural Position of
Mandible
• Centric Occlusal Relation
• Right Lateral Occlusal
Relation
• Left Lateral Occlusal
Relation
• Protrusive Occlusal
Relation

58. Mandibular Positions
• Postural Position of
Mandible
• Centric Occlusal Relation
• Right Lateral Occlusal
Relation
• Left Lateral Occlusal
Relation
• Protrusive Occlusal
Relation

59. Mandibular Positions
• Postural Position of
Mandible
• Centric Occlusal Relation
• Right Lateral Occlusal
Relation
• Left Lateral Occlusal
Relation
• Protrusive Occlusal
Relation

61. Mandibular Movements
• Classification:
Border Movements
Intraborder Movements
Contact Movements
Free Movements

62. Mandibular Movements
• Classification:
Border Movements
Intraborder Movements
Contact Movements
Free Movements

63. Mandibular Movements
• Classification:
Border Movements
Intraborder Movements
Contact Movements
Free Movements

64. Mandibular Movements
• Classification:
Border Movements
Intraborder Movements
Contact Movements
Free Movements

65. Mandibular Movements
• Right Lateral Movement
• Left Lateral Movement
• Protrussive Movement
• Retrussive Movement
• Bennett Movement

66. Mandibular Movements
• Right Lateral Movement
• Left Lateral Movement
• Protrussive Movement
• Retrussive Movement
• Bennett Movement

68. Mandibular Movements
• Right Lateral Movement
• Left Lateral Movement
• Protrussive Movement
• Retrussive Movement
• Bennett Movement

69. Mandibular Movements
• Right Lateral Movement
• Left Lateral Movement
• Protrussive Movement
• Retrussive Movement
• Bennett Movement

71. Mandibular Movements
• Right Lateral Movement
• Left Lateral Movement
• Protrussive Movement
• Retrussive Movement
• Bennett Movement

72. Envelope of Mandibular Motion (by
Posselt)
Superior
Lateral View View
Frontal
View

74. Prepared by Amery Rose Batallones
CLINICAL CONSIDERATIONS

75. Clinical Considerations
• Bruxism
• Arthritis
• Fractures
• Structural Changes
• Disharmony in the
relation of teeth
and the TMJ

76. Clinical Considerations
• Myofacial Pain
Dysfunction
Syndrome
• Luxation or
Dislocation of
Temporomandibular
Joint
• Ankylosis
• Aplasia
• Hyperplasia
• Hypoplasia

77. Thank you!