Temporomandibular joint dysfunction is an umbrella term covering pain and dysfunction of the muscles of mastication and the temporomandibular joints. The most important feature is pain, followed by restricted mandibular movement, and noises from the temporomandibular joints (TMJ) during jaw movement. Although TMD is not life-threatening, it can be detrimental to quality of life; this is because the symptoms can become chronic and difficult to manage.
In anatomy, the temporomandibular joints (TMJ) are the two joints connecting the jawbone to the skull. It is a bilateral synovial articulation between the temporal bone of the skull above and the condylar process of mandible below; it is from these bones that its name is derived. The joints are unique in their bilateral function, being connected via the mandible.
In neuroanatomy, the mandibular nerve (V3) is the largest of the three divisions of the trigeminal nerve, the fifth cranial nerve (CN V). Unlike the other divisions of the trigeminal nerve (ophthalmic nerve, maxillary nerve) which contain only afferent fibers, the mandibular nerve contains both afferent and efferent fibers. These nerve fibers innervate structures of the lower jaw and face, such as the tongue, lower lip, and chin. The mandibular nerve also innervates the muscles of mastication.
The four classical muscles of mastication elevate the mandible and move it forward/backward and laterally, facilitating biting and chewing. Other muscles are responsible for opening the jaw, namely the geniohyoid, mylohyoid, and digastric muscles.
In anatomy, the masseter is one of the muscles of mastication. Found only in mammals, it is particularly powerful in herbivores to facilitate chewing of plant matter. The most obvious muscle of mastication is the masseter muscle, since it is the most superficial and one of the strongest.
The medial pterygoid muscle is a thick, quadrilateral muscle of the face. It is supplied by the mandibular branch of the trigeminal nerve (V). It is important in mastication (chewing).
The lateral pterygoid muscle (or external pterygoid muscle) is a muscle of mastication. It has two heads. It lies superior to the medial pterygoid muscle. It is supplied by pterygoid branches of the maxillary artery, and the lateral pterygoid nerve (from the mandibular nerve, CN V3). It depresses and protrudes the mandible. When each muscle works independently, they can move the mandible side to side.
The buccal nerve is a sensory nerve of the face arising from the mandibular nerve. It conveys sensory information from the skin of the cheek, and parts of the oral mucosa, periodontium, and gingiva.
The mental foramen is one of two foramina (openings) located on the anterior surface of the mandible. It is part of the mandibular canal. It transmits the terminal branches of the inferior alveolar nerve and the mental vessels.
The lingual nerve carries sensory innervation from the anterior two-thirds of the tongue. It contains fibres from both the mandibular division of the trigeminal nerve (CN V3) and from the facial nerve (CN VII). The fibres from the trigeminal nerve are for touch, pain and temperature (general sensation), and the ones from the facial nerve are for taste (special sensation).
The sphenomandibular ligament is one of the three ligaments of the temporomandibular joint. It is situated medially to - and generally separate from - the articular capsule of the joint. Superiorly, it is attached to the spine of the sphenoid bone; inferiorly, it is attached to the lingula of mandible. The SML acts to limit inferior-ward movement of the mandible.
The maxillary artery supplies deep structures of the face. It branches from the external carotid artery just deep to the neck of the mandible.
The lateral pterygoid nerve is a branch of the anterior division of the mandibular nerve. It usually originates as two separate branches that travel near the buccal nerve, and enter the deep surfaces of the superior and inferior heads of the lateral pterygoid muscle.
The infratemporal fossa is an irregularly shaped cavity that is a part of the skull. It is situated below and medial to the zygomatic arch. It is not fully enclosed by bone in all directions. It contains superficial muscles, including the lower part of the temporalis muscle, the lateral pterygoid muscle, and the medial pterygoid muscle. It also contains important blood vessels such as the middle meningeal artery, the pterygoid plexus, and the retromandibular vein, and nerves such as the mandibular nerve (CN V3) and its branches.
The pterygomandibular raphe is a thin tendinous band of buccopharyngeal fascia. It is attached superiorly to the pterygoid hamulus of the medial pterygoid plate, and inferiorly to the posterior end of the mylohyoid line of the mandible. It gives attachment to the buccinator muscle, and the superior pharyngeal constrictor muscle (behind).
The articular disk of the temporomandibular joint is a thin, oval plate made of non-vascular fibrous connective tissue located between the mandible's condyloid process and the cranium's mandibular fossa.
Inferior alveolar nerve block is a nerve block technique which induces anesthesia (numbness) in the areas of the mouth and face innervated by one of the inferior alveolar nerves which are paired on the left and right side. These areas are the skin and mucous membranes of the lower lip, the skin of the chin, the lower teeth and the labial gingiva of the anterior teeth, all unilaterally to the midline of the side on which the block is administered. However, depending on technique, the long buccal nerve may not be anesthetized by an IANB and therefore an area of buccal gingiva adjacent to the lower posterior teeth will retain normal sensation unless that nerve is anesthetized separately, via a (long) buccal nerve block. The inferior alveolar nerve is a branch of the mandibular nerve, the third division of the trigeminal nerve. This procedure attempts to anaesthetise the inferior alveolar nerve prior to it entering the mandibular foramen on the medial surface of the mandibular ramus.
Dislocations occur when two bones that originally met at the joint detach. Dislocations should not be confused with subluxation. Subluxation is when the joint is still partially attached to the bone.
In jawed vertebrates, the mandible, lower jaw, or jawbone is a bone that makes up the lower – and typically more mobile – component of the mouth.
The pterygomandibular space is a fascial space of the head and neck. It is a potential space in the head and is paired on each side. It is located between the lateral pterygoid muscle and the medial surface of the ramus of the mandible. The pterygomandibular space is one of the four compartments of the masticator space.
