this presentation describes the detail anatomy of Temporo-mandibular joint with respect to its articulating surfaces, ligaments, muscles and blood and nerve supply.

1. TMJ
To MBBS 2nd year
05-03-2017
Dr. Laxman Khanal
Assistant Professor, Department of Anatomy
PBL –Resource session
BPKIHS, Dharan

2. Introduction
• Joint between temporal bone (cranial bone) and
mandible (facial bone) that allows the movements of
the mandible for speech and mastication.
• Major function of TMJ is mastication and speech.
• It produces rotation and sliding type of movements.
• Also called as ginglimoarthroidal joint.
• Structurally it is condylar type of joint.
• Acts like class III lever.

3. Palpation of TMJ.

4. Identify the bone.
L

5. Mandibular fossa
Articular eminence

6. Lingula
1. Condylar process
2. Coronoid process

7. Craniomandibular joint
• Two bilateral components are called TMJs.
• Ginglymo arthrodial joint
• Complex joint
• Compound joint

10. Upper joint cavity
1.2ml
Translational movement
Lower joint cavity
0.9ml
Rotational movement

11. Articulating surfaces of TMJ
1. Inferior surface of mandibular fossa & AE
2. Superior surface of articular disc
3. Inferior surface of articular disc
4. Superior surface of condyle of mandible

13. TMJ is Unique !!
• Articular surfaces are covered by fibro
cartilage rather than hyaline cartilage.
• Has four articulating surfaces.
• Two joints cannot be moved independently.
• Movement is not only guided by the shape of
the bones, muscles, and ligaments but also by
the occlusion of the teeth.

14. Condyle
Glenoid fossa
Anterior eminence
Postglenoid tubercle

15. Condyle is in contact with the intermediate zone of
articular disc.

16. c
Articular surfaces and disc

17. Articular surfaces
Mandibular components
-Condyle of mandible
Temporal component
- Articular eminence of temporal bone
-Articular fossa of temporal bone
Articular Disc
• Made up of fibro cartilage
Anterior band
Intermediate band (thinnest)
Posterior band
Posterior bilaminar zone (highly vascular and
innervated)
Anterior end- attachment of upper head of LP

18. Ligaments
Fibrous capsule
Lateral ligament or TM ligament
Sphenomandibular ligaments
Stylomandibular ligaments

20. Attachment of capsule

21. Collaterla ligament

22. Sphenomandibular ligament
• First part of maxillary artery lies lateral to this .
• It is remnants of dorsal part of Meckel’s cartilage.
• Important landmarks for Inferior Alveolar Nerve block.
Stylomandibular ligament
• Formed by thickening of deep lamina of parotid fascia
• Separates parotid gland from submandibular gland

23. Relationship of IAN with the sphenomandibular ligament.

24. Resting position of TMJ
• Condyle lies in mandibular fossa.
• Lip are closed.
• Teeth are separated with slight space.

26. Nerve supply
• Auriculo temporal nerve
• Masseteric nerve
Blood supply
• Maxillary artery
• Superficial temporal
artry
(terminal B/O ECA)

27. Muscles of mastication
Masseter muscle
Temporalis

28. Medial pterygoid
Lateral pterygoid

29. Movements
Elevation / Depression
Protrusion / Retrusion
Right lateral / left lateral

30. Opening and contra lateral side to side movement
Upper head alone acts for closing movement

32. Movements of TMJ
Elevation: all the muscles except LP
Depression : LP
Protrusion : LP and MP
Retrusion: posterior fibers of temporalis
Side to side: LP and MP together

33. TMJ disorders
• The most common condition affecting the
temporomandibular region is temporo
mandibular dysfunction, or myofascial pain
dysfunction syndrome(MPDS)
 Pain
 Muscle spasm
 Limited jaw opening
 Joint sounds

34. TMJ dislocation
• Condyle displaced anterior to articular
eminence
• Causes:
Too wide mouth opening
Missing teeth
Trauma
• Anterior dislocation is more common.

35. TMJ dislocation
• Most common: anterior dislocation

36. How to reduce the dislocated mandible ????

37. Barton’s Bandage for mandibular fracture.