I

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Cll~Cilil
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~{fimqg((!§
~~~rms
,.iiiGJift

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IJlbls mtlliir:I mxt\

._.D:mtmch.!lsf1qs~fl!rmticiJI§
rrmTAikii<i1V 9fia&!&1>

atoo ~n ~u • ., d ~ iJiht'1 ~
~·~~\\Ktpt.tmJlk

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 trau1na

cdls1mt.illt+M•~'l4Ufm•~
Laxity llliBJJtff•ff.1.
Rl1eL11natic
general

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J\rthritis

tvlctabolic
M&\\fJI 1I• •
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@UJIMMDi•mnmmU)
1111i&11uommv nnm,1•mft!1mmtfitftft1
~Di• artI1ritis
.
.

1111m1tmm ~lim••&oW•dflummdmJ

tf rau1natic llbi~~fili~ r416tmmft+lne.mB<DtB

.(t[iliitiiif4,
~-----~- Classification · .. , _. ' - --- -• - • - ~--o·- - -.

I. D e\relopmental disturbances of the T:iYIJ

• J\t)lasia c)f the mandibular cond)'le
• 1--1 yp<>t)lasia <)f the mandibular condyle
• 1--l yperplasia <)f the mandibular condyle
II. Traumatic disturbances of the TMJ
Jl.t11.'tlfto1ilim11 lmOO•J.'itfmii (twi•flfiiml mdH>001ny;ftqR~i'mt))
~fJ:! (4lwm••ttililftdJ
UiD1•ikldl&mm1uft••im M C+mi•&1ttf)
II& Dtmer•••dSdtlliarm•
IllliBtinimfQ1V c:tl-r11111~ctifttte'1q
Ay;dhftA.1
Imoo1mmdtll wdblftd.
t';l.·fcm1Jftdl1\3~1w11&<; ~··~~ JimtaqMcae1rihft&t
 Classification
V. Neoplastic disturbances of the TMJ
VI. Extra-articular disturbances of the TMJ
- 'Xki9lplltlm!Jiti~ft\lgfim •
OCfilMO•~
';ltt{il~ ~•W ~111J)<•Wfill~ ml ~liliil(ftil.
~QA•~
'jlfl•) ~·tflm)r fl;) 00ig@8l!l!"'1!Hm ~

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 ·I ,. Developmental distur1:5ances of~ tlie ,·TMJL~- ·"""""""''

1. 1\plasia of tl1e mandibular condy1le

• Cc)ndylar aplasia or failure of de\relopment c)f the 1nanclil)ular condyle -7
\\'hicl1 may C)CCur unilateral!)· or bilaterall)··
• It is a ra re cc)ndition
• Cl~ ft:
relatea M«•11>11Clfu e.mm clhik!&<:i II
absent external liiBfiIOO.Irilm rain us

Unilateral tlfiiih~ ~-& lltrci'".:aflqmrmf•f

mnm:•. inandiole flmm•db timldit'lWlmHm occurs
bilateral cases Amlm ·(jl(iWJiB

Cc)Stnetic
=~·=
2,. . hl)rp_oplas~of*tl1e 111£ln clibular co nd):le _ _ _ _ _ _ _ _ _ _ __
• U ncl er d e\rel<)lJ111ent / defecti\re for1nation <)f the 111a nclil)ular C<)nd yle
• Cc>ngcnital hypo plasia
• Idiopathic
• Characte1ized by uni / bilateral under development of 1he condyle
• r\ cquircd hypoplasia
• ~lay be due to any agent \\·hich interferes \Vith the norn1al developn1ent of the
cond,·le
•
.
(~a uses:

IlnRijplrRdl\wlk1
rtmamO trau1na
RJer11dlkdt+Jn
Jbfjuftuu

~•tftsl!pl••A;ha 1b Af••if)mml'a lmmm'l&lfd

ttlil'iJ l'm mift uum•1dlm~d••ml'ln1•mtft+m.
-IJlllml BnlfuitftitS<dli\flil"«=imtilG
'mulflijiiit•t.J••MMml!ltPuwmmib ~
Unilateral most com1non
 lftlitODnftmsIDrOft1wGDfffi:dh1~1qmmlC!h.-ttm
'mJ!l dt8m IDtmllftftq Jh\Jtm1tt c#M,\uiUJifdJ.IMdJ l6Juufl
&IWktm• 1mI4Vddml111t••rOliJhJ
iibmb mtllreeifiY~ center
ffireat111en~ ~ ft'Q&4m»J\i
Cartilage fl l)mml lli!,1141}Th•nl3
Unilateral mlI r~(fliJVfWB•'tt>filM Olm
i....i"ltr..1~•11'!1ri"&"Unn
11!!!f
1111
R"'V••••mr•wllmltl§liii.itu•i.
 ...I. D evelopmental,disturl5ances. of~tfie , ifMJ,. ---- --- - - - - - - -11

3.Hj'perplasia of the mandibular condyle

• Cc)ndylar hyperplasia is a rare unilateral enlargen1ent <>f the C<>ndyle
Causes: Obscure
Sugg. I:;act<>rs -7 i\lild chronic inflammation \vhich stimulates the gro\\rth
ot tl1e cona yie c)r aSjacent tissue.

111dll5141a~111qt41l'1ectWP&JilAoiL~ 11.m'\\iHE cfti\ifitlhmcBf

'8DJ CiftfuJ HQ})' t'fmiJl rfini ~ rdiR=
'mm~~lillijylkgSftitbj~lftitiR
'lltme<l6tiftedl J}dm••mwm ••mw~IPlhiidl
se, rere 1rmft.'YRl•,.h m mtfrim cm'tftm to1g81tk+J11

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1M111m11.-a mmJ ItU.,~n·i.:i'°'
lt[S~.fm<ll.U•fr"1fs~ ~Will
JSU>Mifh fm 00B1.id1 ~ CiJ-mtfi:m Gf!lfWJV' pd+J1md\
restore normal

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 •
~m ~1mw1hi•llklJAKmmi anten1on
bdl
Pmifu~
tlnnrm"1•k
m.v> ~ OCil!f•mtniftil~lil.
MtlilMMMfiWt1Wkll C!m~ ~ trauma, fi(U1ma1mfl 1n11w.1!ihl
llllTIJ;1t4;1~ ~BfPifft1,

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treat:m:ent
f4iiiboo001 a 1.11ulh m. fl1i,dftu•i db.n cannc)t
ncJrtnal 1fM4.ftfrni\.

ILuxacic>n lit mm ~ t.«•>iil)i&ml cmtt~ttJfift•m wMh1 rml\ibt.'filfttli& & m

r.artial FJllfillQPw~•l\J1.,
.
Luxacion lm.}f im1 '1111d, t&e RDm Attftlk;m trau1nauc
rtm+1urt4 mm t1t.11NJ1s
;'ia\vning '(/ lhj\il3fllm liit•1114\ltfUr:Jid
'1i®iimlifiB
1kilMN•woctiltODJ midi l8mfB!-illD htitll cdi'dml~ •••uh
lim Giiitldim JhmJ. ID W!JiiiEtl. rJ».ftilti111 ~ mil lh(tq!ftuw mdl
(ffU>~i4itm1t1sid1Ml db rfuur,DJi.lh\ {fug111t•it8Ddm mai.
~m1fu
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lftih•dtuucdtcm~ fmti•••s
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ri/i \W'HD E>ttE!i~UJ
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D'Mr.mv1h1im1i•nm:ftm~lti
____ ....!...:. -~·...:._-=..@tt?#Q#)iiptt·Iiil
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i\lctas ta tic IMlltsmt•tt"s1
i$fij)lfikfty{Q) tmlftufm11d\w10.
ti]fffl
rtlu!mm lml'BIP
11fn.1ctlfiJ.'K') OOl.Dml lilm¥dmlp•'1
D istril)ution egual bet\veen
mm jpiiWn• liillY fl wiav wm •- 6 rm r!fllii''Jlfm xiit•udb qli{fill&tWS
extent, dcRending mlnm'1:I9~f(.1

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 'film! c£1\11'm cD\.~J\mi141f mlD ~tlMtiDC!lil !fim61TtntdmHm
dm M••n ddktllltt>••s•rc~ 1nm1tflnA.
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~m1mmit•mcMDmnDu•ftit$.B~
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11imttflltdmmmS
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.
nf4S•••l41to•i mm 1nen1scus liJymmitm•M ilrfnV•DlifmM«tndt
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narro\vrng &itiJIB '1llm tmD

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 II. Traumatic disturbances of the TMJ

• R/ Ft:
• Reveals abnormal / irregular shape of the head of tl1e cond1rle
'11.teatment:
r;111gfooil
~
OO~•mm~'-1CBt) l!@ocmr~~fl!rmi..1@mil~

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t'iilmmmUlnCNi:mihm
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A'flitu~mnw I/ m~lldl Mt~~ c4Jtdk,

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lihtil11iiftr IDitwft l!(i1'Ul~ti!idla•Jif.lc;fto"miiltifl toli~ excursion.
'Dh!1 lkmr«nml~ fflmiHilifeJm fim(J1w1oWAp.wllmm4lto4JmrB11mdJlrilly
lbm>Ulli:LtN•q;midls•·m ~hva1d1Jjl!ill~ external.
Df«4wftll1m1,.-r4bJ mD stsllilit1fw1ir;1ft0m6t!fwt9ll3ctifma tllhlhl1fb c;il
tnfm~&JiiIYIA
 ID1RJY ftliW 1
~ C«IPI•!frnmt ~Pl1 lijym,1m liii'fil IJilifrih,
lti8lrlfiL1~iDJm~fillt«fcmJ..
11

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11

t•lSk·iiilMllbll/~-~

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 (ij11.-.oot tfflOOl~i:
SP.teaCl stre II
llf•i)ifmrl@ 1nctas tasis.
- lmt.il"'4111JliWii1 ft~difalft&
-~@~.fbldks~
Extre1ne tenclerness
H-P features
• There is a variable amount of destruction of the
articular cartilage and articular disk.
• The joint spaces become obliterated in the healing
r.liase oy tlie Clev.eloHment o ~ gr w ation tissue
scan

IYm'f·Aif•lfliTS-== mi 1h goo~~
11t4hLiltifmiil' /I ~om)y tm ~rd Jhi i8m filft+Mtmidl
~
 I:NEJ...1u\11vlA']QR~ DISillURB1\N CES

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Involve1nent WHIQJ 11•qyW!l!Dndlfu lbd\swDdma-911-(i--iJi-g.
1\nkylc>sis •mrRt1111mi fjhto·«@Ji mJJI4ftvlltti'tdl••s

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 •
illcrease

I ti~t•ttitmft:s
·~ treat1nent {tmt~A'«ftlML'b
l!lnlftld11rlmm Jl<dll~ Ci·n·it-m1t1,
Surgical inte1~enti(Jn {fg1m ~iijJIDJjJf
necessar)r 1no:vement.
[C}llA,
~giml~•ifil«mi'mcdimt~1 rdlnntn:fmmmm~bldqs
,,mm,
mm,rtll@d@BWWi~mDI~~.fm tftm~ ~ {t!)fffw/.@tlcmdk
1Mt1ilu•l.

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d~rQf!fticc ooil!IYib!OttP11\mw~• ~ Ci'.ffi\
1t>t~ Ml Fmioml c•J.1-~il-dhiJilfi s••Rf ~
lltiI!lk•J.fm ri/I ~ M,.
 V. NEOPI_,ASTIC D ISTURB1\NCES OF THE'TJ\ IJ 1

• N eoplasm s and tumor-lil(e growths, benign and

malignant, ma)r involve the TMJ.
• ~t is ~e ~' Nncomrnon.
-fii
Wif•o ~ lktima ctil~ 1nm•rlft~uilafr;i t1I•11~
IJifiro CillPl•:fhl C!lr Fiflfti!Hur M,
tih•J.ititofiiifi'-\.~ ~ ~idl@illm)Alii]
rufilfti@il lhiD\1.i1
f!!.~

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1fiddle
llilhrc41QtI01iACi4lbillft.3
11iijlh&J4flt4iltrtii'W)tijittM\ P.rocess mnm
Neuritisrminmlltu\Gmm•'cn'fl8m•••"mD nc .vc.
C!mt•
f()reign IJ!mW bJliihf6JiitJB1ill"4$-EL
1nandible
Cc)sten's
 articular

~ltDJ ~ flil1M ~ ~ Cilfdmi CilrliiMI•) ~~

J},~r@€mt~efldlirm\Dwif.ilw!Bfa{tfjmt4U5 <!btfiittmJlM@ftm~
"1tb~Cim~
~:i•t-.;1-1•il ~ ~tift•iti~~iBJAilm stresseC:l
JjI4Vim

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 MUSCULAR
Stress _ _ _ _ _ _,.....HYPERACTIVITY ......___ _ _ _ -Oenml Irritation•

i
MUSCULAR
FATIGUE

Muscular I i
] Muscular
Overextension ---i~• MYOSPAS~ ...
~'----- Overcontraction

---~ MYOFASCIAL PAIN - DYSFUNCTION ,._____

'
Occlusal \
Internal ~Degenerative
Contracture Disharmony Derangement Arthritis

-----2:::~ +
ALTERED CHEWING
+
PATIERN
Infection

11u1nrmrmM1&mDD~
MiitmGDl4itn&
~ clenching.
ILiiilit.1m.
P.ersonali n• ftmdh:tim
Increased D!ftnli4Jidl1Wl\]'

- .
anx1e ~y .
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J. Cl~#lfl•~fiC•hh*s'iitL
4. 3l•»ffrarige11m • ~ • s;itid}m) u~ IJ lWw-wSf.W\Mlltb
wum•Ttl. •
,..B II ~Iii

Cfiikt ~ \lf3!rdJWffS'~tili!ltmo
citti\\'Jt•rsm-DI omv rmtfthr@ lmifdL
nnflkttild Mlocwtfl fm I
t11dftw@iifl I • rarili!fim @isftib
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J:m•miJ CIIil!lill
Jtlht!liW~lifrll fltrmr
JlllR
&vi!li11•oflitig e1nl·-
~

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~@'il lili- ~ c4ftm\1Bd11111n1•• (;f!M.1ill4.

m~ t1I•l§ifi£ r.!ItpX•ldJiiIBilem,
I

~'·mr®3mf.m~
 l'n~estigations
- .
~-~--~-~==-==----...--:===- - ----- c c ~ c -_- c -__........~~"'"-"'"--"""'-..""""""'""""""'""""""'""""""""""""""""""""""'"""""""""'""""'...... c c ~ c -_- c -_-·=__ =_=_-

• TlYIJ imaging is used as an additional diagnostic aid in cases of

suspected patholog)r of
• ~l<>rphol<>gy <> f bc>ny components of j<>int
• l;unctional relationship b / \\' condyle and fc>ssa

~ dDiiwi,.{mmH Amq!f••ts
Ranora1nic mdlt~

'ffiidlti4ittiib0\law
'ffitaltttdtm~"'­
ffi rans<Jrl)i tal \il!\w

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diifi1P4ilily
 resonance

mbmmmJ
lft~liN
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• ~iill~ ~ lrf1

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ti•~ mrit {tilnptri]. caIDfPmi'iUi:
mm.bm'fmil
cihfftp(!Ii)~~ ~rd •
 •
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 tmmiffm~ ci.Dumfutelihmt+m•nfce
Mhglimfti ~~mtldM\Wlfu~ contrast
• f61•Dfl@il m1Allllml'll3fib~
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scans

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