DH228 M9 KC - Ch 10 + QUIZ (",)

Which dental radiographic imaging is best for identifying bone abnormalities such as osteophytes, condylar erosion, fractures, ankylosis, and condylar hyperplasia?

A. Panoramic imaging

B. Transcranial imaging

C. Computerized tomography (CT)

D. Magnetic resonance imaging (MRI)

Computerized tomography (CT)

CT is the most accurate for identifying bone abnormalities such as osteophytes, condylar erosion, fractures, ankylosis, and condylar hyperplasia. Panoramic imaging radiographs are limited to identifying gross changes in bone. Transcranial imaging radiographs are limited to identifying gross changes in bone. MRI is used for examining disc position, function, and form and the presence of joint effusions.

3 multiple choice options

What is the most common systemic condition that may affect the TMJ?

A. Lupus

B. Gout

C. Arthritis

D. Scleroderma

Arthritis

The most common systemic conditions that may affect the TMJ are rheumatoid arthritis and juvenile rheumatoid arthritis. Less common systemic diseases that may affect the TMJ include systemic lupus erythematosus. Less common systemic diseases that may affect the TMJ include gout. Less common systemic diseases that may affect the TMJ include scleroderma.

3 multiple choice options

The most common systemic conditions that affect the TMJ are

A. Sjögren syndrome and scleroderma.

B. rheumatoid arthritis and juvenile rheumatoid arthritis.

C. gout and Reiter syndrome.

D. ankylosing spondylitis and mixed connective tissue disease.

rheumatoid arthritis and juvenile rheumatoid arthritis.

Rheumatoid arthritis and juvenile rheumatoid arthritis are the most common systemic conditions that affect the TMJ. Sjögren syndrome and scleroderma are less likely to affect the TMJ than are rheumatoid arthritis and juvenile rheumatoid arthritis. Gout and Reiter syndrome are less likely to affect the TMJ than are rheumatoid arthritis and juvenile rheumatoid arthritis. Ankylosing spondylitis and mixed connective tissue disease are less likely to affect the TMJ than are rheumatoid arthritis and juvenile rheumatoid arthritis.

3 multiple choice options

Which muscle of mastication is responsible for opening the mandible?

A. Temporalis

B. Medial pterygoid

C. Masseter

D. Lateral pterygoid

Lateral pterygoid

The function of the lateral pterygoid muscle is the opening of the mandible. The function of the temporalis muscle is to close the mandible. The function of the medial pterygoid muscle is to close the mandible. The function of the masseter muscle is to close the mandible.

3 multiple choice options

The purpose of the synovial fluid is to

A. provide nourishment and lubrication.

B. divide the space into upper and lower compartments.

C. govern mandibular movement.

D. separate forces resulting from movement.

provide nourishment and lubrication.

The purpose of the synovial fluid is to provide nourishment and lubrication of the avascular structures to the TMJ. An articular disc divides the space into an upper and lower compartment. The muscles of mastication govern the movement of the mandible. The function of the articular disc is to separate forces resulting from movement.

3 multiple choice options

Caution is recommended with long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) because of what complications?

A. Gastrointestinal

B. Cardiovascular

C. Psychiatric

D. Arthritis

Cardiovascular

Caution is recommended with long-term use of NSAIDs because of cardiovascular complications. No direct correlation exists between long-term use of NSAIDs and gastrointestinal complications. There is no direct correlation between long-term use of NSAIDs and psychiatric complications. There is no direct correlation between long-term use of NSAIDs and arthritic complications.

3 multiple choice options

From the choices below, which type of radiographic imaging would be least helpful in diagnosing TMJ disease?

A. MRI

B. CBCT

C. Panoramic imaging

D. Arthrography

Panoramic imaging

3 multiple choice options

Tumors arising in the TMJ area are common. The most common benign tumors that arise in the condyle include the osteochondroma.

A. Both statements are true.

B. Both statements are false.

C. The first statement is true; the second statement is false.

D. The first statement is false; the second statement is true.

The first statement is false; the second statement is true.

Tumors arising in the TMJ area are rare. The most common benign tumors that arise in the condyle include the osteochondroma, osteoblastoma, chondroblastoma, and osteoma. Tumors arising in the TMJ area are rare. The most common benign tumors that arise in the condyle include the osteochondroma. The first statement is false; the second statement is true.

3 multiple choice options

Which muscle of mastication is most superior in its location?

A. Temporalis

B. Lateral pterygoid

C. Masseter

D. Medial pterygoid

Temporalis

The temporalis muscle is a broad muscle that covers much of the temporal bone and is superior in location when compared to the other muscles of mastication. The lateral pterygoid is more inferior in location compared to the temporalis muscle, functioning to open the mandible. The masseter muscle is inferior to the temporalis muscle, functioning to close the mandible. The medial pterygoid is found on the medial side of the lateral pterygoid plate, functioning to close the mandible.

3 multiple choice options

An open lock of the TMJ that the patient cannot reduce is termed

A. subluxation.

B . Dislocation.

C. ankylosis.

D. myofascial pain.

Dislocation.

An open lock that the patient cannot reduce is called dislocation. Dislocation occurs when one or both of the condyles translate anterior to the articular eminence. Subluxation refers to hypermobility in which the patient is able to relocate the mandible back into the glenoid fossa. Ankylosis of the TMJ is defined as immobility of the condyle because of fibrous or bony union between the articulating structures of the joint. Myofascial pain is characterized as a dysfunctional muscle hyperactivity with regional pain, tenderness of the affected muscles, and variable amounts of reduced opening and complaints of malocclusion.

3 multiple choice options

Which term describes the condition where one or both of the condyles translate anterior to the articular eminence, resulting in an open lock that the patient cannot reduce?

A. Dislocation

B. Degenerative

C. Displacement

D. Odontogenic

Dislocation

Dislocation occurs when one or both of the condyles translate anterior to the articular eminence, resulting in an open lock that the patient cannot reduce. Degenerative denotes a progressive or irreversible deterioration. Displacement signifies moving something from its place or position. Odontogenic refers to arising from tooth-forming tissues.

3 multiple choice options

Three cardinal features for TMD include all except one. Which is the exception?

A. Restricted jaw function

B. Orofacial pain

C. Previous dental surgery

D. Joint noise

Previous dental surgery

A history of previous dental surgery is not considered a cardinal feature of TMD. Three cardinal features suggest a TMD, and restricted jaw function is one of the three. Three cardinal features suggest a TMD, and orofacial pain is one of the three. Three cardinal features suggest a TMD, and joint noise is one of the three.

3 multiple choice options

Temporomandibular dysfunction (TMD) can be caused by disorders of the muscles of mastication or by internal derangements of the components of the joint. Three cardinal features that suggest TMD include orofacial pain, joint noise, and restricted jaw function.

A. Both statements are true.

B. Both statements are false.

C. The first statement is true; the second is false.

D. The first statement is false; the second is true.

Both statements are true.

Both statements are true. TMD can be caused by disorders of the muscles of mastication or by internal derangements of the components of the joint. Three cardinal features that suggest a TMD include orofacial pain, joint noise, and restricted jaw function.

3 multiple choice options

While up to _____% of the adult population has at least one sign and/or symptom of a temporomandibular disorder (TMD), most studies suggest that clinically significant TMD-related jaw pain, dysfunction, or both affects about _____% of the general population.

A. 90; 10

B. 75; 13

C. 50; 10

D. 25; 5

75; 13

Although up to 75% of the adult population has at least one sign and/or symptom of a temporomandibular disorder, most studies suggest that clinically significant TMD-related jaw pain, dysfunction, or both affects about 13% of the general population. Significantly more frequent and more severe TMD signs and symptoms are seen in women than in men and older adults. Although up to 75%, not 90%, of the adult population has at least one sign and/or symptom of a temporomandibular disorder, most studies suggest that clinically significant TMD-related jaw pain, dysfunction, or both affects about 5% rather than 10% of the general population. Although up to 75% and not 50% of the adult population has at least one sign and/or symptom of a temporomandibular disorder, most studies suggest that clinically significant TMD-related jaw pain, dysfunction, or both affects about 5% rather than 10% of the general population. Although up to 75% and not 25% of the adult population has at least one sign and/or symptom of a temporomandibular disorder, most studies suggest that clinically significant TMD-related jaw pain, dysfunction, or both affects about 5% of the general population.

3 multiple choice options

Which term describes the inability to fully open the mouth?

A. Trismus

B. Articulation

C. Fusion

D. Crepitus

Trismus

Trismus is defined as the inability to fully open the mouth. Articulation is another term for joint. Fusion refers to the union of two adjoining tooth germs. Crepitus is the dry, crackling sound that may be associated with the temporomandibular (TMJ) joint.

3 multiple choice options

What is the function of the synovial fluid inside the joint?

A. To provide nourishment and lubrication of avascular structures

B. To allow the bones to fit together properly

C. To absorb shock

D. To allow for correct palpation of the joint area

To provide nourishment and lubrication of avascular structures

The synovial fluid is produced by the synovial membrane that lines the joint. The fluid provides nourishment and lubrication of the avascular structures. The synovial fluid does not have an affect on the bones of the TMJ. The synovial fluid does not absorb shock to the joint. The synovial fluid does not allow for correct palpation of the joint area.

3 multiple choice options

Synovial _____________ is the most common benign neoplasm of the synovium.

A. osteoblastoma

B. chondroblastoma

C. osteoma

D. chondromatosis

Synovial chondromatosis

Synovial chondromatosis is the most common benign neoplasm of the synovium. It is characterized by the development of metaplastic, highly cellular cartilaginous foci in the synovial membrane that results in degenerative changes consistent with osteoarthritis. It is characterized by swelling, pain, and limitation of movement. Synovial chondromatosis and not osteoblastoma is the most common benign neoplasm of the synovium. Synovial chondromatosis and not chondroblastoma is the most common benign neoplasm of the synovium. Synovial chondromatosis and not osteoma is the most common benign neoplasm of the synovium.

3 multiple choice options

Which choice represents an indirect form of trauma affecting the TMJ?

A. Clenching, bruxism

B. Whiplash injury

C. Psychosocial factors

D. Osteoarthritis

Whiplash injury

Whiplash injury represents an indirect form of trauma affecting the TMJ. Trauma affecting the TMJ is classified as direct (assault), indirect (whiplash injury), or secondary to parafunctional habits (clenching, bruxism). Other contributing factors include dentofacial deformities and psychosocial factors. TMJ abnormalities are also associated with a number of different systemic diseases. Rheumatoid arthritis and osteoarthritis are the most common. Whiplash injury represents an indirect form of trauma affecting the TMJ. Trauma affecting the TMJ is classified as secondary to parafunctional habits when it is caused by clenching or bruxism.

3 multiple choice options

What is the demographic group that typically presents with temporomandibular disorders (TMD)?

A. Children

B. Females, age 20-40

C. Males, age 40

D. Senior citizens

Females, age 20-40

The majority of patients with TMDs are female aged between 20 and 40 years. Children do not typically present with TMDs. Up to 75% of the population has at least one sign of TMD, and the majority of patients are younger females. Senior citizens are not reported to demonstrate a high incidence of TMD.

3 multiple choice options

Trauma affecting the TMJ is classified as direct, indirect, and secondary to parafunctional habits. Which is an example of a parafunctional habit?

A. Whiplash injury

B. Assault

C. Surgery

D. Clenching

Clenching

Clenching and bruxism are examples of parafunctional habits affecting the TMJ. Whiplash injury is an example of indirect trauma to the TMJ. Assault is an example of direct trauma to the TMJ. Surgery is not an example or direct trauma, indirect trauma, or parafunctional habits.

3 multiple choice options

During a dental appointment, dental hygienists can help a patient with TMD by doing which procedure?

A. Set the patient up slowly after the appointment.

B. Maintain a shorter appointment time.

C. Schedule the patient the first time of the day.

D. Avoid loud background music in the office.

Maintain a shorter appointment time.

Keeping a shorter appointment time allows the patient time to relax in keeping their mouth open. Setting the patient up slowly may aid with persons with hypertension. Scheduling the patient with the first appointment of the day does not help patients with TMD. Avoiding loud background music has no effect on patients with TMD.

3 multiple choice options

The three elevator muscles of mastication that when activated, close the mandible, include the masseter, the medial pterygoid, and the ___________.

A. lateral pterygoid

B. temporalis

C. anterior digastric

D. mylohyoid

temporalis

The temporalis muscle is one of the three elevator muscles of mastication that close the mandible. The lateral pterygoid muscle opens, or depresses, the mandible. The anterior digastric muscle opens, or depresses, the mandible. The mylohyoid muscle opens, or depresses, the mandible.

3 multiple choice options

All are benign tumors that arise in the condyle except one. Which is the exception?

A. Osteoblastoma

B. Synovial chondromatosis

C. Osteoma

D. Chondroblastoma

Synovial chondromatosis

Synovial chondromatosis is the most common benign neoplasm of the synovium, not the condyle. The three most common benign tumors of the condyle are the osteoblastoma, osteoma, and chondroblastoma.

3 multiple choice options

Children are _____ prone to TMJ ankylosis than adults because of greater osteogenic potential and _____ development of the joint meniscus.

A. more; more

B. more; less

C. less; more

D. less; less

more; less

Children are more prone to TMJ ankylosis than adults because of greater osteogenic potential and less development of the joint meniscus. Children are more prone to TMJ ankylosis than adults because of greater osteogenic potential and less rather than more development of the joint meniscus. Children are more rather than less prone to TMJ ankylosis than adults because of greater osteogenic potential and less rather than more development of the joint meniscus. Children are more rather than less prone to TMJ ankylosis than adults because of greater osteogenic potential and less development of the joint meniscus.

3 multiple choice options

The temporomandibular joint (TMJ) is the articulation between the condyle of the mandible and the

A. zygomatic process of the temporal bone.

B. glenoid fossa of the temporal bone.

C. external acoustic meatus.

D. spine of the sphenoid bone

glenoid fossa of the temporal bone.

The TMJ is the articulation between the condyle of the mandible and the glenoid fossa of the temporal bone. It is a highly specialized joint that differs from other joints because of the fibrocartilage that covers the bony articulating surfaces, its ginglymoarthrodial movement, its function and overall health being dictated by jaw movement, and its dependence on the contralateral joint. The TMJ is the articulation between the condyle of the mandible and the glenoid fossa of the temporal bone rather than the zygomatic process of the temporal bone. The TMJ is the articulation between the condyle of the mandible and the glenoid fossa of the temporal bone rather than the external acoustic meatus. The TMJ is the articulation between the condyle of the mandible and the glenoid fossa of the temporal bone rather than the spine of the sphenoid bone.

3 multiple choice options

Which statement about the articular disc in the TMJ joint is true?

A. It is attached to the anterior and posterior aspects of the condyle.

B. It is attached to the inferior belly of the medial pterygoid muscle.

C. The disc is highly vascular.

D. The disc is surrounded and protected by the fibrous connective tissue joint

capsule.

The disc is surrounded and protected by the fibrous connective tissue joint

capsule.

The disc is surrounded and protected by the fibrous connective tissue joint capsule. The articular disc in the TMJ is attached to the lateral and medial rather than the anterior and posterior aspects of the condyle, to the superior belly of the lateral pterygoid muscle, and to the joint capsule. The articular disc in the TMJ is attached to the lateral and medial aspects of the condyle, to the superior rather than the inferior belly of the lateral pterygoid muscle, and to the joint capsule. The disc and the bony surfaces are avascular.

3 multiple choice options

During opening of the jaw

A. rotational movement precedes translation.

B. rotational movement follows translation.

C. only rotational movement occurs; translation occurs only during closure.

D. only translational movement occurs; rotation occurs only during closure.

rotational movement precedes translation.

During opening of the jaw, rotational movement precedes translation. During translation the disc assumes a more posterior position in relation to the condyle. The inferior and superior joint spaces assume different configurations during each of these movements. During opening of the jaw, rotational movement precedes rather than follows translation.

3 multiple choice options

Clicking and popping most commonly reflect

A. parafunctional habits such as bruxism and clenching.

B. disc displacement with reduction.

C. malocclusion.

D. trismus.

disc displacement with reduction.

3 multiple choice options

Which dental radiographic procedure is best for examining disc position, function, form, and the presence of joint effusions?

A. Panoramic imaging

B. Transcranial imaging

C. Computerized tomography (CT)

D. Magnetic resonance imaging (MRI)

Magnetic resonance imaging (MRI)

MRI is mandatory for examining disc position, function, and form and the presence of joint effusions. Arthrography may be useful when MRI is not tolerated and information regarding the position and morphology of the disc is required. Panoramic imaging radiographs are limited to identifying gross changes in bone. Transcranial imaging radiographs are limited to identifying gross changes in bone. CT is the most accurate for identifying bone abnormalities.

3 multiple choice options

Which statement is characteristic of a patient with osteoarthritis?

A. It is characterized by pain that is worse in the morning.

B. It is characterized by pain that is worse in the evening.

C. It is an inflammatory, autoimmune disorder of the joints.

D. Approximately 50% to 75% of patients have involvement of the TMJ during the course of the disease.

It is characterized by pain that is worse in the evening.

Osteoarthritis is characterized by pain that is worse in the evening, as well as limited opening, muscle splinting, and crepitus of the TMJ. Osteoarthritis is the most common disease affecting the TMJ. In rheumatoid arthritis patients may complain of pain that is worse in the morning, limited opening, occlusal changes, and preauricular edema and tenderness. Rheumatoid arthritis is an inflammatory, autoimmune disorder of the joints. Approximately 50% to 75% of patients with rheumatoid arthritis have involvement of the TMJ during the course of the disease. Osteoarthritis is characterized by pain that is worse in the evening rather than in the morning. Rheumatoid arthritis rather than osteoarthritis is an inflammatory, autoimmune disorder of the joints. Approximately 50% to 75% of patients with rheumatoid arthritis rather than osteoarthritis have involvement of the TMJ during the course of the disease.

3 multiple choice options

Tenderness over the lateral pole of the condyle is indicative of

A. crepitus.

B. capsulitis.

C. trismus.

D. auscultation.

capsulitis.

3 multiple choice options

Hypermobility in which the patient is able to relocate the mandible back into the glenoid fossa is referred to as

A. subluxation.

B. dislocation.

C. ankylosis.

D. myofascial pain.

subluxation.

Subluxation refers to hypermobility in which the patient is able to relocate the mandible back into the glenoid fossa. Dislocation occurs when one or both of the condyles translate anterior to the articular eminence, resulting in an open lock that the patient cannot reduce. Ankylosis of the TMJ is defined as immobility of the condyle because of fibrous or bony union between the articulating structures of the joint. Myofascial pain is characterized as a dysfunctional muscle hyperactivity with regional pain, tenderness of the affected muscles, and variable amounts of reduced opening and complaints of malocclusion.

3 multiple choice options

The TMJ exhibits ginglymoarthrodial, or __________, movement.

A. rotational and translational

B. opening

C. closing

D. maximal interdigitation

rotational and translational

The TMJ exhibits ginglymoarthrodial, or rotational and translational, movement. Translational movement occurs in the upper compartment, whereas the lower compartment functions primarily as the hinge or rotational component. The first phase of opening movement is characterized by rotational movement of the condyle followed by anterior translation to approximately the anterior peak of the articular eminence. The opening is accomplished mainly by the lateral pterygoid muscle, with some help from the anterior digastric muscle. The masseter, medial pterygoid, and temporalis are elevator muscles that close the mandible when activated. The point of maximal interdigitation is called centric occlusion.

3 multiple choice options

Opening, or depressor function, of the mandible is accomplished primarily by the _____________ muscle.

A. medial pterygoid

B. lateral pterygoid

C. masseter

D. temporalis

lateral pterygoid

Opening, or depressor function, of the mandible is accomplished primarily by the lateral pterygoid muscle with some help from the anterior digastric muscle. The medial pterygoid is an elevator muscle that closes the mandible when activated. The masseter is an elevator muscle that closes the mandible when activated. The temporalis is an elevator muscle that closes the mandible when activated.

3 multiple choice options

____________ ankylosis is the most common type seen in the TMJ.

A. Fibrotic intraarticular

B. Bony intraarticular

C. Fibrotic extraarticular

D. Bony extraarticular

Fibrotic intraarticular

Fibrotic intraarticular ankylosis is the most common type seen in the TMJ. Ankylosis of the TMJ is defined as immobility of the condyle because of fibrous or bony union between the articulating structures of the joint. Ankylosis can be classified by tissue type (fibrous, bony), location (intraarticular, extraarticular), and extent of fusion (complete, incomplete). Fibrotic intraarticular ankylosis rather than bony intraarticular ankylosis is the most common type seen in the TMJ. Fibrotic intraarticular ankylosis rather than fibrotic extraarticular ankylosis is the most common type seen in the TMJ. Fibrotic intraarticular ankylosis rather than bony extraarticular ankylosis is the most common type seen in the TMJ.

3 multiple choice options

About _____% of all TMJ ankylosis cases result from joint infection, usually after trauma.

a. 10

b. 30

c. 50

d. 70

50

About 50% of all TMJ ankylosis cases result from joint infection, usually after trauma, but 30% result from trauma without infection. About 50% rather than 10% of all TMJ ankylosis cases result from joint infection, usually after trauma. About 50% rather than 30% of all TMJ ankylosis cases result from joint infection, usually after trauma. About 50% rather than 70% of all TMJ ankylosis cases result from joint infection, usually after trauma.

3 multiple choice options

Of the various surgical techniques used to treat TMDs, __________ involves surgical repositioning of the condyle.

A. arthrocentesis

B. arthroscopy

C. condylotomy

D. open joint surgery

condylotomy

Of the various surgical techniques used to treat TMDs, condylotomy involves surgical repositioning of the condyle. Arthrocentesis involves lavaging the joint through a needle. Arthroscopy allows direct visualization and manipulation of the joint. Open joint surgery is used to perform disc repositioning, replacement or excision, and total joint reconstruction using a prosthetic device or autogenous graft.

3 multiple choice options

The TMJ is the articulation between the mandibular condyle and which other structure?

A. Zygomatic process

B. Sphenoid bone

C. Glenoid fossa of the temporal bone

D. Occipital bone

Glenoid fossa of the temporal bone

The TMJ is the articulation between the condyle of the mandible and the glenoid fossa of the temporal bone. The zygomatic process is a portion of the maxilla. The sphenoid bone is a bone of the neurocranium, which sits in front of the temporal and occipital bones. The occipital bone is situated at the back and lower part of the skull.

3 multiple choice options

What is the most likely cause of TMD?

A. Stress

B. Trauma

C. Malocclusion

D. Third molar extractions

Trauma

Trauma has been suggested as the most likely cause of TMDs. Stress has been implicated in masticatory muscle pain, yet it is not considered the most likely cause of TMDs. Although it is a condition to be addressed, malocclusion is not the primary cause of TMDs. Sufficient evidence is not present to suggest that oral surgery procedures (such as third molar extraction) can cause TMDs.

3 multiple choice options

Approximately what percentage of persons with rheumatoid arthritis will have involvement of the TMJ?

A. <10%

B. 20-30%

C. 50-75%

D. Nearly 100%

50-75%

Rheumatoid arthritis is an inflammatory autoimmune disorder of the joints. Approximately 50-75% of patients with rheumatoid arthritis have involvement of the TMJ during the course of the disease.

3 multiple choice options

Subjective evidence of disease or a physical disorder that is observed by the patient

Symptom

Inability to fully open the mouth

Trismus

Noninvasive diagnostic technique that uses radio waves to produce computerized images of internal body tissues

MRI (Magnetic resonance imaging)

Surgical puncture of a joint followed by lavage of joint space

Arthrocentesis

Physical examination using pressure of the hand or fingers

Palpation

Joint

Articulation

Objective evidence of disease that can be observed by a health care provider rather than by the patient

Sign

Dry, crackling sound

Crepitus

Induced inadvertently by a medical or dental care provider or by medical treatment or a diagnostic procedure

Iatrogenic

Which term describes a procedure induced inadvertently by a health care provider or by medical treatment or a diagnostic procedure?

A. Sign

B. Symptom

C. Iatrogenic

D. Auscultation

Iatrogenic

Iatrogenic is a term to describe the inadvertent induction by a health care provider or by medical treatment or diagnostic procedure. Iatrogenic causes of TMDs include the indiscriminate use of corticosteroid injection into the joint. A sign refers to objective evidence of disease that can be observed by a health care provider rather than by the patient. A symptom refers to subjective evidence of disease or a physical disorder that is observed by the patient. Auscultation is listening to sounds within the body.

3 multiple choice options

Listening to sounds within the body, using a stethoscope

Auscultation

Radiography of a joint after injection of opaque contrast material

Arthrography

Method for evaluating and manipulating a joint via the insertion of a camera and instruments

Arthroscopy