Lecture By:
Dr. Chitransha
TEMPOROMANDIBULAR
JOINT
 On each side of the head, between
temporal bone and mandible, that
allows the movements of the
mandible for speech and
mastication.
 It is described as a complex, biaxial,
synovial & bicondylar joint.
 Also known as the craniomandibular
joint or bilateral diarthroidial joint.
ARTICULAR SURFACES
The upper articular surface is formed
by:
1. Articular fossa (anterior part of
Mandibular Fossa )and
2. Articular tubercle of the temporal
bone.
 This surface is concavo-convex from
behind forwards.
 The inferior articular surface is
formed by:
1. Head (condyle) of the mandible.
 This surface is elliptical in shape.
The articular surfaces are covered
by fibrocartilage and not by hyaline
cartilage, hence TMJ is an atypical
synovial joint.
Gross Anatomy of TMJ
 BONY
COMPONENTS
Condylar Head
Articular Fossa
Articular
tubercle
 SOFT TISSUE
COMPONENTS
Articular Disc
Synovial fluid
Ligaments
 The cavity of TMJ is divided by an
intra-articular disc of fibrocartilage
(MENISCUS) into
upper menisco-temporal
lower menisco-mandibular
compartments.
Articular Disc
 The articular disc is an oval plate of
fibrocartilage.
 The periphery of the disc is attached
firmly to the fibrous capsule.
 The ligaments are
1. Fibrous Capsule
2. Temporomandibular
3. Sphenomandibular
4. Stylomandibular Ligaments
Fibrous capsule
 It is a fibrous sac to enclose the joint
cavity.
 It is attached above to the articular
tubercle, the circumference of
articular fossa, and the
squamotympanic fissure and below to
the neck of mandible.
 The synovial membrane lines the
inner aspect of the fibrous capsule
Lateral (temporomandibular)
ligament
 It is a true ligament and formed as a
result of thickening on the lateral
aspect of the capsular ligament.
 It is attached above to the articular
tubercle and below to the
posterolateral aspect of the neck of
the mandible.
 The lateral ligament strengthens the
lateral aspect of the capsule.
Sphenomandibular ligament
 It is attached above to the spine of
the sphenoid and below to the lingula
of the mandible.
 The sphenomandibular ligament
represents the unossified
intermediate part of the sheath of the
Meckel’s cartilage of the first
pharyngeal arch.
 It becomes accentuated and taut
when the mandible is protruded.
Stylomandibular ligament
 It is attached above to the lateral
surface of the styloid process and
below to the angle of the mandible.
 The stylomandibular ligament is
formed due to thickening of the
investing layer of deep cervical fascia,
which separates the parotid and
submandibular glands.
 This ligament also becomes taut
when the mandible is protruded.
Relations of TMJ
Lateral
 Skin and fasciae.
 Parotid gland.
 Temporal branches of the facial
nerve.
Medial
 Tympanic plate separating it from
internal carotid artery.
 Spine of sphenoid.
 Auriculotemporal nerve.
 Middle meningeal artery.
 Sphenomandibular ligament.
 Chorda tympani nerve.
Anterior
 Lateral pterygoid.
 Masseteric nerve and vessels.
Posterior
 Postglenoid part of parotid gland
separating it from external auditory
meatus.
 Superficial temporal vessels.
 Auriculotemporal nerve
NERVE SUPPLY
 Auriculotemporal nerve
 Masseteric nerve
BLOOD SUPPLY
 Maxillary artery.
 Superficial temporal artery.
Veins follow the arteries.
LYMPHATIC DRAINAGE
 The lymph from TMJ is drained into:
 Superficial parotid (preauricular)
nodes.
 Deep parotid nodes.
 Upper deep cervical nodes.
 The movements occurring at the
temporomandibular joints are:
1) Depression
2) Elevation
3) Protraction
4) Retraction
5) Side to side (Chewing)
movements
Muscles Producing
Movement
 Depression (Opening of Mouth)
It is produced mainly by lateral
Pterygoid helped by gravity.
The digastric, geniohyoid, and
mylohyoid muscles help when the
mouth is opened widely or against
resistance.
 Elevation (Closing the Mouth)
It is caused by medial pterygoid,
masseter, and temporalis (vertical
fibres).
 Protraction
 Lateral and medial pterygoids and
superficial fibres of masseter.
 Retraction
It is done by posterior fibres of
temporalis.
Assisted by middle and deep fibres
of the masseter, the digastric and
geniohyoid muscles.
 Side-to-side (Chewing) Movements:
 These movements are performed
by alternate contraction of medial
and lateral pterygoids on each side.
APPLIED
 Dislocation of mandible
 Ankylosis
 During surgery of
temporomandibular joints, the facial
nerve should be preserved.

Temporomandibular joint

  • 1.
  • 2.
     On eachside of the head, between temporal bone and mandible, that allows the movements of the mandible for speech and mastication.
  • 3.
     It isdescribed as a complex, biaxial, synovial & bicondylar joint.  Also known as the craniomandibular joint or bilateral diarthroidial joint.
  • 4.
    ARTICULAR SURFACES The upperarticular surface is formed by: 1. Articular fossa (anterior part of Mandibular Fossa )and 2. Articular tubercle of the temporal bone.  This surface is concavo-convex from behind forwards.
  • 6.
     The inferiorarticular surface is formed by: 1. Head (condyle) of the mandible.  This surface is elliptical in shape. The articular surfaces are covered by fibrocartilage and not by hyaline cartilage, hence TMJ is an atypical synovial joint.
  • 8.
    Gross Anatomy ofTMJ  BONY COMPONENTS Condylar Head Articular Fossa Articular tubercle  SOFT TISSUE COMPONENTS Articular Disc Synovial fluid Ligaments
  • 11.
     The cavityof TMJ is divided by an intra-articular disc of fibrocartilage (MENISCUS) into upper menisco-temporal lower menisco-mandibular compartments.
  • 12.
    Articular Disc  Thearticular disc is an oval plate of fibrocartilage.  The periphery of the disc is attached firmly to the fibrous capsule.
  • 13.
     The ligamentsare 1. Fibrous Capsule 2. Temporomandibular 3. Sphenomandibular 4. Stylomandibular Ligaments
  • 14.
    Fibrous capsule  Itis a fibrous sac to enclose the joint cavity.  It is attached above to the articular tubercle, the circumference of articular fossa, and the squamotympanic fissure and below to the neck of mandible.  The synovial membrane lines the inner aspect of the fibrous capsule
  • 16.
    Lateral (temporomandibular) ligament  Itis a true ligament and formed as a result of thickening on the lateral aspect of the capsular ligament.  It is attached above to the articular tubercle and below to the posterolateral aspect of the neck of the mandible.  The lateral ligament strengthens the lateral aspect of the capsule.
  • 18.
    Sphenomandibular ligament  Itis attached above to the spine of the sphenoid and below to the lingula of the mandible.  The sphenomandibular ligament represents the unossified intermediate part of the sheath of the Meckel’s cartilage of the first pharyngeal arch.  It becomes accentuated and taut when the mandible is protruded.
  • 19.
    Stylomandibular ligament  Itis attached above to the lateral surface of the styloid process and below to the angle of the mandible.  The stylomandibular ligament is formed due to thickening of the investing layer of deep cervical fascia, which separates the parotid and submandibular glands.  This ligament also becomes taut when the mandible is protruded.
  • 21.
  • 22.
    Lateral  Skin andfasciae.  Parotid gland.  Temporal branches of the facial nerve.
  • 23.
    Medial  Tympanic plateseparating it from internal carotid artery.  Spine of sphenoid.  Auriculotemporal nerve.  Middle meningeal artery.  Sphenomandibular ligament.  Chorda tympani nerve.
  • 25.
    Anterior  Lateral pterygoid. Masseteric nerve and vessels.
  • 26.
    Posterior  Postglenoid partof parotid gland separating it from external auditory meatus.  Superficial temporal vessels.  Auriculotemporal nerve
  • 27.
    NERVE SUPPLY  Auriculotemporalnerve  Masseteric nerve
  • 28.
    BLOOD SUPPLY  Maxillaryartery.  Superficial temporal artery. Veins follow the arteries.
  • 29.
    LYMPHATIC DRAINAGE  Thelymph from TMJ is drained into:  Superficial parotid (preauricular) nodes.  Deep parotid nodes.  Upper deep cervical nodes.
  • 30.
     The movementsoccurring at the temporomandibular joints are: 1) Depression 2) Elevation 3) Protraction 4) Retraction 5) Side to side (Chewing) movements
  • 31.
    Muscles Producing Movement  Depression(Opening of Mouth) It is produced mainly by lateral Pterygoid helped by gravity. The digastric, geniohyoid, and mylohyoid muscles help when the mouth is opened widely or against resistance.
  • 32.
     Elevation (Closingthe Mouth) It is caused by medial pterygoid, masseter, and temporalis (vertical fibres).
  • 33.
     Protraction  Lateraland medial pterygoids and superficial fibres of masseter.
  • 34.
     Retraction It isdone by posterior fibres of temporalis. Assisted by middle and deep fibres of the masseter, the digastric and geniohyoid muscles.
  • 35.
     Side-to-side (Chewing)Movements:  These movements are performed by alternate contraction of medial and lateral pterygoids on each side.
  • 36.
    APPLIED  Dislocation ofmandible  Ankylosis  During surgery of temporomandibular joints, the facial nerve should be preserved.