Question 1

Which statement about the articular disc in the TMJ joint is true?

Accepted Answer

The disc is surrounded and protected by the fibrous connective tissue joint capsule. The articular disc in the TMJ is attached to the lateral and medial rather than the anterior and posterior aspects of the condyle, to the superior belly of the lateral pterygoid muscle, and to the joint capsule. The articular disc in the TMJ is attached to the lateral and medial aspects of the condyle, to the superior rather than the inferior belly of the lateral pterygoid muscle, and to the joint capsule. The disc and the bony surfaces are avascular.

Question 2

The most common systemic conditions that affect the TMJ are

Accepted Answer

Rheumatoid arthritis and juvenile rheumatoid arthritis are the most common systemic conditions that affect the TMJ. Sjögren syndrome and scleroderma are less likely to affect the TMJ than are rheumatoid arthritis and juvenile rheumatoid arthritis. Gout and Reiter syndrome are less likely to affect the TMJ than are rheumatoid arthritis and juvenile rheumatoid arthritis. Ankylosing spondylitis and mixed connective tissue disease are less likely to affect the TMJ than are rheumatoid arthritis and juvenile rheumatoid arthritis.

Question 3

During opening of the jaw

Accepted Answer

During opening of the jaw, rotational movement precedes translation. During translation the disc assumes a more posterior position in relation to the condyle. The inferior and superior joint spaces assume different configurations during each of these movements. During opening of the jaw, rotational movement precedes rather than follows translation.

Question 4

Which dental radiographic procedure is best for examining disc position, function, form, and the presence of joint effusions?

Accepted Answer

MRI is mandatory for examining disc position, function, and form and the presence of joint effusions. Arthrography may be useful when MRI is not tolerated and information regarding the position and morphology of the disc is required. Panoramic imaging radiographs are limited to identifying gross changes in bone. Transcranial imaging radiographs are limited to identifying gross changes in bone. CT is the most accurate for identifying bone abnormalities.

Question 5

Temporomandibular dysfunction (TMD) can be caused by disorders of the muscles of mastication or by internal derangements of the components of the joint. Three cardinal features that suggest TMD include orofacial pain, joint noise, and restricted jaw function.

Accepted Answer

Both statements are true. TMD can be caused by disorders of the muscles of mastication or by internal derangements of the components of the joint. Three cardinal features that suggest a TMD include orofacial pain, joint noise, and restricted jaw function.

Question 6

Which dental radiographic imaging is best for identifying bone abnormalities such as osteophytes, condylar erosion, fractures, ankylosis, and condylar hyperplasia?

Accepted Answer

CT is the most accurate for identifying bone abnormalities such as osteophytes, condylar erosion, fractures, ankylosis, and condylar hyperplasia. Panoramic imaging radiographs are limited to identifying gross changes in bone. Transcranial imaging radiographs are limited to identifying gross changes in bone. MRI is used for examining disc position, function, and form and the presence of joint effusions.

Question 7

Which statement is characteristic of a patient with osteoarthritis?

Accepted Answer

Osteoarthritis is characterized by pain that is worse in the evening, as well as limited opening, muscle splinting, and crepitus of the TMJ. Osteoarthritis is the most common disease affecting the TMJ. In rheumatoid arthritis patients may complain of pain that is worse in the morning, limited opening, occlusal changes, and preauricular edema and tenderness. Rheumatoid arthritis is an inflammatory, autoimmune disorder of the joints. Approximately 50% to 75% of patients with rheumatoid arthritis have involvement of the TMJ during the course of the disease. Osteoarthritis is characterized by pain that is worse in the evening rather than in the morning. Rheumatoid arthritis rather than osteoarthritis is an inflammatory, autoimmune disorder of the joints. Approximately 50% to 75% of patients with rheumatoid arthritis rather than osteoarthritis have involvement of the TMJ during the course of the disease.

Question 8

Trauma affecting the TMJ is classified as direct, indirect, and secondary to parafunctional habits. Which is an example of a parafunctional habit?

Accepted Answer

Clenching and bruxism are examples of parafunctional habits affecting the TMJ. Whiplash injury is an example of indirect trauma to the TMJ. Assault is an example of direct trauma to the TMJ. Surgery is not an example or direct trauma, indirect trauma, or parafunctional habits.

Question 9

Opening, or depressor function, of the mandible is accomplished primarily by the _____________ muscle.

Accepted Answer

Opening, or depressor function, of the mandible is accomplished primarily by the lateral pterygoid muscle with some help from the anterior digastric muscle. The medial pterygoid is an elevator muscle that closes the mandible when activated. The masseter is an elevator muscle that closes the mandible when activated. The temporalis is an elevator muscle that closes the mandible when activated.

Question 10

Which choice represents an indirect form of trauma affecting the TMJ?

Accepted Answer

Whiplash injury represents an indirect form of trauma affecting the TMJ. Trauma affecting the TMJ is classified as direct (assault), indirect (whiplash injury), or secondary to parafunctional habits (clenching, bruxism). Other contributing factors include dentofacial deformities and psychosocial factors. TMJ abnormalities are also associated with a number of different systemic diseases. Rheumatoid arthritis and osteoarthritis are the most common. Whiplash injury represents an indirect form of trauma affecting the TMJ. Trauma affecting the TMJ is classified as secondary to parafunctional habits when it is caused by clenching or bruxism.

Question 11

Caution is recommended with long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) because of what complications?

Accepted Answer

Caution is recommended with long-term use of NSAIDs because of cardiovascular complications. No direct correlation exists between long-term use of NSAIDs and gastrointestinal complications. There is no direct correlation between long-term use of NSAIDs and psychiatric complications. There is no direct correlation between long-term use of NSAIDs and arthritic complications.

Question 12

While up to _____% of the adult population has at least one sign and/or symptom of a temporomandibular disorder (TMD), most studies suggest that clinically significant TMD-related jaw pain, dysfunction, or both affects about _____% of the general population.

Accepted Answer

Although up to 75% of the adult population has at least one sign and/or symptom of a temporomandibular disorder, most studies suggest that clinically significant TMD-related jaw pain, dysfunction, or both affects about 13% of the general population. Significantly more frequent and more severe TMD signs and symptoms are seen in women than in men and older adults. Although up to 75%, not 90%, of the adult population has at least one sign and/or symptom of a temporomandibular disorder, most studies suggest that clinically significant TMD-related jaw pain, dysfunction, or both affects about 5% rather than 10% of the general population. Although up to 75% and not 50% of the adult population has at least one sign and/or symptom of a temporomandibular disorder, most studies suggest that clinically significant TMD-related jaw pain, dysfunction, or both affects about 5% rather than 10% of the general population. Although up to 75% and not 25% of the adult population has at least one sign and/or symptom of a temporomandibular disorder, most studies suggest that clinically significant TMD-related jaw pain, dysfunction, or both affects about 5% of the general population.

Question 13

An open lock of the TMJ that the patient cannot reduce is termed

Accepted Answer

An open lock that the patient cannot reduce is called dislocation. Dislocation occurs when one or both of the condyles translate anterior to the articular eminence. Subluxation refers to hypermobility in which the patient is able to relocate the mandible back into the glenoid fossa. Ankylosis of the TMJ is defined as immobility of the condyle because of fibrous or bony union between the articulating structures of the joint. Myofascial pain is characterized as a dysfunctional muscle hyperactivity with regional pain, tenderness of the affected muscles, and variable amounts of reduced opening and complaints of malocclusion.

Question 14

The TMJ exhibits ginglymoarthrodial, or __________, movement.

Accepted Answer

The TMJ exhibits ginglymoarthrodial, or rotational and translational, movement. Translational movement occurs in the upper compartment, whereas the lower compartment functions primarily as the hinge or rotational component. The first phase of opening movement is characterized by rotational movement of the condyle followed by anterior translation to approximately the anterior peak of the articular eminence. The opening is accomplished mainly by the lateral pterygoid muscle, with some help from the anterior digastric muscle. The masseter, medial pterygoid, and temporalis are elevator muscles that close the mandible when activated. The point of maximal interdigitation is called centric occlusion.

Question 15

The purpose of the synovial fluid is to

Accepted Answer

The purpose of the synovial fluid is to provide nourishment and lubrication of the avascular structures to the TMJ. An articular disc divides the space into an upper and lower compartment. The muscles of mastication govern the movement of the mandible. The function of the articular disc is to separate forces resulting from movement.

Question 16

Tenderness over the lateral pole of the condyle is indicative of

Accepted Answer

Capsulitis is tenderness over the lateral pole of the condyle. Crepitus is a dry crackling sound; tenderness over the lateral pole of the condyle is not indicative of crepitus. Trismus is the inability to fully open the mouth. Auscultation refers to listening to sounds within the body, using a stethoscope.

Question 17

Hypermobility in which the patient is able to relocate the mandible back into the glenoid fossa is referred to as

Accepted Answer

Subluxation refers to hypermobility in which the patient is able to relocate the mandible back into the glenoid fossa. Dislocation occurs when one or both of the condyles translate anterior to the articular eminence, resulting in an open lock that the patient cannot reduce. Ankylosis of the TMJ is defined as immobility of the condyle because of fibrous or bony union between the articulating structures of the joint. Myofascial pain is characterized as a dysfunctional muscle hyperactivity with regional pain, tenderness of the affected muscles, and variable amounts of reduced opening and complaints of malocclusion.

Question 18

Clicking and popping most commonly reflect

Accepted Answer

Clicking and popping commonly reflect disc displacement with reduction. It occurs in approximately 33% of asymptomatic patients. It is of little clinical consequence in the absence of pain or other symptoms relating to the TMJ because it is controversial as to whether these noises represent an adaptive response or an early symptom of progression to disc displacement without reduction. Clicking and popping, not parafunctional habits, commonly reflect disc displacement with reduction. Clicking and popping, not malocclusion, commonly reflect disc displacement with reduction. Clicking and popping, not trismus, commonly reflect disc displacement with reduction.

Question 19

All are benign tumors that arise in the condyle except one. Which is the exception?

Accepted Answer

Synovial chondromatosis is the most common benign neoplasm of the synovium, not the condyle. The three most common benign tumors of the condyle are the osteoblastoma, osteoma, and chondroblastoma.

Question 20

The temporomandibular joint (TMJ) is the articulation between the condyle of the mandible and the

Accepted Answer

The TMJ is the articulation between the condyle of the mandible and the glenoid fossa of the temporal bone. It is a highly specialized joint that differs from other joints because of the fibrocartilage that covers the bony articulating surfaces, its ginglymoarthrodial movement, its function and overall health being dictated by jaw movement, and its dependence on the contralateral joint. The TMJ is the articulation between the condyle of the mandible and the glenoid fossa of the temporal bone rather than the zygomatic process of the temporal bone. The TMJ is the articulation between the condyle of the mandible and the glenoid fossa of the temporal bone rather than the external acoustic meatus. The TMJ is the articulation between the condyle of the mandible and the glenoid fossa of the temporal bone rather than the spine of the sphenoid bone.

Quiz 10: Orofacial Pain and Diseases Affecting the Temporomandibular Joint

Which statement about the articular disc in the TMJ joint is true?

The most common systemic conditions that affect the TMJ are

During opening of the jaw

Which dental radiographic procedure is best for examining disc position, function, form, and the presence of joint effusions?

Temporomandibular dysfunction (TMD) can be caused by disorders of the muscles of mastication or by internal derangements of the components of the joint. Three cardinal features that suggest TMD include orofacial pain, joint noise, and restricted jaw function.

Which dental radiographic imaging is best for identifying bone abnormalities such as osteophytes, condylar erosion, fractures, ankylosis, and condylar hyperplasia?

Which statement is characteristic of a patient with osteoarthritis?

Trauma affecting the TMJ is classified as direct, indirect, and secondary to parafunctional habits. Which is an example of a parafunctional habit?

Opening, or depressor function, of the mandible is accomplished primarily by the _____________ muscle.

Which choice represents an indirect form of trauma affecting the TMJ?

Caution is recommended with long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) because of what complications?

While up to _% of the adult population has at least one sign and/or symptom of a temporomandibular disorder (TMD) , most studies suggest that clinically significant TMD-related jaw pain, dysfunction, or both affects about _% of the general population.

An open lock of the TMJ that the patient cannot reduce is termed

The TMJ exhibits ginglymoarthrodial, or __________, movement.

The purpose of the synovial fluid is to

Tenderness over the lateral pole of the condyle is indicative of

Hypermobility in which the patient is able to relocate the mandible back into the glenoid fossa is referred to as

Clicking and popping most commonly reflect

All are benign tumors that arise in the condyle except one. Which is the exception?

The temporomandibular joint (TMJ) is the articulation between the condyle of the mandible and the

Quiz 10: Orofacial Pain and Diseases Affecting the Temporomandibular Joint

Which statement about the articular disc in the TMJ joint is true?

The most common systemic conditions that affect the TMJ are

During opening of the jaw

Which dental radiographic procedure is best for examining disc position, function, form, and the presence of joint effusions?

Temporomandibular dysfunction (TMD) can be caused by disorders of the muscles of mastication or by internal derangements of the components of the joint. Three cardinal features that suggest TMD include orofacial pain, joint noise, and restricted jaw function.

Which dental radiographic imaging is best for identifying bone abnormalities such as osteophytes, condylar erosion, fractures, ankylosis, and condylar hyperplasia?

Which statement is characteristic of a patient with osteoarthritis?

Trauma affecting the TMJ is classified as direct, indirect, and secondary to parafunctional habits. Which is an example of a parafunctional habit?

Opening, or depressor function, of the mandible is accomplished primarily by the _____________ muscle.

Which choice represents an indirect form of trauma affecting the TMJ?

Caution is recommended with long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) because of what complications?

While up to _____% of the adult population has at least one sign and/or symptom of a temporomandibular disorder (TMD) , most studies suggest that clinically significant TMD-related jaw pain, dysfunction, or both affects about _____% of the general population.

An open lock of the TMJ that the patient cannot reduce is termed

The TMJ exhibits ginglymoarthrodial, or __________, movement.

The purpose of the synovial fluid is to

Tenderness over the lateral pole of the condyle is indicative of

Hypermobility in which the patient is able to relocate the mandible back into the glenoid fossa is referred to as

Clicking and popping most commonly reflect

All are benign tumors that arise in the condyle except one. Which is the exception?

The temporomandibular joint (TMJ) is the articulation between the condyle of the mandible and the

While up to _% of the adult population has at least one sign and/or symptom of a temporomandibular disorder (TMD) , most studies suggest that clinically significant TMD-related jaw pain, dysfunction, or both affects about _% of the general population.