Temporomandibular joint (TMJ) is one of the most intricate and complicated loading joints found in humans. TMJ is also called the mandibular joint; it is an ellipsoid variety of the left and right synovial joints which form a bicondylar articulation. The components of this joint are a fibrous capsule, a disk, synovial membrane, fluid, and tough adjacent ligaments. The mandible and the cranium are mechanically two different components; therefore, the appropriate term for this joint is the craniomandibular articulation. It is not possible to understand the accurate points of occlusion without a thorough knowledge of the biomechanics, physiology, and anatomy of TMJ. The primary necessity for successful occlusal treatment is steady and comfortable TMJ. This understanding of the TMJ is the foundation to diagnosis and treatment of almost everything a dentist does.
This article is the continuation of temporomandibular joint (TMJ) disorders-Part I. This article focuses on the intracapsular disorders of the TMJ and the most common types that we as a dentist encounter. The condition of the intracapsular structure of TMJ affects the position of the TMJs; it also affects the occlusal relation.
The terminology "temporomandibular disorder" (TMD) covers a group of conditions. A lot of attempts have been made to categorize TMD, but all have shortfalls. Some classify by frequency of presentation, some by etiology, and some by anatomy. However, there is substantial overlap in classification system as they are not clinically suitable. Therefore, not even one system persuades all the criteria. TMD is a wide-ranging collection of clinical problems that involve the muscle of mastication, the temporomandibular joint, surrounding bone and soft tissue components, or at times combinations of all of them. Any factor that affects one part of the system is likely to have impact on the other parts also, so it is essential to avoid blind side when we have to consider likely signs and symptoms of a TMD. About 20-30% of the adult populations are affected to some degree; it is predominately a condition of young and middle-aged adults, rather than of children or the elderly, and is approximately twice as common in women as in men. TMD is the second most common non-dental origin orofacial pain, but at the same time, the recurrence of other symptoms such as earache, headache, neuralgia, and tooth pain, which can be related to the TMD or be present as secondary findings to be assessed in the differential diagnosis process.
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