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Anatomy of the manducatory apparatus
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148 b
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The temporomandibular joint (TMJ) is a suspended bicondylar synovial joint with interposed disc, which connects the base of the skull and the mandible. The stability of the two unstable convex articular surfaces is ensured by the articular disc, made of fibrocartilage. The capsulo-ligamentary system contributes to TMJ stability. The motor muscles of the TMJ include the mandibular elevator and didactic muscles, and the mandibular depressor muscles. The anatomical relationships between the joints are essential to understanding TMJ symptomatology and surgical management. Mandibular dynamics are ensured by antagonistic elevator and depressor muscles, as well as by the medial pterygoid, which has its own role, making it the muscle of dysfunction.Dental panoramic scans are sometimes useful in the initial bone assessment, while CT scans of the TMJ or Cone-Beam are particularly useful for demonstrating bone damage. The reference examination is MRI, which enables a multiplanar, dynamic study by successive acquisitions at different degrees of mouth opening.
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