Consideration of temporomandibular joint in occlusion-oriented oral and maxillofacial surgery
Professor Tetsu TAKAHASHI
Tohoku University
Sendai
JAPAN
Temporomandibular joint (TMJ) is a diathrodial
joint, which is composed of the
temporal bone and the mandible, as well as a specialized dense fibrous
structure, the articular disk, several ligaments, and numerous associated
muscles. Functionally the TMJ is a compound joint, composed of four
articulating surfaces: the articular facets of the temporal
bone and of the mandibular condyle and the superior and
inferior surfaces of the articular disk. The articular disk divides the joint
into two compartments. The lower compartment permits hinge motion or rotation
and hence is termed ginglymoid. The superior compartment permits
sliding (or translatory) movements and is therefore
called arthrodial. Hence the TMJ as a whole can be termed ginglymoarthrodial.
Trauma such as
condylar fractures, growth anomalies, neoplastic diseases, and TMJ disorders including
osteoarthritis cause dento-maxillo-facial deformities and occlusal disorders.
When we correct such dento-maxillo-facial deformities including occlusion,
special care should be taken not to aggravate TMJ function such as articulation
and occlusion. Therefore, we oral and maxillofacial surgeons should always
consider TMJ antomy, pathophysiology, and function. In this lecture, I would
like to focus on TMJ, specifically on its biology and function in oral and
maxillofacial surgery.
