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TMJ joint: Bones that form it, anatomy, movements, TMJ dysfunction

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Research:

The temporomandibular (tem-puh-roe-man-DIB-u-lur) joint (TMJ) is the sliding hinge that connects the mandible (one on each side) to the temporal bone of the cranium (the front of the ear) (Friedman, 2019). These bones are surrounded by three extracapsular ligaments. The stylomandibular ligament is a thickened band of cervical fascia, this stretches from the styloid process and angles to the posterior border of the ramus on the mandible. This supports the weight of the jaw and the facial muscles. The lateral ligament supports the thickening of the capsule to the joint and helps to prevent the dislocation of the joint. This is connected from the zygomatic bone to the mandible. The sphenomandibular ligament is an interior ligament that is attached from the spina angularis on the sphenoid bone to the lingula of the mandible. This is the primary bone for mastication (chewing) (Jones, 2020). TMJ also has four muscles that directly affect the movement and function of the jaw. The masseter muscle, which connects from the mandible to the cheekbone, is the major muscle used for chewing. The temporalis muscle is fan-shaped and stretches from the temporal fossa and the medial face of the zygomatic process to the coronoid mandibular process and helps with chewing motions specifically for grinding and chewing food with the molars. Then two pterygoids are medial and lateral. The medial pterygoid is attached at an angle to the lateral pterygoid that forms a sling for the masseter muscle, that supports and suspends the mandible.  These two muscles help with the forward and backward motion of the lower jaw (biting, chewing, speaking, and clenching) (Bordoni, 2020). There have been recent studies (still underway) looking into botox injection for TMD relief. The long term results in animals showed decreased bone density because of the muscles being paralyzed from the botox. However, in a NY study of 79 women, 39 of whom had 2-5 rounds of botox in a year and 44 women who continued use of other treatments. They did not notice any major differences in bone density, however, they were using a very low dose that was spread out and may not work for intended purposes if TMD is severe (Communications, 2020).

Critical Thinking:

Often TMJ is confused with TMD (temporomandibular joint disorder) or TMJ syndrome, which is the condition that affects TMJ bones, muscles, and ligaments and causes pain. Although finding out exactly what causes TMD (when the joint in TMJ is not functioning properly) is extremely difficult, it’s typical symptoms are ringing ears, pain when chewing or smiling, clicking or grinding in the jaw, pain in the jaw, facial pain, and headaches (Pettit, 2017). The two basic needs we all need is to be able to hydrate so to swallow and to be able to eat. Without properly functioning jaw muscles to help chew (so there is not choking) and start the digestions process we would be a sad lot to look at. The muscles responsible for helping TMJ are not just about food though but being able to communicate or warn. I understand sign language is the alternative as well as writing things down but not being able to say words specifically because the jaw will not move to support the specific sounds could lead to some interesting word confusion.

References

Bordoni, B. (2020, July 31). Anatomy, Head and Neck, Temporomandibular Joint. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK538486/.

Communications, N. Y. U. W. (2020, September 14). Botox for TMJ Disorders May Not Lead to Bone Loss in the Short Term, But More Research is Needed on Higher Dose, Long-Term Use. NYU. https://www.nyu.edu/about/news-publications/news/2020/september/botox-tmj-bone-loss.html.

Friedman, M. (2019, October 10). Temporomandibular Joint Disorders (TMJ & TMD): Overview. WebMD. https://www.webmd.com/oral-health/guide/temporomandibular-disorders-tmd.

Jones, O. (2020). The Temporomandibular Joint. TeachMeAnatomy. https://teachmeanatomy.info/head/joints/temporomandibular/.

Pettit, N. J. (2017, August 2). TMJ vs TMD: Know the Difference. MedCenter TMJ. https://www.medcentertmj.com/tmj-disorder-causes-treatments/tmj-vs-tmd-know-the-difference/.

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