ARTICULAR DISC OF TEMPOROMANDIBULAR JOINT

ARTICULAR DISC OF TMJ by
Dr.Sneha R.Nair

1. Pitch Deck 1

2. ARTICULAR DISC OF TMJ
PRESENTED BY,
DR.SNEHA R.NAIR
MDS PROSTHODONTICS & CROWN & BRIDGE

3. CONTENTS:-
INTRODUCTION
REVIEW OF LITERATURE
FUNCTIONS OF ARTICULAR DISC OF TMJ
PARTS OF ARTICULAR DISC OF TMJ
BOUNDARIES OF ARTICULAR DISC OF
TMJ
BLOOD SUPPLY
NERVE SUPPLY
PROSTHODONTIC SIGNIFICANCE
ARTICULAR DISC DISPLACEMENT
REFERENCE

4. INTRODUCTION:-
The temporomandibular joint (TMJ) is a
complex joint that involves the articulation
between the mandible and the temporal bone.
The articular disc is a fibrocartilaginous
structure that separates the mandibular
condyle and the glenoid fossa of the temporal
bone within the TMJ. The articular disc plays a
crucial role in the biomechanics and stability of
the TMJ, and its dysfunction can lead to various
TMJ disorders.
Divides the joint into upper and lower
compartments where upper compartment
helps in gliding movement and lower helps in
rotation and gliding movement
It is Concavo convex superiorly and Concave
inferiorly.

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REVIEW OF LITERATURE:-
1.1801-1821: The German anatomist Johann Friedrich Meckel
described the TMJ and its components, including the articular disc, in
his work “Handbuchder menschlichenAnatomie.”
2. 1836: The French anatomist Jules GermainCloquetprovided a more
detailed description of the articular disc in his work “Anatomiede
l’homme.”
3. 1867: The British anatomist Richard Owen suggested that the
articular disc played a role in the function of the TMJ, although he did
not fully understand its function.
4. 1892: The German anatomist Wilhelm Waldeyerproposed that the
articular disc served as a cushion between the mandibular condyle and
the temporal bone.

6. 4. In 1921, Dr.James Costendescribed a clinical syndrome characterized by pain and
dysfunction of the TMJ, which is now known as Costen’ssyndrome. This was documented in
the book “Temporomandibular Joint and Masticatory Muscle Disorders” by Audra L. Gold,
Richard A. Ohrbach, and Fredric C. Kessler.
5. In the 1940s and 1950s, Dr.B.J. Froriepand Dr.J.R. Rotes-Querolproposed a theory of
internal derangement of the TMJ, which suggested that displacement or dislocation of the
articular disc was a common cause of TMJ dysfunction. This was documented in the book
“Temporomandibular Joint Disorders: Diagnosis and Treatment” by Louis G. Mercuriand
George E. Ghali.

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6. 1939: The American anatomist Ralph E. Wolfe described the histology of the
articular disc in his work “The temporomandibular joint.”
7. 1953: The American orthopedicsurgeon John L. Williams proposed that the
articular disc was able to adapt to changes in the shape and size of the condyle
during jaw movement.
8. 1960s-1970s: Advances in imaging techniques, such as arthrography and
tomography, allowed for better visualization of the articular disc and improved
diagnosis of disc-related disorders.
9. 1990s-2000s: Magnetic resonance imaging (MRI) became the preferred imaging
modality for evaluating the articular disc and diagnosing TMJ disorders.

8. FUNCTION OF ARTICULAR DISC OF
TMJ:-
1. Articular Disc prevents friction between
articular surfaces
2. Acts as cushion and helps in shock absorption
3. It stabilizes the condyle by filling up space
between articulating surface
4. Fibersin joint help to regulate movement in
joint
5. Helps in distribution of weight across the tmj
by increasing area of contact.

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10. PARTS OF ARTICULAR DISC OF TMJ
Anterior band:This is the thinnest and most mobile part
of the disc. It attaches to the anterior margin of the
mandibular condyle and is responsible for the
translational movement of the condyle during opening
and closing of the mouth
Intermediate zone:This is the thickest and most
avascular part of the disc. It is responsible for load
distribution and shock absorption during mastication.
Posterior band:This is the thickest and most immobile
part of the disc. It attaches to the posterior margin of the
mandibular condyle and is responsible for stabilizing the
condyle during jaw movements.

11. Mandibular fossa

12. Retrodiscaltissue:This is a fibrous connective tissue that covers the
posterior surface of the articular disc and attaches it to the posterior
part of the mandibular fossa.
Superior lamina:This is a layer of fibrocartilage that covers the upper
surface of the disc and separates it from the superior joint cavity.
Inferior lamina:This is a layer of fibrocartilage that covers the lower
surface of the disc and separates it from the inferior joint cavity.

13. BOUNDARIES OF ARTICULAR DISC OF TMJ: -
Anterior margin: This is the front edge of the disc that
attaches to the anterior margin of the mandibular condyle.
Posterior margin:This is the back edge of the disc that
attaches to the posterior margin of the mandibular
condyle.
Superior surface: This is the upper surface of the disc that
is covered by the superior lamina of fibrocartilage and
separates it from the superior joint cavity.
Inferior surface: This is the lower surface of the disc that is
covered by the inferior lamina of fibrocartilage and
separates it from the inferior joint cavity.
Posterior attachment: This is the fibrous connective tissue
that covers the posterior surface of the disc and attaches it
to the posterior part of the mandibular fossa.

15. BLOOD SUPPLY OF ARTICULAR DISC OF TMJ: -
Inferior alveolar artery:This is a branch of the maxillary artery that runs
through the mandibular canal and supplies blood to the lower teeth, the lower
lip, and the skin of the chin. It also gives off branches to the TMJ region,
including the lateral pterygoidmuscle and the articular disc.
Superficial temporal artery: This is a branch of the external carotid artery that
runs in front of the ear and supplies blood to the scalp and the skin of the
temple. It also gives off branches to the TMJ region, including the lateral
pterygoidmuscle and the articular disc.
Massetericartery:This is a branch of the maxillary artery that supplies blood
to the masseter muscle, which is involved in chewing. It also gives off branches
to the TMJ region, including the lateral pterygoidmuscle and the articular disc.

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17. NERVE SUPPLY OF ARTICULAR DISC OF TMJ:-
Auriculotemporalnerve: This is a branch of the mandibular division of the
trigeminal nerve (CN V3) that supplies sensation to the skin of the temple,
the auricle of the ear, and the TMJ region. It gives off branches that supply
the lateral pterygoidmuscle and the articular disc.
Massetericnerve: This is a branch of the mandibular division of the
trigeminal nerve (CN V3) that supplies sensation to the masseter muscle,
which is involved in chewing. It also gives off branches that supply the TMJ
region, including the lateral pterygoidmuscle and the articular disc.
Deep temporal nerves: These are branches of the mandibular division of the
trigeminal nerve (CN V3) that supply sensation to the temporalis muscle,
which is involved in chewing. They also give off branches that supply the TMJ
region, including the lateral pterygoidmuscle and the articular disc.

18. Posterior superior alveolar nerve: This is a branch of the maxillary division of
the trigeminal nerve (CN V2) that supplies sensation to the upper teeth, the
maxillary sinus, and the TMJ region. It gives off branches that supply the
lateral pterygoidmuscle and the articular disc.
Cervical nerves:The TMJ region is also supplied by sensory nerves from the
cervical plexus, specifically the cervical nerves C2 and C3. These nerves
supply sensation to the skin of the neck and the back of the head and may
also provide some innervation to the TMJ region.

19. PROSTHODONTIC SIGNIFICANCE OF ARTICULAR
DISC OF TMJ:-
1. The disc acts as a cushion between the mandibular condyle and the
temporal bone, absorbing forces and minimizing wear and tear on the joint
surfaces.
2. Some prosthodontic treatments, such as the fabrication of dentures or fixed
prostheses, can impact the function of the TMJ and the articular disc. Improper
occlusal forces, incorrect jaw positioning, and occlusal interferences can all
contribute to excessive wear and tear on the disc and other structures within
the TMJ, leading to pain and dysfunction.

20. 3. In prosthodontics, the restoration of proper occlusion and jaw
position is critical for ensuring the longevity and function of the
articular disc and the TMJ as a whole. Prosthodontists must take
care to assess and manage TMJ disorders during treatment planning
and to select materials and techniques that will minimize stress on
the TMJ and support proper function.
4. Additionally, prosthodontic treatments may involve the use of
devices, such as occlusal splints or bite guards, that are designed to
protect the TMJ and minimize wear and tear on the articular disc.
These devices can be custom-fabricated to ensure proper fit and
function and to meet the specific needs of individual patients.

21. ARTICULAR DISC DISPLACEMENT:-

23. REFERENCE:-
1. BD CHAURASIA
2. JEFFREY P. OKESON
3. “Temporomandibular Joint and Masticatory Muscle Disorders” by Audra L. Gold,
Richard A. Ohrbach, and Fredric C. Kessler.
4.“Temporomandibular Joint Disorders: Diagnosis and Treatment” by Louis G.
Mercuriand George E. Ghali.
5.Meckel JF. Handbuchder menschlichenAnatomie. 1801-1821.
6.Cloquet JG. Anatomiede l’homme. 1836.
7.Owen R. On the homologies of the structure termed the articular meniscus of the
human knee-joint. Philosophical Transactions of the Royal Society of London.
1867;157:233-242.
8.Waldeyer W. Das Raetselder Articulatiotemporomandibularis. Archivfür
mikroskopischeAnatomie. 1892;39(2):303-318.
9. Wolfe RE. The temporomandibular joint. Springfield, IL: Charles C. Thomas; 1939.
10. Williams JL. The etiologyof temporomandibular joint dysfunction syndrome.
The Journal of Prosthetic Dentistry. 1953;3(5):611-623.

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