Penyusun :

Ê Harris Kusnandar
Ê Deasty Elvina
Ê Jo Carolina
Ê Leonita Hartanti
Ê Inosensius Adi
Disorder of the temporomandibular joint are
abnormalities that interfere with the normal
form or function of the joint.

Arthritides, inflammation, growth

abnormalities.
 Ô

 

Ê memporomandibular joint (m J) disfunction is
the most common jaw disorder, 86% adults
and adolescent showing >1 clinical symptoms.
Ê Signs and symptoms: pain in the m J or ear or
both, headache, muscle tenderness, joint
stiffness, clicking or other joint noises,
reduced range of motion, and subluxation.
 O

 




Ê As a supplement information, when: osseus
abnormalities or infection suspected,
conservative treatment failed, symptoms
worsening, history of trauma, clinical signs.
Ê mo evaluate: integrity and relationship of the
hard and soft tissues, confirm the extent stage
of progression of known disease, and evaluate
the effects of treatment.




 
 Ô

Ê A bonny ellipsoid structure connected to the
mandibular ramus by a narrow neck.
Ê mhe shape of the condyle varies considerably,
and these variations may cause difficulty with
radiographic interpretation, this underlines
the importance of understanding the range of
normal appearance.
Ê ost condyles have a pronounced ridge
oriented mediolaterally on the anterior
surface, marking the anterioinferior limit of
the articulating area.
Ê mhe ridge is the upper limit of the pterygoid
fovea, a small depression on the anterior
surface at the junction of the condyle and
neck.
Ê It is the attachment site of the superior head
of the lateral pterygoid muscle and shouldn͛t
be mistaken for an osteophyte (spur), which
indicate degenerative joint disease.
Ê 2

Ê memporal components of m J are calcified by
6 months of age, complete calcification of
cortical borders may not be complete until 20
years of age.

Ê Radiographs of condyles in children may so a

little or no evidence of a cortical border.
Ê In the absence of disease, the cortical borders
in adults are visible radographically.
 ›


Ê Located at the inferior aspect of the squamous
part of the temporal bone, is composed of the
glenoid fossa and articular eminence of the
temporal bone. Covered with a thin layer of
fibrocartilage.
Ê ͞temporal component of m J͟
Ê In normal m J, the roof of the fossa , the
posterior slope of the articular eminence, and
the eminence itself form an S shape when
viewed in sagital plane.
Ê 2ossa depth varies, and the development of
the articular eminence relies on functional
stimulus from the condyle.

mhe mandibular fossa very flat and

underdeveloped in patients with micrognathia
or condylar agenesis.
Ê All aspects of the temporal component may
be pneumatized with small air cells derived
from the mastoid air complex. Seen in
approximately in 2% of patients.

2
 u





 
Ê Composed of fibrous connective tissue,
located between the condylar head and
mandibular fossa.
Ê Diveides the joint cavity into two
commpartements, inferior and superior joint
spaces.
2


Ê During mandibular opening, as the condyle

rotates and translates downward and forward
, the disk also moves forward and rotates so
that͛s its thin central portion remains between
the articulating convexities of the condylar
head and articular eminence.
 

    
Ê Consists of a bilaminar zone of vascularized
and innervated loose fibroelastic tissue.
Ê As the condyle moves forward, tissue of
posterior attachment expand in volume,
primarily as a result of venous distention, and
as the disk move forward, tension is produced
in the elastic posterior attachment.
Smooth recoil of the disk
 


 






Ê ͞Radiographic joint Space͟; between the
condyle and temporal component.
Ê mhe left and right condylar position within the
fossa can be determined and compared by the
dimensions of the radiographic joint space
viewed on collateral lateral images.
Ê Because the radiographic outline of the
glenoid fossa and the condyle do not match
like a smooth ball and socket joint, the joint
space often varies from medial to lateral
aspects of the joint.
Ê 2

Ê arkedly eccentric condylar positioning
usually represents an abnormality.
Ê Exp, inferior condylar positioning (widened
joint space) maybe seen in case involving fluid
or blood within the joint.
Ê Superior condylar positioning (decreased OR
no joint space) may indicate loss,
displacement, or perforation of intracapsular
soft tissue components.
 Ô

› 

Ê mhe condyle typically found within a range of

2-5 mm posterior and 5-8 mm anterior in the
crest of the eminence.
Ê Reduce condylar translation, has little Or no
downward and forward movement and
doesn͛t leave the mandibular fossa seen in
patient who clinically have a reduced degree
of mouth opening.
Ê Hypermobility : translate >5 mm anterior to
the eminence.
 


 


Ê Depends on the specific clinical problems.
Ê Both joints should be imaged during the
examination, for comparison.
   




Panoramic Projection
Ê Provide: overall view of teeth and jaws,
comparing the left and right sides of the
mandible, as a screening projection to identify
odontogenic diseases and other disorder that
maybe the source of m J symptoms.
Ê Limitation : distorted view of the joints,
severe image quality.
Ê 2

Ê ~ross osseus changes in the condylus,
asymmetries, extensive erosions, large
osteophytes, tumors, fractures.
Ê Shouldn͛t be used as a sole imaging modality.

Plain 2ilm Imaging odality

Ê Combined of: transcranial, transpharyngeal,
transorbital, and submentovertex projection.
Conventional momography
Ê Is a radiographic technique that produces
multiple thin image slices, permitting
visualization of the osseus structures
essentially free of superimpositions of
overlapping structures.

Computed momography
Ê mwo devices available: Conventional Cm and
CBCm, but only conventional Cm provides
images of the surrounding soft tissues.
Ê Cm useful for determining the presence and
extent of ankylosis and neoplasms and degree
of bone involvement in arthritides, imaging
complex fractures, for evaluating
complications from the use of
polytetrafluoroethylene or silicon sheet
implants.
  
  




Ê Indications : m J pain and dysfunction, clinical
finding suggest disk displacement, and
symptoms unresponsive to conservative
therapy.